Drinking Behavior Survey And Control Strategy Study In Adolescents In Six Chinese Cities

BackgroundThe situation of adolescent drinking has become a global public health issue. In order to guarantee the healthy growth of adolescents, to control the damages caused by alcohol, as well as to reduce of health risk when they grow up, it is of great signifi-cance to conduct surveys on adolescent drinking behaviors and develop relevant con-trol strategy. It will eventually reduce the burden of disease causing by alcohol in the whole nation.ObjectivesTo investigate the prevalence of adolescents drinking in China, the knowledge, attitude and practice (KAP) which associated with alcohol use, and the critical influ-ence factors, and to provide scientific policy advice for prevention and control strat-egy through a survey conducted in middle school students in 6 Chinese cities includ-ing Beijing, Shanghai, Guangzhou, Jinan, Chengdu and Harbin.Subjects and methodsA questionnaire survey on the prevalence of drinking, the related KAP and the influence factors was carried out. A total of 32200 questionnaires were given out and 32092 of them were recovered, with a gross recovery rate of 99.6%. Among all the questionnaires recovered,30605 were valid (the validation rate is 95.4%). Numbers of respondents in Beijing, Shanghai, Guangzhou, Jinan, Chengdu and Harbin were 4261, 3432,5770,5384,5959 and 5799, respectively. A comprehensive method including Multiple Logistic regression model, Bayesian Net model and Multilevel model was used in analyzing the influence factors of adolescent drinking and overdrinking. The SWOT method was used to analyse the control actions on adolescent drinking.Results1. The prevalence of lifetime drinking, past-year drinking and past 30 days drink-ing in the middle school students surveyed were 51.2%,38.2% and 19.5%, respec-tively.3.2% of the students were binge drinkers and 15.4% had got drunk. Most drinkers (59.0%) consumed alcohol no more frequent than once a month in the past year.40.9% of the drinkers consumed less than 1 drink each time. Drinkers who re-ported often having beer, distilled spirits, wine, yellow wine, liquor or rice wine were 83.7%,10.8%,46.9%,3.3%,11.0%,10.0% and 5.1%, respectively.2. For the knowledge related to drinking,49.1% of the respondents gave the cor-rect answer to the statement that "People who start drinking before 15 years old are more likely to be addicted to alcohol than those start drinking at adult stage ". For all the correct answers to the question asked about the harm due to long-term heavy drinking,41.4% of the respondents chose "fatty liver",19.6% chose "cerebral atro-phy",21.2% chose "amnesia", and 68.7% chose "alcohol addiction". For the attitude held toward drinking,30.7% of the respondents approved the statement that "It is un-social not to drink at parties with friends", and 39.9% approved that "It is impolite to refuse others’refilling your wine glass". For the drinking practice,61.9% of the re-spondents reported that they frequently drank at parties with friends, and 52.7% often drank at family dinners. Most of the students would drink when something good hap-pened, while 33.6% and 31.4% usually drank when they got depressed or sad. As to the occasions for drinking, the proportions of the students that usually drinking at res-taurants, KTV or friends’ were 46.1%,31.5% and 23.2%, respectively.3. There were 6 risk factors selected by both the Multiple Logistic regression model and the Bayesian Net model, including parents’ approval on their drinking, high percentage of drinkers in their friends, high frequency of parties, high frequency of mother’s drinking, friends’ urge on their drinking, and high frequency of father’s drinking. Among all the statistically significant risk factors, parents’ approval and high percentage of drinkers in their friends showed the greatest impact on adolescent drinking. The drinking probability of students with parents’ approval on their drinking was 10 times of those with parents’restriction. Meanwhile, the drinking probability of students with more than half of drinker friends was 12 times of those with no drinker friend. The publicity of adverse effects of drinking in school media, however, was a protective factor for adolescent drinking. For overdrinking, the common risk factors selected by the two models were high percentage of drinkers in their friends, high fre-quency of parties, and friends’urge on their drinking, all of which were friends re-lated. It was revealed in the Multilevel model that the students studying at schools with a higher density of surrounding catering service venues had a higher risk for stu-dents’drinking behavior.4. The following strategy was obtained through the analysis using the SWOT model:(1) From the perspective of the school, educations on the harmful effects of drinking in low grade students should be given. (2) Based on the findings related to parents’ attitude, the schools and the communities are supposed to let the parents real-ize the harm that alcohol will do to their children. (3) The supervision on the alcohol market should be reinforced and the punitive measures should be issued. (4) Improve the wine packages and promote the use of Standard Drink (SD). (5) A surveillance system at national level should be built and the cooperation mechanism among differ-ent departments should be improved.ConclusionsThe situation of adolescent drinking in China is pretty severe. The students’ knowledge, attitude and practice related to drinking are not satisfactory. The critical influence factors on students’drinking are their parents’ attitude about their drinking, the drinking behaviors of their friends, as well as the distribution of catering service venues around their schools. On the basis of the findings in this study, a practical con-trol strategy should be developed and relevant measures should be taken to control the situation of adolescent drinking in our country.