Patterns and trends of alcohol consumption in rural and urban areas of China: findings from the China Kadoorie Biobank

Abstract

Background: In China, alcohol consumption has increased significantly in recent decades. Little evidence exists, however, about temporal trends in levels and patterns of alcohol consumption and associated factors in adult populations.

Methods: In 2004-08, the China Kadoorie Biobank recruited ~ 512,000 adults (41% men, mean age 52 years [SD 10.7]) from 10 (5 urban, 5 rural) geographically diverse regions across China, with ~ 25,000 randomly selected participants resurveyed in 2013-14. The self-reported prevalence and patterns (e.g., amount, beverage type, heavy drinking episodes) of alcohol drinking at baseline and resurvey were compared and related to socio-demographic, health and other factors.

Results: At baseline, 33% of men drank alcohol at least weekly (i.e., current regular), compared to only 2% of women. In men, current regular drinking was more common in urban (38%) than in rural (29%) areas at baseline. Among men, the proportion of current regular drinkers slightly decreased at resurvey (33% baseline vs. 29% resurvey), while the proportion of ex-regular drinkers slightly increased (4% vs. 6%), particularly among older men, with more than half of ex-regular drinkers stopping for health reasons. Among current regular drinkers, the proportion engaging in heavy episodic drinking (i.e., > 60 g/session) increased (30% baseline vs. 35% resurvey) in both rural (29% vs. 33%) and urban (31% vs. 36%) areas, particularly among younger men born in the 1970s (41% vs. 47%). Alcohol intake involved primarily spirits, at both baseline and resurvey. Those engaging in heavy drinking episodes tended to have multiple other health-related risk factors (e.g., regular smoking, low fruit intake, low physical activity and hypertension).

Conclusions: Among Chinese men, the proportion of drinkers engaging in harmful drinking behaviours increased in the past decade, particularly among younger men. Harmful drinking patterns tended to cluster with other unhealthy lifestyles and health-related risk factors.

Keywords: Alcohol; China; Patterns; Trends.

Fig. 1

Alcohol drinking characteristics in male weekly drinkers in 2004–8 and 2013–4, by birth cohort. Prevalence and mean were adjusted for regions. Size of boxes is proportional to the sample size of the respective birth cohort. Error bars are 95% confidence intervals. Mean consumption per session (g/session) and heavy episodic drinking was based on alcohol intake data reported on the last time the participants drank. Heavy episodic drinking is defined as drinking > 60 g of pure alcohol in one session for men. All men at baseline (n = 210,259) and resurvey (n = 9569) were included in (a). All male weekly drinkers at baseline (n = 69,904) and resurvey (n = 2732) were included in (b-d)

Fig. 2

Alcohol drinking characteristics in male weekly drinkers in 2004–8 and 2013–4, by health-related risk factor index. Prevalence and mean were adjusted for age and regions. Size of boxes is proportional to the sample size of the respective risk factor index group. Error bars are 95% confidence intervals. Mean consumption per session (g/session) and heavy episodic drinking was based on alcohol intake data reported on the last time the participants drank. Heavy episodic drinking is defined as drinking > 60 g of pure alcohol in one session for men. Risk factor index was derived by summing the individual scores of each of the four risk factors (0 if no, 1 if yes): regular smoking, lack of daily fruit intake, hypertension, low physical activity. All men at baseline (n = 210,259) and resurvey (n = 9569) were included in (a). All male weekly drinkers at baseline (n = 69,904) and resurvey (n = 2732) were included in (b-d)