Background Alcohol consumption is a risk factor for Non-Communicable Diseases (NCD). A national NCD risk factor survey conducted in Sri Lanka in 2008 estimated a prevalence of alcohol use of 26% among males aged between 17-64 years. It is important to assess the current situation, in order to determine trends in alcohol consumption in the country which will contribute to planning of comprehensive prevention programmes. Objective To determine the prevalence of alcohol use and the pattern of drinking of alcohol in Sri Lanka. Methods A descriptive cross sectional study was conducted in the 14 to 64 year age group. Sample size was 3750 comprising 750 participants in each 10 year age/sex stratum (250 males and 500 females). Out of this figure 3728 responded Multi stage cluster sampling technique was used and a Public Health Midwife (PHM) area was considered as a cluster. Data were collected using an interviewer administered questionnaire obtained from the "Alcohol" module of the WHO STEP wise approach. Core variables and some expanded variables were assessed in the data collection tool. Data collectors (n=36) were PHMs attached to the Medical Officer of Health office in the area where the cluster was selected. Analysis was done using SPSS version 16 and results in relation to prevalence of alcohol use were presented as percentages. Results Prevalence of current drinkers were 39.6% among males and 2.4% among females when adjusted to the population of the districts in which the sample was obtained. .The most consumed type, among those who have ever used alcohol is beer (76.9%) followed by spirits (51.5%), wine (25.8%), kasippu (22.2%), palmyrah toddy (16.9%), toddy (16.8%) and other types not detailed in the questionnaire (5.3%). Conclusions Alcohol consumption has increased since the last survey in 2008 (male: 26%, female: 1.2%). Preventative activities focusing on vulnerable groups should be implemented at the national as well as regional levels. At the same time non-drinkers must be routinely addressed to sustain their status. As prevalence is high among males a targeted cost effective rehabilitation programme should be prioritised. The increasing trend among female drinking indicates the need of primary preventive actions targeted at them.
The prevalence of smokeless tobacco (SLT) use in Sri Lanka has been reported high, especially among rural and disadvantaged groups. Different smokeless tobacco products were not only widely available but also very affordable. An increasing popularity of SLT use among the youth and adolescents is a cause for concern in Sri Lanka. There were evidences of diverse benign, premalignant, and malignant oral diseases due to smokeless tobacco use in the country. The level of awareness about health risks related to the consumption of smokeless tobacco products was low, particularly among the people with low socio-economic status. In Sri Lanka various forms of smokeless tobacco products, some of them imported, are used. At the national level, 15.8% used smokeless tobacco products and its use is three-fold higher among men compared to women. Betel quid is by far the traditional form in which tobacco is a general component. Other manufactured tobacco products include pan parag/pan masala, Mawa, Red tooth powder, Khaini, tobacco powder, and Zarda. Some 8.6% of the youth are current users of smokeless tobacco. There are studies demonstrating the harmful effects of smokeless tobacco use, especially on the oral mucosa, however, the level of awareness of this aspect is low. The highest mean expenditure on betel quid alone in rural areas for those earning Rs. 5,000/month was Rs. 952. The core issue is the easy availability of these products. To combat the smokeless tobacco problem, public health programs need to be intensified and targeted to vulnerable younger age groups. Another vital approach should be to levy higher taxation.
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