Prevalence, patterns and predictors of alcohol consumption in a mountainous district of Bhutan BHIM N. SUBADY 1 , SAWITRI ASSANANGKORNCHAI 2 & VIRASAKDI CHONGSUVIVATWONG 2 1 Tashiyangtse District Hospital, Dzongkhag Administration, Trashiyangtse, Bhutan, and 2 Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, HatYai, Songkhla, Thailand Abstract Introduction and Aims. South Asian countries, with their diverse cultures, have varying prevalences of alcohol consump- tion. Little is known about Bhutan, a Himalayan country.The objectives of this study are to estimate the prevalence of alcohol consumption among the residents of a rural community in Bhutan and determine their patterns of and factors associated with drinking. Design and Methods. A cross-sectional household survey using a multistage systematic sampling technique was conducted in eight sub-districts of Tashiyangtse. A total of 442 subjects of 270 households were surveyed in 17 villages using the Alcohol Use Disorders Identification Test (AUDIT), with the tri-level method and face-to-face interviews. Results. The drinking prevalence (at least one standard drink in the past year) was 38.5% (52% in men and 30% in women). The prevalence of low-, moderate- and high-risk drinking based on the AUDIT was 22.4%, 13.6% and 2.5%, respectively.Annual per capita alcohol consumption was 5442 and 2566 g in men and women, respectively, while the corresponding values of home-made alcohol consumption were 3768 and 2127 g, respectively. Among drinkers, 30.3% of men and 25.9% of women reported encountering financial consequences. The home was almost the exclusive drinking venue (92.4%). Belief in the medicinal use of alcohol was 34.8% in men and 58% in women as the reason to start drinking. This belief was a strong independent predictor for current drinking after adjustment for age and sex. Discussion and Conclusions. Home-made alcohol and home drinking with a belief of medicinal effects were the major cause of drinking and its consequences in the study area. [Subady BN, Assanangkornchai S, Chongsuvivatwong V. Prevalence, patterns and predictors of alcohol consumption in a mountainous district of Bhutan. Drug Alcohol Rev 2013;32:435–442] Key words: AUDIT, prevalence, medicinal use, home-made alcohol, Bhutan. Introduction Alcohol is the main cause of 60 different diseases and injuries and a component cause in another 200. Harmful use of alcohol kills approximately 2.5 million people each year. In middle-income countries, alcohol consumption is the third largest risk factor for diseases and disabilities. Alcohol accounts for approximately 4% of all deaths worldwide, higher than HIV/AIDS or tuberculosis. Per capita alcohol consumption in the South-East Asia regions of the World Health Organiza- tion is only slightly more than one-third of the world average (2.2 vs. 6.1 l of pure alcohol, respectively). On the other hand, over two-thirds (69%) of alcoholic products in countries from South-East Asia regions of the World Health Organization are home-made or ille- gally produced compared with less than one-third (29%) worldwide [1]. Bhutan is a small, landlocked country situated along the southern slopes of the Himalayan range with a population of 634 982. Seventy per cent of the popu- lation live in rural areas [2]. The geographical terrain is divided into three regions distinguished by altitude: the greater Himalaya region in the north, the inner Hima- laya highland in between and the southern foothills, with dividing altitudes 3000 and 1500 m above sea levels. Tashiyangtse district lies in the inner Himalaya highlands and the climate in this region is temperate, Bhim N. Subady MB, BS, Doctor, Sawitri Assanangkornchai MD, PhD, Associate Professor,Virasakdi Chongsuvivatwong MD, PhD, Professor. Correspondence to Associate Professor Sawitri Assanangkornchai, Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, HatYai, Songkhla, 90110, Thailand. Tel: +66 74451165; Fax: +66 74429922; E-mail: savitree.a@psu.ac.th Attributed to: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. Received 12 April 2012; accepted for publication 15 October 2012. REVIEW Drug and Alcohol Review (July 2013), 32, 435–442 DOI: 10.1111/dar.12015 © 2012 Australasian Professional Society on Alcohol and other Drugs