NEW DELHI: As India’s per capita alcohol consumption has been rising steadily over the past decade, the need of the hour is to have a dedicated national alcohol policy with evidence-based measures, said a top ICMR official.
What also needs to be focused on is the co-occurrence of tobacco and alcohol use among Indians that poses major public health challenges.
Speaking with this paper, Dr Shalini Singh, Director, Indian Council of Medical Research-National Institute of Cancer Prevention and Research, Noida (ICMR-NICPR), a national cancer prevention institute, said, “Public health interventions addressing alcohol cannot be siloed from those addressing tobacco; integrated NCD risk factor surveillance and joint prevention messaging are essential.”
“The co-occurrence of tobacco and alcohol use, a well-established pattern epidemiologically, is especially dangerous. The combination multiplicatively increases the risk of head and neck cancers, oesophageal cancer, and liver disease,” she said.
Flagging that India currently lacks a comprehensive national alcohol policy similar to the Cigarettes and Other Tobacco Products Act, 2003 (COTPA) for tobacco, Dr Singh said what is needed is minimum unit pricing, advertising bans, especially surrogate advertising, and outlet density regulation.
“The evidence base is unambiguous that tobacco and alcohol are among the leading modifiable risk factors for India’s growing NCD burden, including cardiovascular diseases and cancers,” she told.
Highlighting the National Family Health Survey (NFHS-6) findings, Dr Singh said, “The NFHS-6 data strengthen the case for a National Alcohol Control Policy, minimum unit pricing, restrictions on alcohol advertising, both direct and surrogate, over different media platforms, and standardised labelling with health warnings.”
The latest NFHS-6 data showed alcohol consumption has increased among men, but is no less among women in India.
“The increase in alcohol use among men is consistent with trends observed in many emerging economies or low- and middle-income countries across the globe, where rising disposable incomes, changing social norms, aggressive marketing by the alcohol industry, and inadequate regulatory enforcement are collectively driving consumption upward," said the top scientist.
The reason behind persistent consumption of alcohol among women in select states, she said, particularly reflects context-specific social norms where alcohol use by women is less stigmatised, alongside issues of locally brewed alcohol (country liquor), which carries additional risks from adulterants and unregulated production.
“This cannot be dismissed as a marginal concern,” she added. In eight states, liquor consumption has increased among women as compared to the national average.
What is particularly of concern is the high consumption rate of alcohol in many states as compared to urban pockets – a rising trend indicated by NFHS-6 data.
"The rural data from NFHS-6 make a compelling case for integrating tobacco and alcohol use screening and brief counselling into the work of frontline health workers and embedding cessation support into Ayushman Bharat–Health and Wellness Centres (AB-HWCs),” she added.
She further said that the rural-urban gradient in tobacco and alcohol use is a manifestation of the structural determinants of health.
"Sustained anti-tobacco and anti-alcohol media campaigns should be adapted for rural audiences, regional languages, and specific demographic groups, including women and youth, and must be budgeted and executed annually, not episodically," she added.
