Alcohol is emerging as a major public health problem in India, and the proportion of men who start to drink alcohol in their teens has surged more than threefold over the past few decades, according to researchers at Columbia University’s Mailman School of Public Health, the Alcohol Research Group, and Sangath, an India-based NGO. Those living in urban areas and poorer households are particularly affected and more likely to start drinking at an early age. Findings are published online in the Journal of Epidemiology & Community Health.
Studies from high-income countries have shown that starting drinking early in life is a consistent predictor of alcohol-related harm through the life course. But whether this association also existed in low and middle-income countries, such as India, had not been clear.
The researchers randomly questioned just under 2000 men aged 20 to 49 years old from rural and urban areas in the state of Goa – where alcohol outlets are increasingly common—on the age at which they first started to drink alcohol, how much they drank, and whether they had sustained any injuries as a result of their drinking. They also assessed levels of psychological distress.
The responses showed that 39 percent of men between the ages of 18 and 49 are current drinkers. Among them, about 15 percent usually consume six or more drinks per occasion, 29 percent indulge in heavy drinking (six drinks or more or 60 grams of pure alcohol), and about 34 percent get drunk at least monthly or more frequently.
The proportion of men who started drinking in their teens rose from 20 percent for those born between 1956 and 1960 to 74 percent for those born between 1981 and 1985—a more than threefold rise. Teen drinkers were more than twice as likely to be distressed and alcohol dependent as those who did not start drinking early in life. Respondents were also three times more likely to have sustained injuries as a result of their drinking.
Consistent with studies from high-income countries, this study found that starting to drink alcohol during the teenage years is associated with a greater likelihood of developing lifetime alcohol dependence, hazardous or harmful drinking, alcohol related injuries, and psychological distress in adulthood.
“Alcohol consumption and its harmful effects are emerging as a major public health problem, and the trend is alarming,” said Mr. Aravind Pillai, who is a doctoral candidate in the Mailman School’s department of epidemiology and the study’s first author. “Our findings highlight the importance of generating public awareness about the hazards of starting to drink early in life, and of enforcing regulations designed to limit underage drinking.”
Funding was provided by the National Institute on Alcohol Abuse and Alcoholism (grants R21 AA014773 and P50 AA005595). Deborah Hasin, PhD, professor of Epidemiology at the Mailman School, is a co-author on the study.