The effects of alcohol tax policies on alcohol consumption and alcohol use disorders in Mainland of China: an interrupted time series analysis from 1961-2019

Background: Overwhelming evidence suggests that increasing alcohol taxes is an effective strategy for curbing alcohol consumption. However, research on the effects of such strategies in low- and middle-income nations is limited.Objective: The aim is to explore the temporal effect of alcohol tax policy in China.Methods: We employ interrupted time series analysis to investigate the temporal effects of tax policy changes on alcohol consumption and related consequences in Mainland China from 1961 to 2019. The study population, the total population of mainland region of China, aged more than 15 years.Results: The results show that the volume tax policy, which was announced in 2000 and implemented in 2001,  led to an immediate reduction in the alcohol consumption (coefficient = -0.429, p < .001). Following the implementation of higher alcohol taxes in 1998 and 2001, the prevalence of alcohol use disorders (AUDs) and related years lived with disability (YLDs) gradually decreased. The relaxation of tax policy in 2006 led to a significant increase in alcohol consumption, both immediately (coefficient = 0.406, p < .001) and in the middle term (coefficient = 0.495, p < .001), as well as contribute to an immediate or medium term significant increase in the prevalence of AUDs (coefficient = 0.038, p = .010; coefficient = 0.032, p < .001) and YLDs (coefficient = 4.363, p = .001; coefficient = 4.226, p < .001).Conclusion: This study demonstrates that changes in alcohol consumption and related consequences (increase or decrease) have followed corresponding changes in alcohol tax policies (easing or tightening), indicating that increasing alcohol taxes can be an effective strategy in China for controlling alcohol consumption and related harms.

Association between alcohol consumption in midlife and cognitive function in old age: Findings from the China health and Nutrition Survey

BACKGROUND AND AIMS

Alcohol consumption has been reported to impair the physical and mental health of the elderly. This study aimed to explore the association between alcohol consumption patterns in midlife and cognition in the elderly among the Chinese population.

METHODS AND RESULTS

Study subjects were individuals aged ≥45 years in the shared database of the China Health and Nutrition Survey in 1997, who were followed up in 2006. A questionnaire was used to collect information about alcohol consumption (frequency, amount and type). Alcohol consumption (grams/week) was classified into none, light (≤84), light-to-moderate (84.01-168), moderate-to-heavy (168.01-336) and heavy (≥336.01) categories in men, and none, light (<42) and moderate (≥42) categories in women. Cognitive function was measured in 2006 using a subset of items from the modified Telephone Interview for Cognitive Status. The lowest quintile was used as the cut-off point for cognitive impairment. A multivariate logistic regression model was applied. The study involved 1926 participants with a mean age of 56.91 years, and men accounted for 51.66% of the total participants. Drinking behaviours and cognitive scores had significant sexual difference (P < 0.001). Cognitive impairment was identified in 135 men and 237 women. Compared with light drinking, heavy drinking and non-drinking were associated with cognitive impairment in men [adjusted odds ratio (aOR) and 95% CI were 2.19 (1.59-3.00), 1.54 (1.21-1.96), respectively; P < 0.001]. Compared with light drinkers, female non-drinkers and moderate drinkers were associated with cognitive impairment [aOR and 95% CI were 1.54 (1.16-2.03) and 1.75 (1.08-2.85), respectively; P < 0.001].

CONCLUSIONS

Scientific evidence on the adverse effects of heavy drinking on elderly cognition and the possibly protective effects of light drinking could influence policy decisions on alcohol consumption in China.

Men's decrease and women's increase in harmful alcohol use from the 2014 to 2018 national surveys in Taiwan: A harbinger for an emerging national trend in East Asia?

BACKGROUND

Gender differences in alcohol use have narrowed in Western societies, but that in Asia has been less investigated. By comparing the 2014 and 2018 waves of the national survey in Taiwan, we aimed to examine the gender differences in population trends in past-month alcohol use, binge drinking, and harmful alcohol use.

METHODS

The national survey enrolled 17,837 participants in 2014 and 18,626 participants in 2018. Binge drinking was defined as having ≥5 drinks on one occasion in the past month, and harmful alcohol use as having an Alcohol Use Disorders Identification Test score of ≥8.

RESULTS

There were significant decreases from 2014 to 2018 in the population's prevalence of past-month alcohol use, binge drinking, and harmful alcohol use. However, males and females had different trends: males showed significant reductions in all three alcohol use behaviours (a decrease of 3.79%, 1.59%, and 2.60%, respectively), while females exhibited a significant rise in harmful alcohol use (from 1.32% to 1.72%), particularly among those aged 18-29 years.

CONCLUSION

There was gender convergence in alcohol use in Taiwan, mainly due to men's decrease and women's increase in harmful alcohol use. Our findings have important implications for the intervention and prevention of the problematic use of alcohol in East Asia.

Daily Social Pressure and Alcohol Consumption Among Chinese Women: A Cross-Sectional Study

The purpose of this study was to examine the daily social pressure and socioeconomic factors related to women's alcohol consumption in China. Cross-sectional data were obtained from the 2012 China Family Panel Studies. A multivariate logistic regression analysis of a sample of 16 339 female adults with the mean age of 45.3 years was used to examine the relationships between dependent and independent variables. According to the results, first, the greater the daily social pressure, the more likely women were to engage in general alcohol consumption (odds ratio = 1.061) and risk drinking (odds ratio = 1.057). Second, while there is a positive relationship between the general level of social pressure and women's alcohol consumption, the relationship between the severe level of social pressure and women's alcohol consumption was not significant. Finally, women in the Central region were less likely to engage in risk drinking than women in the Western region; women with secondary school education were more likely to engage in risk drinking than women with primary school education or below; and age was significantly positively associated with both general and risk drinking. In conclusion, increasing alcohol consumption among women may be due to increased social pressure.

Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts

BACKGROUND

Although the association of moderate alcohol consumption with specific disorders, such as cardiovascular disease and cancers, has been well documented, the evidence of the broader impact of alcohol consumption on health-related quality of life is less clear. Our objective was to examine the association of drinking patterns with changes in physical and mental well-being across populations.

METHODS

We conducted a multilevel analysis with multivariate responses in the population-representative FAMILY Cohort in the Hong Kong Special Administrative Region, China, to examine the association between alcohol drinking patterns across 2 waves (2009-2013) (i.e., quitters, initiators, persistent drinkers, persistent former drinkers and lifetime abstainers) and changes in physical and mental well-being (Physical and Mental Component Summary of the 12-Item Short Form Health Survey [SF-12]). Analyses were stratified by sex. We validated findings using a nationally representative cohort in the United States, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2005).

RESULTS

In the FAMILY Cohort (n = 10 386; median follow-up 2.3 yr), the change in mental well-being was more favourable in female quitters than in lifetime abstainers (β = 1.44, 95% confidence interval [CI] 0.43 to 2.45; mean score change of +2.0 for quitters and +0.02 for lifetime abstainers). This association was validated in the NESARC (n = 31 079; median follow-up 3.1 yr) (β = 0.83, 95% CI 0.08 to 1.58; mean score change of -1.1 for quitters and -1.6 for lifetime abstainers).

INTERPRETATION

The change in mental well-being was more favourable in female quitters, approaching the level of mental well-being of lifetime abstainers within 4 years of quitting in both Chinese and American populations.

Prevalence of binge drinking and its association with mental health conditions and quality of life in Singapore

AIMS

Although heavy alcohol consumption has been linked to a myriad of adverse health problems, there is a paucity of population-based studies in Asian countries. The aims of this study were to determine the past-year prevalence of binge drinking in Singapore and its associations with socio-demographic factors, mental health conditions and quality of life.

METHODS

Data from the Singapore Mental Health Study 2016 (N = 6126) on binge drinking were included in the analysis. Multiple logistic regressions were used to assess the adjusted odds ratio (OR_adj) between binge drinking and relevant socio-demographic variables, and mental health conditions.

RESULTS

In the sample, 13.7% of respondents reported past-year binge drinking, 17.6% of males and 9.8% of females were binge drinkers. Most of them were infrequent binge drinkers (7.3% binge drink less than monthly). Moderate associations between binge drinking and mood and anxiety disorders (OR_adj = 1.8-4.4), were noted, while associations with alcohol use disorders were much stronger (OR_adj = 5.3-9.7). Associations between binge drinking and anxiety disorders were observed exclusively in females (OR_adj = 2.3-3.3). Binge drinkers reported a lower quality of life compared to their non-binging counterparts; binge-drinking males seemed to be more affected.

CONCLUSIONS

The prevalence of binge drinking is low in Singapore compared to global estimates; most binge drinkers in Singapore were infrequent binge drinkers. However, binge drinking was found to be associated with a myriad of mental health conditions, and a decline in quality of life was noted among binge drinkers.