Alcohol consumption has become more prevalent in China in recent years but limited large-scale epidemiological evidence has made it difficult to know the true scale of the problem. A new large study of Chinese adults, published by the scientific journal Addiction, has found that eight percent of men in China are problem drinkers, and that problem drinking is more prevalent among men of lower socio-economic status and in rural areas. Problem drinking is associated with significantly increased risk of physical and mental health problems and premature death.
Researchers from Oxford University, Peking University, and the Chinese Academy of Medical Sciences led a large collaborative study of over 500,000 men and women aged 30-79 years from ten rural and urban areas in China. Women in the study drank little alcohol, but a third of men drank alcohol regularly and one in four of these men experienced at least one indicator of problem drinking.
'Problem drinking' was defined by self-report as one or more of the following indicators in the past month: drinking in the morning, being unable to work or to do anything due to drinking, negative emotions after drinking, being unable to avoid drinking, or having the shakes when stopping drinking.
Co-author Pek Kei Im, of the Nuffield Department of Population Health at the University of Oxford, says: "In China, the patterns of drinking differ from Western populations. Our study shows that problem drinking is fairly common among Chinese men, particularly among more disadvantaged groups."
Compared with low-risk drinkers, men with problem drinking had poorer self-reported health, poorer life satisfaction, more sleep problems, and a higher risk of depression and anxiety. Men with two or more problem drinking indicators had an approximately two-fold higher risk for all-cause mortality and a 15% higher risk for hospitalisation compared with low-risk drinkers. Professor Zhengming Chen, co-author from the Nuffield Department of Population Health at the University of Oxford, says: "This large collaborative study has shown that drinking alcohol can result in significant adverse consequences, for both mental and physical health and wellbeing."
The prevalence of alcohol dependence in China increased from 0.02% to 0.68% between the 1980s and 1990s, and per capita alcohol consumption increased from 4.1L in 2005 to 7.2L in 2016, whereas in Europe per capita consumption decreased from 12.3L to 9.8L over the same period.
Co-author Dr Iona Millwood, of the Nuffield Department of Population Health at the University of Oxford, says: "Drinking has been on the rise in China since the 1980s, and now we're looking at a significant national health problem that is beginning to resemble those in Western countries. Knowing the scale of the problem, and the fact that it's more intense in rural and poorer areas, can help to inform policy decisions to improve health outcomes in China."
Peer reviewed: Yes
Type of study: Longitudinal study
Subject of study: People
Funding: Government/research council and charity/NGO
This paper is free to download from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14873 or by contacting Jean O'Reilly, Editorial Manager, Addiction, email@example.com, tel +44 (0)20 7848 0452.
To speak with co-author Dr. Iona Millwood: contact her at the Nuffield Department of Population Health, University of Oxford by email (firstname.lastname@example.org) or telephone (+44 (0) 1865 743612).
Full citation for article: Im PK, Millwood IY, Chen Y, Guo Y, Du H, Kartsonaki C, Bian Z, Tan Y, Su J, Li Y, Yu C, Lv J, Li L, Yang L, Chen Z, on behalf of the China Kadoorie Biobank (CKB) collaborative group (2019) Problem drinking, wellbeing and mortality risk in Chinese men: findings from the China Kadoorie Biobank. Addiction 115: doi: 10.1111/add.14873.
1. UK Wellcome Trust [grant numbers 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z]
2. National Natural Science Foundation of China [grant numbers 81390540, 81390541, 81390544]
3. National Key Research and Development Program of China [grant numbers 2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904]
Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2018 ISI Journal Citation Reports ranking in the substance abuse category (science edition).