Transcript Monitoring of Alcoholic Beverages Consumption in Thailand

Monitoring of Alcoholic
Beverages Consumption
in Thailand
Gun Chernrungroj M.D., M.P.H., Ph.D.
Non-communicable Disease Information Center,
Department of Disease Control,
Ministry of Public Health, Thailand
Background
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Alcohol use is embedded in Thai Societies
In 2004, about 20.8 Thai used alcoholic
beverages.
Constraints on production and trade and
on consumption of alcohol have been
weakened.
Alcohol has become one of the most
important risk to health.
Public Health and Social Problems
Caused by Harmful Use of Alcohol
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Domestic violence
Unintentional injuries
Damage nearly every organs in the body
and cause more than 60 diseases and
conditions
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Alcohol dependence
Liver cirrhosis
Injuries
Burden of alcohol in Thailand
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The most recent burden of disease study in
2542 Disability-adjusted life year (DALY)
Death from alcohol = 17,000 deaths (4%)
Death and Disability = 540,000 year (5.8%)
(global = 4%) (developed countries =
9.2%)
Alcohol is the second most risk factors that
causes death and disability in Thai
population
Burden of alcohol in Thailand
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Estimated economic lost by alcohol in
2546 13,007 – 33652 million baht
0.22 – 0.56 of gross domestic product
(GDP)
Why monitoring Alcohol use?
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Quantitative estimate magnitude of health
problems caused by alcohol.
Detection of changes of population
consumption.
Documentation of the distribution and
spread of alcohol consumption.
Evaluation of control and prevention
measures.
Characteristic of a monitoring (surveillance)
system
influence
Research
Surveillance
evaluate
Information
Health Policies &
Programs
Research
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What is the health problem caused by
alcoholic beverages?
What is the risk of getting the diseases by
alcohol consumption?
How to prevent new drinker?
What is the most effective measure to
prevent and control alcohol consumption?
Surveillance or Monitoring
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What is the size of the problem of alcohol
consumption in population?
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Morbidity
Current drinker
What is the burden of alcohol
consumption to the population?
Existing Program and Policies
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Do the existing programs and policies can
reduce the burden from use of alcohol?
How do we know?
Framework of Indicators for Alcohol Monitoring
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Production
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Amount of production (Department of excise)
Local production
Number of alcohol manufacture
Individual Consumption
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Population (survey)
Qualitative
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Abstainer
Current drinker
Quantitative
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Average amount of drink
Sources of Data
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Burden of Alcohol consumption (Multiple sources)
Morbidity from harmful use of alcohol
Tax revenue from the Department of Excise
Number of alcohol manufacturers
National Survey
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National Statistical Office
Ministry of Public Health
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National Health Examination Survey
Behavior Risk Factor Surveillance System
Situation of Production and Sell of Alcohol
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2543 government stop monopolized
alcohol production
In 2547
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66 manufacturers (company)
5943 groups of Distilled alcohol home and
cottage industry
1960 groups of Fermented home and cottage
industry
Situation of alcohol consumption in population
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Indirect method
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Total alcohol production/population
Underestimated
No data of local production, illegal brewing,
smuggling and tourist alcohol.
Not account for tourist (20 million/year) and migrant
labor (approx 3 million) (mostly actively drink)
In 2543: over produced before stop monopolized
market (in 2543 WHO & FAO reported: Thailand
ranked No 5 in the world)
Production of Liquor and Beer 2537-2547
ี ภาษีในประเทศไทย 2537-2547
ปริมาณเครือ
่ งดืม
่ แอลกอฮอล์ทเี่ สย
ปริมาณ(ล้านลิตร)
3000
2506
2500
2000
1500
1000
500
1541
1218 1185
1148 1149
950
863
795
743
760
734
714 736
666
666 641
616
557
509
504
เหล ้า
เบียร์
0
0
2537 2538 2539 2540 2541 2542 2543 2544 2545 2546 2547
ปริ มาณยอดจาหน่ายสุ ราระหว่างปี 2530- 2540 (ล้านลิตร),
ปริ มาณสุ รา เบียร์และแอลกอฮอล์ที่คนไทยที่อายุ 15 ปี ขึ้นไป
บริ โภคต่อคนต่อปี (ลิตรต่อคนต่อปี )
900
25
700
600
15
500
400
10
300
200
5
100
1997
1996
1995
1994
1993
1992
1991
1990
1989
0
1988
0
liter per person
20
1987
million liters
800
spirit consumption
(million litres)
spirit
Beer
pure alcohol
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Direct
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Survey in population
Definition, questionnaire, and methodology of
survey.
Prevalence of current drinker, abstainer, binge
drinker
Average amount and frequency of alcohol
drinking (per week/ per year)
Survey related to Alcohol
consumption in Thailand
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Survey of tobacco and alcohol
consumption by National Statistical Office
National Health Examination Survey by
MOPH
Behavior Risk Factor Surveillance System
by MOPH
Major indicators in Surveys
Tobacco &
Alcohol Sur
NHE
BRFSS
√
√
√
Binge
drinker
√
√
Average
drink/week
√
√
Current
drinker
Drink and
drive/ride
√
√
Definition
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Alcohol consumption
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Individual practices with respect to use of
alcoholic beverages of all types including beer,
wine, fortified wine, and distilled spirit.
Abstainer
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absence of alcohol use as a lifelong practice
Quantities of Alcohol consumption
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Amount of Alcohol in different type of
beverages
Type
Ethanol content (%)
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Thai Beer
Hard liquor
Wine
5-6
28 - 40
12 - 13
(USA 3.5)
Definition of alcohol use
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Abstainer
Current drinker
Ex-drinker
Binge drinker
Average of consumption per week
Standard Drink
Number of current drinker, age > 15.
2534 - 2547 (million)
จำนวนผู้ดื่ม (ล้ ำนคน)
จำนวนผู้ดื่มสุ รำหรื อเครื่องดื่มมึนเมำ
20
15 12.4
10.5
10
5
1.8
13.7
11.9
15.3
13
16.15
13.57
total
male
1.7
2.3
2.57
female
0
2534
2539
2544
2547
2547
(HE)
ปี
Prevalence of Current Drinker,
age > 15, 2534 - 2547
ร้ อยละ(ควำมชุก)
ร้ อยละของผู้ดื่มสุ รำ พ.ศ 2534-2547
80
60
40
20
58.6
42.32
32.7
32.6
31.5
31.6
26.93
9.8
10.3
9.5
8.1
53.7
55.4
55.9
55.5
total
male
female
0
2534
2539
2544
2547
2547
(HE)
ปี
Morbidity caused by alcohol
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Reported cases of alcoholic liver disease
Other alcohol related diseases and injuries
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Multiple causes
Number of Alcoholic liver diseases 2539 - 2545
จานวนผูป
้ ่ วยในทีได้
่ ร ับการวินจ
ิ ฉย
ั ว่าเป็นโรคต ับจากแอลกอฮอล์ 2539-2545
11345
12000
จานวนผูป
้ ่ วย
10000
8000
7224
8321
7821
9123
9961
6920
ราย
6000
4000
2000
0
2539
2540
2541
2542
ปี (พ.ศ.)
2543
2544
2545
ร้อยละของการบาดเจ็บที่เกี่ยวข้องกับการใช้เครื่องดื่มแอลกอฮอล์
จาแนกตามสาเหตุสาคัญ ปี 2543-2547
2543
2544
2545
2546
2547
32.8
33.6
33.6
33.2
38.6
อุบัตเิ หตุพลัดตกหกล้ ม
8.1
8.9
9.2
9.5
9.6
การตัง้ ใจทาร้ ายตนเอง
20.6
20.9
20.8
22.8
21.3
การถูกทาร้ าย
อุบัตเิ หตุแรงเชิงกลวัตถุ
สิ่งของ
50.9
51.1
52.1
60.6
58.4
6.5
5.9
6.8
7.3
7.3
อุบัตเิ หตุการขนส่ ง
Summary of Situation
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Alcohol production and consumption are
on the rise and very rapid in most recent
years.
Disease and Injuries related to alcohol
consumption have been rising.
Both number of drinkers and amount of
alcohol are also increase.
Future work for effective alcohol
monitoring system
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Increase standard and method of alcohol
production data collection.
National standard of definition of alcohol
consumption and survey methodology.
Strengthening evidence for sound policy
development.
More analysis for special groups of
concern: who are affected the most?