London School of Hygiene & Tropical Medicine

The proportion of men who start to drink alcohol in their teens has surged more than threefold over the past few decades in Goa, India, according to research by Dr Aravind Pillai, Mailman School of Public Health, Columbia University, and Professor Vikram Patel of the London School of Hygiene and Tropical Medicine, published today in the Journal of Epidemiology & Community Health .

The study of just under 2000 randomly selected 20-49 year old men from rural and urban areas in Northern Goa showed that the proportion of men who started drinking in their teens rose from 20% for those born between 1956 and 1960 to 74% for those born between1981-85 - a more than threefold rise.

It also showed that those living in urban areas and poorer households are more likely to start drinking at an early age, and this is associated with a greater likelihood of developing lifetime alcohol dependence, hazardous or harmful drinking, alcohol related injuries, and psychological distress in adulthood.

Teen drinkers were more than twice as likely to be distressed and alcohol dependent as those who did not start drinking early in life. And they were three times as likely to have sustained injuries as a result of their drinking. These findings are consistent with studies from high-income countries, which find that starting to drink alcohol during the teenage years is a predictor of alcohol-related harm across the life course.

In India, alcohol consumption and its harmful effects are emerging as a major public health problem. The researchers highlight the importance of generating public awareness about the hazards of starting to drink early in life, and of enforcing regulations designed to limit underage drinking.

Professor Vikram Patel said: "It is time now for the government to take a close look at its alcohol policy, in particular clamping down on the open surrogate marketing of alcohol targeting younger audiences, enforcing regulations on under-age drinking in bars and other outlets, and the strengthening of life skills around the risks of early initiation of alcohol use in schools".

Professor Patel is Wellcome Trust Senior Research Fellow in Clinical Science, Professor of International Mental Health and Director of the School's Centre for Global Mental Health, and NGO partner Sangath, which carried out the research in Goa.

Publication

• Aravind Pillai, Madhabika B Nayak, Thomas K Greenfield, Jason C Bond, Deborah S Hasin, Vikram Patel. Adolescent drinking onset and its adult consequences among men: a population based study from India. J Epidemiol Community Health doi:10.1136/jech-2014-204058.

Image: Vikram Patel / WHO