Extent of Alcoholism: In special reference to India.

Alcoholic beverages are widely consumed throughout the world. While most of the adult population drinks at low-risk levels most of the time or abstains altogether, the broad range of alcohol consumption patterns, from daily heavy drinking to occasional hazardous drinking, creates significant public health and safety problems in nearly all countries. Worldwide per capita consumption of alcoholic beverages in 2005 equaled 6.13 litres of pure alcohol consumed by every person aged 15 years or older. A large portion of this consumption – 28.6% or 1.76 litres per person was homemade and illegally produced alcohol or, in other words, unrecorded alcohol. The consumption of homemade or illegally produced alcohol may be associated with an increased risk of harm because of unknown and potentially dangerous impurities or contaminants in these beverages. A large variation exists in adult per capita consumption. The highest consumption levels can be found in the developed world, mostly the Northern Hemisphere, but also in Argentina, Australia and New Zealand. Medium consumption levels can be found in southern Africa, with Namibia and South Africa having the highest levels, and in North and South America. Low consumption levels can be found in the countries of North Africa and sub-Saharan Africa, the Eastern Mediterranean region, and southern Asia and the Indian Ocean. The consumption of unrecorded alcohol is a significant issue and poses a difficult dimension for measuring the true nature of global alcohol consumption. Data must be culled from many sources to accurately estimate this sector of consumption, which accounts for nearly 30% of total worldwide adult consumption.(Global Health Status Report on Alcohol and Health, WHO,2011) The World Health Organization initiated The Global School-based Student Health Survey(GSHS, 2004), which is a collaborative surveillance project designed to help countries measure and assess the behavioural risk factors including alcohol use and protective factors in 10 key areas among young people (aged 13–15 years). The GSHS is a relatively low-cost school-based survey which uses a self-administered questionnaire to obtain data on young people's health behaviour and protective factors related to the leading causes of morbidity and mortality among children and adults worldwide.Table 5 gives an overview of the national data from GSHS concerning current drinking among young people aged 13–15 years. In the WHO Global Survey on Alcohol and Health (2008), the fi ve-year trend of under-age drinking was assessed: out of 73 responding countries, 71% indicated an increase, 4% a decrease, 8% were stable and 16% showed inconclusive trends. The five-year trend of drinking among 18–25 year olds indicated that, out of 82 responding countries, 80% showed an increase, 11% decrease, 6% were stable and 12% showed inconclusive trends. Across the world, but also within regions, there is a strong negative association between total consumption and the proportion of unrecorded consumption in total consumption. This means that in countries, often poorer or developing countries, where alcohol use is rather low, much of this use is served by homemade or illegally produced and, therefore, cheaper alcohol, whereas in developed countries alcohol consumption is higher but most of it is with recorded legally produced alcohol. Alcohol use is very uneven in India among different regions, population groups and socioeconomic strata. Overall, even though alcohol abuse among those who consume alcohol is high, the proportion of teetotalers in the general population is high among adult men and very high among adult women and children below 15 years. According to the 2003 World Health Survey (total sample size n = 9540, males n = 4605 and females n = 4935; sample population aged 18 years and above), the rate of lifetime abstainers was 89.6% (total), 80.2% (males) and 98.4% (females) are in India. Estimates from key alcohol experts show that in India the proportion of adult males and females who had been abstaining (last year before the survey) was 75% (males) and 96% (females). Data is for after year 1995. The rate of heavy and hazardous drinking among the total population was 1.4% (total), 2.4% (males) and 0.4% (females). Heavy and hazardous drinking was defined as average consumption of 40 g or more of pure alcohol a day for men and 20 g or more of pure alcohol a day for women. The mean value (in grams) of pure alcohol consumed per day among drinkers was 35.9 (total), 38.3 (males) and 12.9 (females). the rate of heavy episodic drinking among the total population was 1.4% (total), 2.9% (males) and 0.1% (females). Heavy episodic drinking was defined as at least once a weekconsumption of five standard drinks in one sitting. The 2003 National Household Survey of Alcohol and Drug Abuse of 40 697 males aged between 12 to 60 years old found that the rate of lifetime abstainers among the sampled population was 74.1%. Of the total sampled population, 21.4% were reported to be current users of alcohol (used in last 30 days). A sample of 1831 people (aged 10 years and above) interviewed in 1997–1998 in Meghalaya and upper Assam region found that the prevalence rate of alcohol use was 12.5%. Female alcohol use was low (3.2%) compared with male use (20.2%). Distribution by age documents that prevalence was approximately 23% among adults and the older age group (30 years and above) and 4.2% among adolescents and young adults (10 to 29 years). The rate of youth drinking was found to be 1.5% (total), 2.4% (males) and 0.6% (females).