Monitoring of Alcoholic Beverages Consumption in Thailand

1. Monitoring of Alcoholic Beverages Consumption in Thailand Gun ChernrungrojM.D., M.P.H., Ph.D. Non-communicable Disease Information Center, Department of Disease Control, Ministry of Public Health, Thailand

2. Background • 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.

3. Public Health and Social Problems Caused by Harmful Use of Alcohol • Domestic violence • Unintentional injuries • Damage nearly every organs in the body and cause more than 60 diseases and conditions • Alcohol dependence • Liver cirrhosis • Injuries

4. Burden of alcohol in Thailand • 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

5. Burden of alcohol in Thailand • Estimated economic lost by alcohol in 2546 13,007 – 33652 million baht • 0.22 – 0.56 of gross domestic product (GDP)

6. Why monitoring Alcohol use? • 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.

7. Characteristic of a monitoring (surveillance) system influence Health Policies & Programs Research Surveillance evaluate Information

8. Research • 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?

9. Surveillance or Monitoring • What is the size of the problem of alcohol consumption in population? • Morbidity • Current drinker • What is the burden of alcohol consumption to the population?

10. Existing Program and Policies • Do the existing programs and policies can reduce the burden from use of alcohol? • How do we know?

11. Framework of Indicatorsfor Alcohol Monitoring • Production • Amount of production (Department of excise) • Local production • Number of alcohol manufacture • Individual Consumption • Population (survey) • Qualitative • Abstainer • Current drinker • Quantitative • Average amount of drink

12. Sources of Data • 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 • National Statistical Office • Ministry of Public Health • National Health Examination Survey • Behavior Risk Factor Surveillance System

13. Situation of Production and Sell of Alcohol • 2543 government stop monopolized alcohol production • In 2547 • 66 manufacturers (company) • 5943 groups of Distilled alcohol home and cottage industry • 1960 groups of Fermented home and cottage industry

14. Situation of alcohol consumption in population • Indirect method • 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)

15. Production of Liquor and Beer 2537-2547

16. ปริมาณยอดจำหน่ายสุราระหว่างปี 2530- 2540 (ล้านลิตร), ปริมาณสุรา เบียร์และแอลกอฮอล์ที่คนไทยที่อายุ 15 ปีขึ้นไปบริโภคต่อคนต่อปี (ลิตรต่อคนต่อปี)

18. Direct • 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)

19. Survey related to Alcohol consumption in Thailand • Survey of tobacco and alcohol consumption by National Statistical Office • National Health Examination Survey by MOPH • Behavior Risk Factor Surveillance System by MOPH

20. Major indicators in Surveys

21. Definition • Alcohol consumption • Individual practices with respect to use of alcoholic beverages of all types including beer, wine, fortified wine, and distilled spirit. • Abstainer • absence of alcohol use as a lifelong practice

22. Quantities of Alcohol consumption • Amount of Alcohol in different type of beverages • Type Ethanol content (%) • Thai Beer 5 - 6 (USA 3.5) • Hard liquor 28 - 40 • Wine 12 - 13

23. Definition of alcohol use • Abstainer • Current drinker • Ex-drinker • Binge drinker • Average of consumption per week • Standard Drink

24. Number of current drinker, age > 15. 2534 - 2547(million)

25. Prevalence of Current Drinker,age > 15, 2534 - 2547

26. Morbidity caused by alcohol • Reported cases of alcoholic liver disease • Other alcohol related diseases and injuries • Multiple causes

27. Number of Alcoholic liver diseases 2539 - 2545

28. ร้อยละของการบาดเจ็บที่เกี่ยวข้องกับการใช้เครื่องดื่มแอลกอฮอล์ร้อยละของการบาดเจ็บที่เกี่ยวข้องกับการใช้เครื่องดื่มแอลกอฮอล์ จำแนกตามสาเหตุสำคัญ ปี 2543-2547

29. Summary of Situation • 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.

30. Future work for effective alcohol monitoring system • 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?