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GLOBAL
Per Capita Consumption
According to (WHO) estimates, there are about 2 billion people worldwide who consume alcoholic beverages and 76.3 million with diagnosable alcohol-use disorders. Table 2.1 shows per capita consumption of alcohol in various regions of the world.
Annual per capita alcohol consumption per adult can be derived by:
Alcohol production + Alcohol imports - Alcohol exports population 15 years of age and over
Table 2.1 : Annual per capita consumption of alcohol per adult 15 years of age and over
Region Consumption (litres) 03.9 16.2 00.4 10.5 01.7 04.8 Range Median Countries surveyed/ Total No. 28/46 32/35 12/21 49/52 07/11 20/27 Percentage of population covered 76.7 99.9 90.4 99.9 98.4 99.9
0.02 - 07.72 1.66 - 14.03 0.05 - 10.00 0.85 - 15.12 0.04 - 08.64 0.34 - 18.39
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Regular users
Social user
Dependent users
Source: Get High on Life Without Alcohol. Report by WHO SEARO , 2003
Harmful Use
A Pattern of alcohol use that is causing damage to health. The damage may be physical (as in case of hepatitis from prolonged use of alcohol) or mental (e.g. episode of depressive disorder secondary to heavy consumption of alcohol).
Source: Adapted from WHO (2003b)
Hazardous Use
Hazardous use is a pattern of alcohol consumption carrying with it risk consequences to the drinker. The damage may be to health-physical or mental, or they may include social consequences to the drinker or others. In assessing the extent of risk, the pattern of use, as well as other factors such as family history, should be taken into account.
Source: Adapted from Babor and Higginas Bibble (2001)
Dependence Syndrome
A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated alcohol use and that typically include a strong desire, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to alcohol use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.
Source: Adapted from Benegal et al (2001)
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HIGH Consumption
Social drinkers
Population base
Population base
Source: Get High on Life Without Alcohol. Report by WHO SEARO, 2003
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Figure 2.3: Per capita consumption (age 15+) by WHO Region 1970-96 (in litres of pure alcohol)
AFRO 14 12 10 8 6 4 2 AMRO EMRO EURO
Figure 2.4: Per capita consumption (age 15+) by Economy Region 1970-96 (in litres of pure alcohol)
14 12 10 8 6 4 2 Total Developed Developing In transition
x SEARO
1972
1982
1970
1976
1978
1980
1986
1988
1974
1984
1990
1992
1972
1982
1970
1976
1978
1980
1986
1988
1990
1992
1974
1984
Source: Global Status Report on Alcohol, WHO, 1999 (based on data from FAO & UNDP)
Source: Global Status Report on Alcohol, WHO, 1999 (based on data from FAO & UNDP)
1994
1996
15
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The average drinking pattern is a summary measure of the extent of alcohol use in a country or community, estimated users, the average per capita consumption and pattern of drinking from survey findings. The estimate average drinking pattern is in the range of 1 to 4 (4 being the most detrimental pattern based on the number of heavy drinking occasions, drinking outside meals, high levels of fiesta drinking in public place and 1 being least detrimental pattern, least heavy drinking occasions, drinking with meal, low levels of fiesta drinking and least drinking in public places.)
Source: Gaining Less or Losing More? WHO Alcohol Control Series 2, 2006
World Trade Organization and alcohol Amongst the key elements in international agreements of the World Trade Organization, important aspects relevant to alcohol control policy include: Equal treatment to foreign and domestic liquor Removal of state monopoly on the manufacture, distribution and retailing of alcohol Reduction or elimination of quotas on the quantity of liquor which can be imported These requirements are likely to increase alcohol consumption in traditionally low-use countries.
Source: WHO, 2003
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INDIAN
India is showing a phenomenal increase in alcohol consumption, with the initiation age on an alarming decrease. The recorded market and consumption levels are still very low vis--vis the global standard. The illicit market (spurious, seconds and thirds) consumption is far more than legal sales. Table 2.2 and 2.3 provide details of the types of alcohol beverages available commonly.
Table 2.2: Types of alcoholic beverages
Beverages Brandy Whisky Rum Wine (Port, Sherry, Champagne, etc) Beer Source Fruit juices Cereal grains Molasses/sugarcane Grapes (also other fruits) Cereals Alcohol contents (percentage) 40 - 50 40 - 55 40 - 55 10 - 22 4-8
Table 2.3: Types of local brews in the countries of the South-East Asia Region
Country Bangladesh Bhutan India Indonesia Nepal Sri Lanka Thailand Local brews Bangla Mad, Cholai, Tari Ara Arrack, Desi Sharab, Tari, Tharra, Toddy, Fenny Palm wine Raksi, Tadi, Chayang, Tomb Toddy, Arrack Oou, Krachae, Namtanmao, Sartha, Waark
Source: Get high on life without alcohol-Report by WHO SEARO Region, 2003
ARRACK
BEER
400 300 200 100 0 Light Beer
IML
Strong Beer
1988 1989 1990-91 1991-92 1992-93 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999
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Production 231035679 55981448 6411451 22062 4186853 252756 332400 18600 21600 1577180 (24%) (11%) (0.3%) (65% ) (4%) (5%) (0.3%) (0.4%) 0 (25%)
Import 17876448 1445338 105116 3004 10350 6876 3594 7300 2487 820 1029 3810 56579 (8.1%) (7%) (3%) (10%) (7%) (3%) (7%) (2%) (1%) (10%) (4%) (53%)
India is one of the largest producers of alcohol in the world and contributes to 65 percent of production and nearly 7 percent of imports into the South Asian region. The amount of alcohol produced in India during 2006 - 07 was approximately 4 million metric tonnes.
Source: H. K. Sharma, National Drug Dependence Treatment Centre AIIMS, New Delhi
Though consumption is still low, patterns of alcohol consumption vary widely through the country. Punjab, Andhra Pradesh, Goa and the north-eastern states have a much higher proportion of male alcohol consumers than the rest of the country. Women tend to drink more in the states of Arunachal Pradesh, Assam and Sikkim in north-east; Madhya Pradesh, Chhattisgarh, Orissa and Andhra Pradesh in central and east India; and Goa in the west, compared to other states.
International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005-06: India: Volume I. IIPS. Mumbai
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A recent National Household Survey of Drug Use recorded alcohol use in the past year in only 21 perecent of adult males. Expectedly, this figure cannot mirror accurately the wide variation that obtains in a large and complex country such as India. The prevalence of current use of alcohol ranged from a low of 7 perecent in the western state of Gujarat (officially under Prohibition) to 75 perecent in the North-eastern state of Arunachal Pradesh. There is also an extreme gender difference. Prevalence among women has consistently been estimated at less than 5 perecent but is much higher in the northeastern states. Significantly higher use has been recorded among tribal, rural and lower socio-economic urban sections.
f Official statistics o e consumption ar incomplete as undocumented unts consumption acco ent of for almost 50 perc . total consumption pita Estimates of per ca d to consumption nee factor in this lume. undocumented vo
Delhi Jaipur
Siliguri
Guwahati Imphal
Ahmedabad Kolkata
Nagpur
Ranchi
Bangalore Chennai
Thrissur
21
24%
32%
Rural
Urban
Population
Source: Dr. Vivek Benegal, NIMHANS, Bangalore, 2004
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Due to low levels of literacy and awareness, marginalized communities are very severely affected by harm from alcohol consumption, including illicit and spurious liquor. Table 2.7 shows the tragedies reported due to use of illicit alcohol. Table 2.7: Media reported illicit alcohol tragedies in India, 2003-05
Place, Year Villupuram, Tamil Nadu, 2005 Nelamangala, Bangalore, 2005 Hoskote, Bangalore, 2005 Rewari, Haryana, 2005 Bikaner, Rajasthan, 2005 Kolayat, Rajasthan 2005 Menambedu, Tamil Nadu, 2005 Lucknow, Uttar Pradesh, 2005 Cuddalore (near Chennai), Tamil Nadu 2004 Diwosas, Bareilly, Uttar Pradesh, 2004 Thrissur, Kerala, 2004 Unnao, Uttar Pradesh, 2004 Mumbai, Maharashtra, 2004 Tangra, West Bengal, 2004 Koopana, Kerala, 2004 Hissar, Haryana, 2003 Dharwad, Karnataka, 2003 Tiruvallur, Tamil Nadu, 2003
Source: Compiled from media reports in daily newspapers
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Deaths or cases 5 deaths 21 deaths 10 deaths 8 deaths 5 deaths 21 deaths 13 deaths 7 deaths, 46 deaths 14 deaths 3 deaths 9 deaths 99 deaths,100 hospitalized 35 deaths 7 deaths, 30 ill 6 deaths, 12 ill 6 deaths 13 deaths, 92 male ill
Remarks ---------------Fake government emblems on the sachets ------------------------------Nearly 36 suspected to have died ---------------Intoxicants worth Rs.170,000 and 15,175 liters illicit liquor seized ---------------120 treated, 29 lost their vision 33 deaths in the previous month ---------------------------------------------1110 litres illicit liquor seized ----------------------------------------------------------------------------
Documented
Undocumented
5.11 million consumers in Karnataka state annually consume 100.87 million litres absolute alcohol equivalent (56.53 million litres excise paid and 44.345 million litres of beverage undocumented)
44% 56%
Per capita consumption of 2.98 litres absolute alcohol per year (1.67 litres excise paid beverage and 1.3 liters undocumented beverage per person per year.) Keeping in mind the large numbers of abstainers, a more appropriate measure of actual consumption would be 19.7 litres absolute alcohol equivalent per consumer per year.
Source: WHO Collaborative project on unrecorded consumption of Alcohol (2003). Project report from the India site.
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Table 2.9: Alcohol consumption (average age of initiation) Year Age 1986 19 1990 17 1994 15 1998 14.5 2002 14 2006 13.5
Age of onset
25 24 23 22 21 20 19 18