Academic journal article Bulletin of the World Health Organization

Alcohol and Alcohol-Related Harm in China: Policy Changes needed/L'alcool et Ses Mefaits En Chine: Les Changements Politiques necessaires/El Alcohol Y Los Danos Relacionados Con El Alcohol En China: Cambios Necesarios En la Politica

Academic journal article Bulletin of the World Health Organization

Alcohol and Alcohol-Related Harm in China: Policy Changes needed/L'alcool et Ses Mefaits En Chine: Les Changements Politiques necessaires/El Alcohol Y Los Danos Relacionados Con El Alcohol En China: Cambios Necesarios En la Politica

Article excerpt

Introduction

In China, alcohol consumption is increasing faster than other parts of the world. Data from recent decades show a steady increase in alcohol production and consumption and in rates of alcohol-related conditions. (1,2) These dramatic increases, noted after the 1980s, stem from China's fast economic development and the parallel rise in average income level.

Drinking alcoholic beverages has been traditionally accepted in China during major social events, such as the spring festival, wedding ceremonies and birthday parties. However, the rapid growth in the Chinese economy has been accompanied by noticeable changes in the drinking behaviour of the Chinese population. Furthermore, alcohol is now commonly consumed to relieve stress, facilitate social interaction and foster good relations between supervisors and employees, since these often eat out together after work or hold business meetings over dinner. (1,2)

In this article, we first review recent trends in alcohol-related harm in China, primarily alcohol use disorders, and then describe the policies in place to mitigate alcohol-related harm. We finish with a set of recommended policy changes that could help contain the rapid increase in alcohol-related harm currently observed in the country.

Drinking and drinking patterns

A recent national survey of drinking in China revealed that 55.6% of the men and 15.0% of the women were current drinkers. (3) Among respondents who endorsed alcohol consumption, 62.7% of the men and 51.0% of the women reported excessive drinking, 26.3% and 7.8%, respectively, reported frequent drinking, and 57.3% and 26.6%, respectively, reported binge drinking. These figures show that China has experienced dramatic increases in the consumption of alcoholic beverages since the late 1970s and even the 1990s. (4) High-risk drinking behaviour has reached epidemic proportions in China. (3)

The Chinese population consumes a wide range of alcoholic beverages. The production of most alcoholic beverages has increased steadily since 2004 (Fig. 1), to the point that China is now one of the largest beer-producing countries in the world. (5) Wine production and consumption have also increased substantially. The average annual consumption of alcohol among Chinese people 15 years of age or older has increased progressively, from 0.4 litres of pure alcohol in 1952 to 2.5 litres at the end of the Cultural Revolution in 1978, (1) to 4.9 litres in 2009. Furthermore, a substantial amount of unrecorded alcohol is also produced and consumed in China, so that the data in Fig. 1 only reflect the alcohol production officially recorded by the government.

In many places, especially in socially and economically disadvantaged areas, alcoholic beverages whose production goes unrecorded account for a considerable proportion of the alcohol consumed. As shown in Table 1, approximately 1.7 (30%) of the 5.9 litres of pure alcohol consumed in China in 2000 were unrecorded. Many cases involving the illegal, unrecorded manufacture and sale of alcoholic beverages have been unreported, some of which have resulted in mass poisoning and death. The sale and use of illegally manufactured liquor are almost impossible to regulate and must be eradicated. Morbidity and mortality from poisoning with methanol and other contaminants are a major public health concern.

Alcohol-related harm

Alcohol-related harm has not been systematically studied in China because reliable data are not available. Alcohol use disorders (AUDs), which encompass harmful patterns of drinking, such as alcohol dependence and abuse, have grown to become a frequent problem linked to disturbances in mental and physical health and in social functioning in China. According to recent World Health Organization (WHO) estimates, rates of AUD in China are 6.9% and 0.2% among men and women, respectively. (6)

According to a review by Hao et al. …

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