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Background: Binge drinking (BD) is a significant risk factor for several acute and chronic illnesses, including injuries. This study examines the rate, frequency and intensity of BD in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: This was a cross-sectional survey of 998 adults attending the three largest outpatient clinics in BCMM. Rate, frequency and intensity of BD were assessed using the WHO STEPwise questionnaire. Descriptive and inferential statistics were carried out to determine the rate and determinants of binge drinking. Results: The overall rate of BD was 15.0%. Frequency and intensity of BD were 5.4 episodes per month and 13.4 drinks on one occasion, respectively. The study data showed that BD was commoner in males than females (24.0% vs. 10.8%). Smokers engage more in BD than non-smokers (44.0% vs. 9.9%). In the analysis of socio-demographic variables, BD was commonest among students, age group 18–25 years, those never married and those on incomes between 2001 and 5000 Rand per month. In the multivariate logistic regression, after adjusting for confounders, only age less than 25 years (p < 0.001) and male gender (p < 0.001) were significant predictors of binge drinking. Also, male gender (p = 0.002) was significantly associated with frequency of BD. There was no significant gender variation in the intensity of BD. Only age and smoking were significantly associated with the intensity of BD. Conclusion: The rate of binge drinking was high among the study participants, and those who binge drink tend to do so frequently and at a high intensity. Women who binge drink also do so at a high intensity. There is a need for sensitisation campaigns and health advocacy talks on the dangers associated with binge drinking among young adults in this setting.
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South African Family Practice
ISSN: 2078-6190 (Print) 2078-6204 (Online) Journal homepage: http://www.tandfonline.com/loi/ojfp20
Adult binge drinking: rate, frequency and intensity
in Buffalo City Metropolitan Municipality, South
Africa
Eyitayo Omolara Owolabi, Daniel Ter Goon, Oladele Vincent Adeniyi &
Eunice Seekoe
To cite this article: Eyitayo Omolara Owolabi, Daniel Ter Goon, Oladele Vincent Adeniyi & Eunice
Seekoe (2017): Adult binge drinking: rate, frequency and intensity in Buffalo City Metropolitan
Municipality, South Africa, South African Family Practice, DOI: 10.1080/20786190.2017.1382970
To link to this article: http://dx.doi.org/10.1080/20786190.2017.1382970
© 2017 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis
Group
Published online: 14 Oct 2017.
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ISSN 2078-6190 EISSN 2078-6204
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RESEARCH
Adult binge drinking 2017; 4(1):1–7
https://doi.org/10.1080/20786190.2017.1382970
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South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Informa UK Limited
[trading as the Taylor & Francis Group]
Adult binge drinking: rate, frequency and intensity in Bualo City Metropolitan
Municipality, South Africa
Eyitayo Omolara Owolabi
a
*, Daniel Ter Goon
a
, Oladele Vincent Adeniyi
b
and Eunice Seekoe
a
a
Department of Nursing Science, University of Fort Hare, East London, South Africa
b
Department of Family Medicine, Walter Sisulu University/Cecilia Makiwane Hospital, East London, South Africa
*Corresponding author, email: owolabiomolara101@gmail.com
Background: Binge drinking (BD) is a signicant risk factor for several acute and chronic illnesses, including injuries. This study
examines the rate, frequency and intensity of BD in Bualo City Metropolitan Municipality (BCMM), South Africa.
Methods: This was a cross-sectional survey of 998 adults attending the three largest outpatient clinics in BCMM. Rate, frequency
and intensity of BD were assessed using the WHO STEPwise questionnaire. Descriptive and inferential statistics were carried out
to determine the rate and determinants of binge drinking.
Results: The overall rate of BD was 15.0%. Frequency and intensity of BD were 5.4 episodes per month and 13.4 drinks on one
occasion, respectively. The study data showed that BD was commoner in males than females (24.0% vs. 10.8%). Smokers engage
more in BD than non-smokers (44.0% vs. 9.9%). In the analysis of socio-demographic variables, BD was commonest among
students, age group 18–25years, those never married and those on incomes between 2001 and 5000 Rand per month. In the
multivariate logistic regression, after adjusting for confounders, only age less than 25years (p < 0.001) and male gender (p <
0.001) were signicant predictors of binge drinking. Also, male gender (p = 0.002) was signicantly associated with frequency of
BD. There was no signicant gender variation in the intensity of BD. Only age and smoking were signicantly associated with the
intensity of BD.
Conclusion: The rate of binge drinking was high among the study participants, and those who binge drink tend to do so frequently
and at a high intensity. Women who binge drink also do so at a high intensity. There is a need for sensitisation campaigns and
health advocacy talks on the dangers associated with binge drinking among young adults in this setting.
Keywords: Binge drinking, Bualo City, frequency, intensity, rate, South Africa
Introduction
Alcohol is a mind-altering substance that has been in use for
centuries and in various cultures and it is associated with varieties
of health, social and economic burden.1 Globally, alcohol use is
the third leading modiable risk factor for morbidity and
mortality and the rst leading risk factor in middle-income
countries.2 Alcohol use is responsible for 3.3 million deaths (5.9%)
worldwide and a cause of over 200 diseases and injuries.3
Alcohol is a leading risk factor for morbidity and mortality in
South Africa.4 South Africa is considered a hard-drinking country
with an annual per-capita consumption rate of 5 billion litres,
one of the highest recorded globally.3,5,6 Excessive alcohol
consumption constitutes a signicant public health threat for
South Africans.5,7 Alcohol use in South Africa is often characterised
by abstinence from alcohol juxtaposed with heavy episodic
drinking, basically binge drinking, with a signicant rise among
females and a relatively stable rate among males.7 Alcohol use in
South Africa varies by gender, race and province.8
Binge drinking, dened as the consumption of four or more
alcoholic drinks among women or ve or more among men on a
single occasion, is a form of hazardous drinking.7,9 Binge drinking
often results in acute impairment with numerous health
consequences and constitutes a risk factor for several chronic
and acute traumas and illnesses such as motor vehicle accidents,
violence, suicide, hypertension, acute myocardial infarction, and
sexually transmitted diseases among others.3,10 Binge drinking
increases the risks of breast cancer and unintended pregnancies
in women in the reproductive age group, sudden infant death
and foetal alcohol spectrum disorders during pregnancy.9
Apart from the prevalence of binge drinking, the frequency and
intensity of binge drinking are two other important measures for
determining the adverse health outcomes of hazardous alcohol
use.11 The frequency of binge drinking is dened as the number of
binge-drinking episodes over a certain time period while intensity
is dened as the average number of drinks consumed per episode
of binge drinking.12 These two measures, frequency and intensity,
have been reported to contribute signicantly to poor health-
related quality of life as well as alcohol-related morbidity and
mortality.11,13 Several studies have reported the prevalence of
alcohol use in South Africa.5,7,8,14 However, binge drinking has
rarely been investigated in the Eastern Cape Province, an
economically disadvantaged province with an anecdotal report
of high alcohol-drinking habits. Most importantly, no study has
been conducted in South Africa on the frequency and intensity of
binge drinking among individuals who binge drink. Such
information is vital in determining the severity and pattern of
binge drinking, and assessing the population at risk of adverse
health outcomes of alcohol use, as well as crafting eective public
health policies targeted towards the reduction of harmful alcohol
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2 South African Family Practice 2017; 1(1):1–7
use. This study aimed at determining the rate, frequency and
intensity of binge drinking among adults in BCMM, South Africa.
Study methods
Study settings and participants
This cross-sectional study forms part of the Bualo City
Metropolitan Municipality (BCMM) Non-Communicable Disease
Surveillance Study. The methods for the larger study have been
published elsewhere.15 Briey, participants were recruited from
the three largest outpatient clinics: Cecilia Makiwane hospital,
and Nontyatyambo and Empilweni-Gompo Community Health
Centres. These health facilities are located in the rural and semi-
urban communities of BCMM and provide healthcare services for
a total of 755 200 residents in BCMM.16 Bualo City Metropolitan
Municipality is situated on the east coast of Eastern Cape
Province and consists of the towns of East London, King William’s
Town, Bisho and the large townships of Mdantsane and
Zwelitsha. The majority (85.1%) of the residents of BCMM are
black Africans, with 6.0% coloured population, 0.8% Asian/
Indians and 7.7% whites.16
Sample and sampling technique
The appropriate sample size was estimated using the following
formula:
Where Z1−α is the condence level, P is the expected proportion
of individuals with cardio-metabolic risk factors, and D is the
margin of error. P was set at 0.40 and D at 0.05. The calculation
was performed at 95% condence level. The required sample
size (1 107 participants; 369 per study site) was included in the
study. All ambulatory individuals (both patients and relatives)
who fullled the inclusion criteria and were available during the
period of study were conveniently recruited. The study was
conducted in April and May 2016. Participants were included if
they were 18years and above. However, debilitated, pregnant,
breastfeeding or individuals with psychiatric disorders were
excluded from the study. Due to incomplete data, 199
participants were excluded, thus a total of 998 participants were
included in the data analysis.
Data collection
Study instrument
The previously validated WHO STEPwise questionnaire17 was
used to obtain information from the study participants. It
comprised three major items: demographic and behavioural
data, and measurements. The instrument was adapted locally
and a pilot study that included 20 participants at one of the
sites was conducted to validate its suitability in the local setting
as well as to test the eectiveness of the research process.
However, the result of the pilot study was not included in the
analysis.
Study procedure
Data were obtained by personal interview on demographic and
behavioural characteristics using the WHO STEPwise
questionnaire. Demographic variables included items on sex,
age, marital status, level of education, employment status and
average monthly income. Participants’ income was categorised
into R2000 or less per month, R2001–5000 and above R5000.
Their level of education was determined by self-reporting of the
highest grade level attained in school and was categorised as
having no formal education, primary (grade 1–7), secondary
N
=(Z
1𝛼
)
2
×(P(1p))∕D
2
(grade 8–12) or tertiary (post-secondary). Participants were
dened as unemployed if they reported that they were not
employed in either the formal or informal sector.
Binge drinking was dened as self-reported consumption of four
or more standard alcoholic drinks on one occasion by women or
ve or more standard alcoholic drinks on one occasion by men in
the past 30days. Frequency of binge drinking was dened as the
average number of episodes of binge drinking while intensity of
binge drinking was dened as the average number of drinks
consumed during occasions of binge drinking in the past 30days.
Data analysis
Descriptive and inferential statistics were used for the data analysis.
Frequencies (n) and proportions (%) were reported for categorical
variables. The associations between the demographic variables
and binge drinking were assessed through bivariate analysis.
Multivariate analysis was used to ascertain the determinants of
binge drinking. Mean frequency and intensity were compared
across the socio-demographic variables using analysis of variance
(ANOVA). Analysis was carried out at a 95% condence level. A p-
value of < 0.05 was considered statistically signicant. The
Statistical Package for Social Science (SPSS®) version 21.0 was used
for the data analysis (IBM Corp, Armonk, NY, USA).
Ethical considerations
Ethical approval was obtained from the University of Fort Hare
Research Ethics Committee (Reference number, GOO061SOLO01).
Afterwards, permission to conduct the study was obtained from
the Eastern Cape Department of Health, the management of the
Sub-District Department of Health in Bualo City Metropolitan
Municipality and nally the management of the respective
health facilities. Participants received detailed information on
the purpose and process of the study. Each participant
subsequently gave written, informed consent for his/her
voluntary participation in the study including referral to clinicians
for interventions in the event of abnormal ndings. The
participants’ right to privacy, condentiality and anonymity were
taken into consideration.
Results
Table 1 presents the demographic characteristics of the
participants. A total of 998 participants were included in the
analysis. The mean age of participants was 42.6 (SD±16.5)years,
with an age range of 18 to 75 years. The majority of the
participants were black (98.1%), female (67.8%), single (63.9%)
and had at least a grade 8 level of education (69.7%). About half
of the participants had no means of income (44.6%) and were
unemployed (47.7%), while only a few (7.5%) participants earned
above R5000 monthly.
Of the 998 participants, the prevalence of binge drinking was
15% (n = 150). However, 47% of those who reported current
alcohol consumption (n = 319) binge drink.
As shown in Table 2, gender, age, marital status, employment
status, income categories, body mass index (BMI) categories and
smoking were statistically associated with binge drinking. Binge
drinking was highest among males (24%), participants aged 18 to
25years (24.6%), those never married (19.2%), students (23.2%),
those earning an income of R2001 to R5000 per month (21.8%),
those who were underweight (21.9) and current smokers (44%).
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Adult binge drinking: rate, frequency and intensity in Bualo City Metropolitan Municipality, South Africa 3
In the multivariate regression, only age less than 25years, male
gender and current smoking were signicant predictors of binge
drinking. Participants aged less than 25years were three times
more likely to binge drink compared to those above 25years.
Males were twice as likely to binge drink compared to females
while smokers were about seven times more likely to binge drink
than non-smokers (Table 3).
The mean frequency of binge drinking was 5.4 episodes and it
ranged from 1.0 to 32.0 episodes. Sex was the only signicant
factor associated with the frequency of binge drinking (p-
value=0.002). Male participants had a higher frequency of binge
drinking (6.4 episodes) (Table 4).
The mean intensity of binge drinking among the study
participants was 13.4 drinks (4.0–56.0 drinks) with no signicant
gender variation. Age and smoking were signicantly associated
with the intensity of binge drinking. The highest mean intensity
of binge drinking was found among participants aged 36 to
45years (16.0 drinks) and current smokers (13.9 drinks) (Table 5).
Discussion
Binge drinking is an essential public health issue that often
results in acute impairment with several health consequences.3
Of the 998 participants, 15% binge drink, while 47% of current
alcohol users binge drink. The rate of binge drinking among
adults in this setting in Eastern Cape Province is higher than the
reported national prevalence of 9.7%.18 This points at the
documented increase in hazardous alcohol use in South Africa.5
This rate is slightly lower than the reported prevalence among
US adults, which ranged from 17.1% to 23% between 2010 and
2015.9,19,20 Harmful alcohol users are not only at risk, but also put
others at risk. Considering its signicant adverse health and
social impacts, harmful alcohol use requires health intervention
measures among the general population.
Binge drinking was found to be higher among males, younger
participants (aged 18–25years), never-married participants and
students. This is not surprising, as several studies have
documented similar ndings.9,19,21 Males have been reported as
the most frequent perpetrators of harmful alcohol use.5,22,23
Alcohol use is perceived to be more socially acceptable among
males than females and this might be the underlying factor for
the higher rate recorded among the male participants. However,
evidence indicates a convergence in the prevalence of alcohol
use among the two genders, as the gap has been documented
to be closing in recent years.7,24 The increase in hazardous
drinking among women in this setting could be attributed to
women’s rights and social status.25 This trend portends grave
danger in the region for increasing unintended pregnancies,
sexually transmitted infections, especially HIV, and the risks of
sudden infant deaths and foetal alcohol spectrum disorders
during pregnancy. Thus, alcohol reduction interventions should
not only target males; rather, both sexes should be targeted as
there is a possibility of escalation of this burden in the near
future.
Also, those in the younger age group binge drink more than the
older participants. This corroborates the ndings of Reddy et al.21
in a National Youth Survey in South Africa, which reported a high
(25.1%) prevalence of binge drinking. This might also explain the
high prevalence found among students and single participants
as they constitute the majority of the younger age group.
Hazardous and binge drinking have been identied as habits
commonly found among youths. These often decline with age,
as people become mature, undertake more responsibilities or
even develop health problems.26 Other reasons could be peer
pressure, boredom, ignorance of the harmful eects of alcohol
use, the relatively low price of alcohol, as well as ease of access to
alcohol, evidenced by growing numbers of unlicensed liquor
outlets in South Africa.5 Young adults should be specically
targeted for screening and interventions by primary health care
physicians in the study setting. This is supported by evidence
Table 1: Demographic characteristics of the participants by gender
Variables Male
(n = 321) n (%)
Female
(n = 677) n (%)
Total
(n = 998) n (%)
Age group (years):
18–25 40 (12.5) 143 (21.1) 183 (18.3)
26–35 74 (23.1) 149 (22.0) 223 (22.3)
36–45 67 (20.9) 116 (17.1) 183 (18.3)
46–55 57 (17.8) 110 (16.2) 167 (16.7)
56–65 41 (12.8) 99 (14.6) 140 (14.0)
≥ 66 42 (14.1) 60 (8.9) 102 (10.2)
Level of education:
No formal
schooling
62 (19.3) 84 (12.4) 146 (14.6)
Grade 1–7 57 (17.8) 99 (14.6) 156 (15.6)
Grade 8–12 171 (53.3) 409 (60.4) 580 (58.1)
Tertiary 31 (9.7) 85 (12.6) 116 (11.6)
Monthly income (Rand):
No income 134 (41.7) 300 (44.3) 445 (44.6)
R150–2000 89 (27.7) 248 (36.6) 326 (32.7)
R2001–5000 74 (23.1) 100 (14.8) 174 (17.4)
R5001and above 24 (7.5) 29 (4.3 53 (5.3)
Marital status:
Single 193 (60.3) 444 (65.6) 637 (63.9)
Married 115 (35.9) 185 (27.3) 300 (30.1)
Separated 1 (0.3) 5 (0.7) 6 (0.6)
Divorced 9 (2.8) 13 (1.9) 22 (2.2)
Widowed 2 (0.6) 30 (4.4) 32 (3.2)
Racial group:
Black 313 (97.5) 666 (98.4) 979 (98.1)
Coloured 8 (2.8) 9 (1.3) 17 (1.7)
White 0 (0.0) 2 (0.3) 2 (0.2)
Type of employment:
Government
employee
30 (9.3) 33 (4.9) 63 (6.3)
Non-government
employment
98 (30.5) 133 (19.7) 231 (23.2)
Self-employment 30 (9.3) 32 (4.7) 62 (6.2)
Students 19 (5.9) 80 (11.8) 99 (9.9)
Unemployed 115 (24.2) 361 (53.4) 476 (47.7)
Retired 29 (9.0) 37 (5.5) 66 (6.6)
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4 South African Family Practice 2017; 1(1):1–7
Binge drinking was also found to be higher among those
participants earning between R2000 and R5000. This nding is
similar to those of Keyes and Hasin,28 Cerdá et al.,29 Matheson et
al.,30 Mulia and Karriker-Jae31 and Public Health England.32 The
high prevalence of binge drinking found among low-income
earners has been associated with poverty-inicted economic
deprivation and stress experienced by low-income earners. As
such, alcohol use is seen as an ‘easy way’ out with a tendency to
drink at a hazardous rate.31,33,34 Also, nutritional deciency has
been documented as one of the adverse eects of binge
drinking,35 thus supporting the observed higher rate found
among underweight patients.
Binge drinking was found to be higher among smokers. Smoking
and harmful alcohol use often goes hand-in-hand.36 Thus, the
higher rate of binge drinking found among cigarette smokers is
not surprising.37,38 The relationship between smoking and alcohol
has long been documented.37–39 Alcohol use and smoking have
been reported to be complementary behaviours.39 Several factors
have been identied to be closely associated with this. Such
factors range from physiological to psychological factors.
Repeated use of nicotine, the major component of cigarettes, has
been implicated in stimulating alcohol consumption.40 Also,
nicotine has been shown to reduce the intoxicating eects of
alcohol, which could prompt individuals seeking the intoxicating
eect to drink more.22,41 Since both behaviours are complementary
and the major focus of primary health physicians is often on
smoking, there is an urgent need to integrate screening and
behavioural counselling interventions for both lifestyle habits at
the primary health care facilities in the region. Likewise, prevention
programmes should take cognisance of both behaviours, and
there should be a reconsideration of the long-separated public
health policies relating to tobacco and alcohol use.
The mean frequency of binge drinking among the study
participants was 5.4 episodes (1.0–32.0 episodes) with a
signicant gender dierence. However, the mean intensity of
binge drinking was 13.4 drinks (4.0–56.0 drinks) with no
signicant gender dierence. To the best knowledge of the
authors, no study in South Africa has been conducted on the
frequency and intensity of binge drinking among binge drinkers.
and recommendation of the United States Preventive Services
Task Force27 on screening of patients 18years or older for alcohol
misuse during consultation by primary care physicians, thus
creating opportunity for behavioural counselling interventions.
Table 2: Association between socio-demographic characteristics and
binge drinking
OR = odds ratio; CI = condence interval.
Variables Binge drink Do not binge
drink
p-value
Gender:
Male 77 (24.0) 244 (76.0) < 0.001
Female 73 (10.8) 604 (89.2)
Age (years):
18–25 45 (24.6) 138 (75.4)
26–35 45 (20.2) 178 (79.8)
36–45 24 (13.1) 159 (86.9) < 0.001
46–55 25 (15.0) 142 (85.0)
56–65 8 (5.7) 132 (94.3)
≥ 66 3 (15.0) 99 (85.0)
Level of education:
No formal
schooling
27 (18.5) 119 (81.5)
Grade 1 to 7 14 (9.0) 142 (91.0)
Grade 8 to 12 89 (15.3) 491 (84.7) 0.096
Tertiary 20 (17.2) 96 (82.8)
Marital status:
Never married 122 (19.2) 515 (80.8) < 0.001
Married 28 (7.8) 332 (92.2)
Employment status:
Government
employee
9 (14.3) 54 (85.7)
Non-govern-
ment employee
47 (20.3) 184 (79.7)
Self-employed 9 (14.5) 53 (85.5)
Student 23 (23.2) 76 (76.8) 0.001
Unemployed 60 (12.6) 416 (87.4)
Retired 2 (3.0) 64 (97.0)
Income categories (Rand):
No income 73 (16.4) 372 (83.6)
150–2000 32 (9.8) 294 (90.2)
2001–5000 38 (21.8) 136 (78.2) 0.003
Above 5000 7 (13.2) 46 (86.8)
Body mass index categories:
Underweight 9 (25.0) 27 (75.0)
Normal 55 (20.3) 216 (79.7)
Overweight 44 (18.3) 196 (81.7) <0.001
Obese 42 (9.3) 409 (90.7)
Current smoker:
Yes 66 (44.0) 84 (56.0) < 0.001
No 84 (9.9) 764 (90.1)
Table 3: Multivariate logistic regression showing predictors of binge
drinking
Variables βWald Adjusted odds
ratio (95% CI)
p-value
Age (years):
≤ 25 1.2 12.4 3.4 (1.7–6.8) < 0.001
25 and above
(reference)
Gender:
Male 0.8 7.5 2.3 (1.3–4.1) 0.006
Female (reference)
Smoking:
Yes 1.9 37.8 6.5 (3.5–11.9) < 0.001
No (reference)
Income (Rand):
Less than 3000 0.4 2.2 1.5 (0.9–2.7) 0.136
3000 and above
(reference)
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Adult binge drinking: rate, frequency and intensity in Bualo City Metropolitan Municipality, South Africa 5
signicant gender variation was found for intensity of binge
drinking. This is disturbing, as females who binge drink do so at
almost the same rate as their male counterparts. This further
corroborates the documented increasing hazardous drinking
rate among South African women.7 Women are more vulnerable
to many adverse consequences of alcohol use than men. Also,
women have a greater likelihood of developing organ damage
and trauma related to alcohol than men.42 With the current
ongoing increase in hazardous drinking among women, there is
a need for prompt interventions to reduce this adverse behaviour
among South African women. Participants aged 36 to 45years
and those who currently smoke had a higher intensity of binge
drinking. This nding among current smokers is expected.
Nicotine is believed to reduce the intoxicating eects of alcohol,
which will likely prompt individuals seeking this eect to drink
more.22,41 Finally, middle-aged individuals are likely to have more
disposable income, which improves their purchasing power and
enables them to increase their intensity of binge drinking.
As such, the nding concerning the frequency and intensity of
binge drinking in our sample could only be compared with
studies elsewhere. The frequency and intensity of binge drinking
in this present study is higher than the reported frequency and
intensity among US adults, with 4.1 episodes and 7.7 drinks,
respectively.9 This nding substantiates the documented
hazardous pattern of drinking reported among South Africans.7
Considering the detrimental eect of high frequency and
intensity of binge drinking on health-related quality of life, there
is a need to intensify eorts to reduce this unhealthy lifestyle
behaviour among adults in Bualo City Metropole. Health
education of patients attending healthcare facilities on these
harmful behaviours should also be prioritised in the district.
Additionally, male participants had a higher frequency of binge
drinking. Harmful alcohol use has been reported to be higher
among this group23 and, as such, the higher frequency of binge
drinking found among them is not surprising. However, no
Table 4: Distribution of mean frequency of binge drinking by socio-
demographic variables using ANOVA
Variables nMean SD p-value
Age (years):
18–25 45 4.8 4.5
26–35 45 5.6 4.9
36–45 24 6.8 2.5
46–55 25 4.6 4.0 0.393
56–65 8 6.2 2.9
Above 65 3 4.7 0.6
Sex:
Male 77 6.4 5.2 0.002
Female 73 4.3 2.4
Level of education:
No formal schooling 27 4.6 1.2
Grade 1–7 14 5.5 3.6
Grade 8–12 89 5.9 4.9 0.226
Tertiary 20 4.0 3.0
Marital status:
Never married 122 5.4 4.3 0.893
Ever married 27 5.5 4.0
Smoker:
Yes 66 5.9 4.7 0.154
No 84 4.9 3.7
Income categories (Rand):
No income 73 5.3 5.3
150–2000 32 4.9 2.7
2001–5000 38 5.5 3.0 0.658
Above 5000 7 7.1 2.6
Employment status:
Government 9 6.1 2.5
Non-government 47 5.7 2.7
Self-employed 9 7.8 9.7 0.427
Student 23 4.9 4.3
Unemployed 60 4.8 4.0
Retired 3 6.5 2.1
Table 5: Distribution of mean intensity of binge drinking across socio-
demographic variables using ANOVA
Variable nMean SD p-value
Age (years):
18–25 45 11.9 7.7
26–35 45 15.7 12.5
36–45 24 16.0 9.2 0.042
46–55 25 10.0 6.0
56–65 8 15.8 8.2
Above 65 3 4.7 0.6
Gender:
Male 77 13.8 8.8 0.653
Female 73 13.1 10.5
Level of education:
No formal schooling 27 11.5 10.0
Grade 1–7 14 11.6 5.4
Grade 8–12 89 14.2 10.3 0.539
Tertiary 20 13.6 8.2
Marital status:
Never Married 122 14.2 10.0 0.893
Ever married 27 9.9 7.1
Smoker:
Yes 66 13.9 10.8 0.037
No 84 13.0 8.6
Income categories (Rand):
No income 73 12.6 10.2
150–2000 32 12.7 10.0
2001–5000 38 15.1 8.6 0.493
Above 5000 7 16.1 9.0
Employment status:
Government 9 13.4 8.1
Non-government 47 13.5 7.6
Self-employed 9 18.1 15.0 0.741
Student 23 14.0 8.5
Unemployed 60 12.5 10.8
Retired 3 13.0 9.9
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6 South African Family Practice 2017; 1(1):1–7
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South Africa. S Afr Med J. 2016;106:551–3. https://doi.org/10.7196/
SAMJ.2016.v106i6.10944
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South Africa: ndings from a national population-based survey. Afr J
Psych. 2011;14:30–7.
19. Kanny D, Liu Y, Brewer RD, et al. Vital signs: Binge drinking prevalence,
frequency, and intensity among adults — United States, 2010. Morb
Mortal Weekly Rep. 2013;61: 14–9.
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Predictors, consequences, and changes in the U.S. Am J Prev Med.
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org/10.1016/j.drugalcdep.2015.08.023
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gender convergence in alcohol use over the past three decades
(1984–2008), the HUNT study, Norway. BMC Public Health. 2016;16:
723–9. https://doi.org/10.1186/s12889-016-3384-3
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level factors on men’s and women’s alcohol consumption and alcohol
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44462008000300010
Strength and limitations
Although a standardised procedure and questionnaire was
utilised in this study, the limitations of this study cannot be
ignored. The study was conducted in the health facilities, and
utilised a cross-sectional design and self-reporting of lifestyle
behaviours. The convenience sampling used in this study might
have introduced some bias, thus the rate reported cannot be
generalised to the entire BCMM population. Also, it is possible
that sampling patients from 18years of age might have led to
under-reporting of the prevalence of binge drinking in the
setting as binge drinking has been reported to be higher among
adolescents and young adults. However, given the scarcity of
information about the frequency and intensity of binge drinking
in the Eastern Cape Province of South Africa, the study provides
a snapshot of the magnitude of this particular lifestyle behaviour,
which is a public health concern in South Africa. Anecdotal
evidence has linked high binge drinking with morbidity and
mortality in South Africa, including the Eastern Cape. The
relatively large sample size of the study gave credence to the
ndings of this study. In addition, this study provided useful
epidemiological data on binge drinking, the ndings of which
could assist district health managers in crafting eective
interventions at the primary health care level across the district
to help individuals reduce their level of alcohol consumption to
the barest minimum for better healthy living.
Conclusion
There is an alarmingly high prevalence of binge drinking among
the study participants, and those who binge drink tend to do so
frequently and at a high intensity. Also, increasing harmful
alcohol use was found among the women. There is a need for
multilevel interventions to target high-risk drinkers and to create
awareness in the general population on the problems associated
with hazardous drinking. Finally, primary health care practitioners
and district health managers should prioritise awareness
creation, screening and implementation of prevention strategies
for harmful alcohol use, particularly among young adults.
Acknowledgements – The authors are grateful to the National
Research Foundation and the Health and Welfare Sector
Education and Training Authority, South Africa for funding the
study. They also acknowledge all the patients who took the time
to participate in this study.
Conicts of interest – The authors declare that they have no
conicts of interest.
ORCID
Oladele Vincent Adeniyi http://orcid.org/0000-0003-0216-
6701
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... However, the effect size of current smoking on binge drinking is contradictory in previous studies. While some studies have estimated the strength of the association between binge drinking and current smokers to be modest, other studies have estimated a 5-14 times higher chance of binge drinking among current smokers compared to non-smokers in the adult population (9)(10)(11)(12)(13). ...
... South Africa (11). The summary of included studies, the odds ratios and 95% confidence intervals for crude and adjusted estimates, and description confounders are presented in Tables 1, 2. Table 1 summarizes the study characteristics of the included studies. ...
... In one of the studies, the association was reported for six Asian-American subpopulations, separately (Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese) (13). Five studies reported the association in all subjects without separating by gender (11,13,(20)(21)(22), two studies reported association separately for male, female, and total subjects (5, 10), one study reported association separately for male and female subjects without reporting for total sample (9), finally one study was female only (12). ...
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Background The substantial increasing trend of binge drinking is a global alarm. Our aim was to undertake a systematic review and meta-analysis of cross-sectional studies to explore the association of current smoking with binge drinking among adults. Methods We systematically searched Web of Knowledge; PubMed; Scopus; Embase and Ovid (MEDLINE, EMBASE, PsycARTICLES, PsycINFO, PsycEXTRA, and PsycTests) (from inception to 27 May 2020) databases to identify cross-sectional studies of the association between current smoking and binge drinking. Study screening, data extraction, and methodological quality assessment were all carried out by two independent authors. Adjusted odds ratio (AOR) was pooled with 95% confidence intervals (CI) using random effects model in the meta-analysis, followed by the investigation of the heterogeneity via Q -test and I ² statistic. We assessed publication bias using a funnel plot, the Egger’s, and Begg’s tests. Results We identified 3,171 studies and included nine cross-sectional studies with 64,516 participants. A significant association was found between current smoking and binge drinking among both genders (AOR = 2.97; 95% CI = 1.98 to 4.45; I ² = 90.5%). Subgroup analysis showed that this association among women, men, Caucasians, and Asians/Africans were (AOR = 3.68; 95% CI = 1.03 to 13.18; I ² = 98.9%), (AOR = 2.53; 95% CI = 1.87 to 3.42; I ² = 73.1%), (AOR = 1.36; 95% CI: 1.01–1.83, I ² = 47.4%), and (AOR = 3.93; 95% CI: 2.99–5.17, I ² = 61.3%), respectively. There was no evidence of publication bias. Conclusion Current smoking is associated with binge drinking and can be used for identifying and screening binge drinkers. Moreover, this association is stronger among men, and Asians/Africans. This meta-analysis estimation was limited to English-language studies, and the full text of about 3.5% of reports for retrieval was not found, then generalization of the results should be done with caution.
... This evidence further affirms the fact that health workers, including the nurses also participate in unhealthy lifestyle behaviours such as harmful alcohol use, and nurses in this settings are not exempted. Their rate of alcohol consumption is slightly lower than the reported prevalence (32%) among the general population in the same setting (Owolabi et al., 2017d). Considering the important role of nurses, particularly the primary healthcare professional nurses, in the advocacy for healthy lifestyle behaviors, alcohol use among them might impede this role. ...
... Male nurses had a higher prevalence of lifetime alcohol use. This is not surprising as similar findings have been documented among other populations (Owolabi et al., 2017d;Reddy et al., 2010). Alcohol use appears more socially acceptable among men compared to women (Bratberg, 2016). ...
... Also, as observed in this study, the use of alcohol decreases with advancing age. This is similar to other studies (Owolabi et al., 2017d;Reddy et al., 2010). As age advances, maturity and more responsibilities sets in. ...
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Nurses play significant roles in health promotion and health education about healthy lifestyle practices and are considered role models of healthy lifestyle behaviours. It is unclear if their knowledge of healthy lifestyle choices translate to practice. This study assessed the lifestyle behaviours of primary healthcare professional nurses in the Eastern Cape Province, South Africa. This descriptive, cross-sectional study involved 203 purposively selected primary healthcare nurses in Eastern Cape Province, South Africa. We utilised the WHO STEPwise questionnaire to assess the lifestyle behaviour (smoking, alcohol use and physical activity) of the nurses. Descriptive and inferential statistics were carried out at a significance level of p<0.05. The participants’ mean age was 45.17 (Standard Deviation±11.26) years. Of all the participants, 27% had ever taken alcohol, and 18% currently use alcohol. Only 8% had ever smoked and of these, 3% currently smoke. Of all the participants, 33% do not engage in physical activities, and only 29% of them met the WHO recommendation for being active. Most of them were aware of the benefits of physical activities. Majority of the participants cited lack of time (74%) and lack of commitment (63%) as barriers to physical activity and few of them cited health challenges (3.9%). Among the primary health care professional nurses in this setting, we found a high prevalence of alcohol use and low prevalence of smoking and physical activity among primary health care nurses in this setting. There is a need to implement effective workplace strategies and wellness programmes that will foster healthy lifestyle practices among the nurses.
... Some socioeconomic or demographic factors (such as gender, age, family type, religion, educational and employment status) had also been found as playing a mediating role in alcoholic beverages abuse among youngsters. Studies (Eze, Njoku & Eseadi, 2017;Owolabi, Goon, Adeniyi & Seekoe, 2017;Lasebikan, Ayinde, Odunleye, Adeyefa, Adepoju & Fakunle, 2018) revealed the influence of gender and age difference in alcoholic beverages abuse. Other scholars (Salaudeen, Musa, Akande & Bolarinwa, 2011;Gray, 2018;Evereth, 2019) have found an association between alcohol abuse and dysfunctional family, media influence of alcohol use and protective role of religion on alcohol use. ...
... This means that male and female hospitality firms' employees have similar view of implications of abuse of alcoholic beverages but they were different in regards to religion and educational attainment. This finding is in contrast with the finding of past related studies (Eze, Njoku & Eseadi, 2017;Owolabi, Goon, Adeniyi & Seekoe, 2017) which revealed that there is gender influence in alcohol abuse among the youth. On the other hand, religion and educational influences were found from the findings of Collins (2016) and Katikireddi, Whitley, Lewsey, Gray and Leyland (2017) as influences on the alcohol-related consequences. ...
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Studies on alcoholic beverages are numerous but few have investigated from the viewpoints of hospitality firms' employees, particularly in Nigeria. Thus, the focus of this study on the causes and implications of abuse of alcoholic beverages among youth: perception of hospitality firms' employees in Kwara State, Nigeria. Using a descriptive survey design, 400 participants were purposely selected. A self-designed, valid and reliable (with a coefficient of .85) instruments were administered to the respondents. At the end of the questionnaire administration process, 365 copies were retrieved; while 285 were valid for data analysis. The data was later subjected to descriptive and inferential statistics. Peer influence, to become more confident, to relax (loosen up) better were the topmost ranked causes of the abuse of alcoholic beverages; and highly ranked implications are an increase in act of criminality/display of violent behaviour in the community, rapid ageing (looking older than their age) and absenteeism from school or work. Furthermore, the 3-way ANOVA results indicate that no significant difference exists in the perception of hospitality firms' employees on the causes of abuse of alcoholic beverages among youth based on gender and educational attainment; while there was a significant difference based on religion. Relevant recommendations were made based on the above findings.
... Various other reasons have been purported to contribute to harmful alcohol use among this age group, and these include peer pressure, academic-related stress and workload and unhealthy competitions among peers [21,36,37]. Pertaining to the frequency of alcohol use, gender play a significant role and males are more likely to engage in binge drinking more frequently than their female counterparts [38]. There is a fairly substantial evidence base for justifying the implementation of prompt and effective measures for curtailing harmful alcohol use among university students in Nigeria. ...
... As already known, alcohol users do not only constitute a threat to themselves but also their families, society and their immediate environment. Also, alcohol use among university students is usually associated with poor academic performance, mental and psychological disorders, self-harm and injuries with several other health risks, even though our study did not confirm this [22][23][24][25]38]. ...
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Background: Globally, alcohol use is responsible for 320 deaths every hour, and the impact is more among those in the younger age group. Despite the adverse health and social challenges associated with alcohol use, alcohol remains the most used and abused psychoactive substance among young adults. Our study aimed at determining the prevalence, correlates and frequency of alcohol use among young adults in two Nigerian universities. We further explored the role of family structure, family support and religion/religiosity on alcohol use in this study setting. Such findings could help to inform public health policy formulation in the country. Methods: This was a cross-sectional study conducted in two selected universities in the North Central region of Nigeria. The study was conducted among a final sample of 784 students selected using stratified random sampling. An interviewer-administered questionnaire was used to collect data on ever and current alcohol use and frequency of alcohol use between February and April 2018. The data were analysed using descriptive and inferential statistics. Results: The level of ever and current use of alcohol was 43.5 and 31.1%, respectively. The mean frequency of alcohol use among the study participants was three days, but ten days among current alcohol users. In the adjusted model, male sex, age above 19 years, infrequent attendance of religious rituals, and belonging to rich/middle-class family were significantly associated with a higher likelihood of ever use and current use of alcohol, while living in the same household as one's father was associated with lower odds of current and ever use of alcohol. Conclusion: There is a high rate of lifetime and current use of alcohol among university students in the study setting. Alcohol use was significantly associated with living with parents, religion and religiosity. Both high and low socioeconomic status were associated with alcohol use. There is a need to implement measures in controlling alcohol manufacturing and marketing as well as policies regulating alcohol outlets establishment around educational institutions as well as the working hours in such outlets. Finally, there is a need to organise interventions aimed at reducing this unhealthy social norm among students in this setting.
... In addition, SSA faces a growing burden of harmful alcohol consumption [9]. According to the World Health Organization (WHO), SSA is characterized by binge drinking or episodic excessive drinking [10,11]. The prevalence of binge drinking among current drinkers in SSA is one of the highest in the world, at over 60% [5]. ...
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Background The burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in the African context. This study aimed to determine the sociodemographic factors associated with daily tobacco smoking and binge drinking in Zambia. Methods The study stems from nationwide population-based representative survey data collected using the World Health Organization’s STEPwise approach for non-communicable disease risk factor surveillance in 2017 among 18–69-year-old Zambians. The main outcomes were daily tobacco smoking and binge drinking, and the demographic and socioeconomic variables included sex, marital status, age, residence, level of education and occupation. Prevalence ratios (PR) were calculated using log-binomial regression analysis. Results Overall, 4302 individuals (weighted percentage 49.0% men and 51.0% women) participated in the survey. The prevalence of daily tobacco smoking was 9.0%, and 11.6% of participants engaged in binge drinking, both of which were higher among men than women (17.1% vs. 1.3% and 18.6% vs. 5.3%, respectively). The adjusted prevalence of daily tobacco smoking was 14.3 (95% CI: 9.74-21.01) times higher in men than women, and 1.44 (95% CI 1.03-1.99) times higher in the > 45-year-old group compared to the 18–29-year-old group. Significant positive associations with daily tobacco smoking were found among those with no education 2.70 (95% CI 1.79- 4.07) or primary education 1.86 (95% CI 1.22-2.83) compared to those with senior secondary or tertiary education. The adjusted prevalence of daily tobacco smoking was 0.37 times lower (95% CI 0.16-0.86) among students and homemakers compared to employed participants. The adjusted prevalence of binge drinking was 3.67 times higher (95% CI 2.83-4.76) in men than in women. Significantly lower adjusted prevalences of binge drinking were found in rural residents 0.59 (95% CI: 0.46-0.77) compared to urban residents and in students/homemakers 0.58 (95% CI: 0.35-0.94) compared to employed participants. Conclusion This study shows huge differences between men and women regarding tobacco smoking and binge drinking in Zambia. A high occurrence of tobacco smoking was observed among men, older members of society and those with lower levels of education, while binge drinking was more common in men and in those living in urban areas. There is a need to reshape and refine preventive and control interventions for tobacco smoking and binge drinking to target the most at-risk groups in the country.
... Also, victims of sexual violence may turn to alcohol to cope with the trauma of the incident [45]. Studies have shown that alcohol use and abuse is common among young people in South Africa [48,49]. Thus, the high prevalence of sexual violence could somewhat be attributed to the abuse of alcohol. ...
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Background Epidemiological data on the prevalence and factors associated with sexual violence is critical to understanding the magnitude of the problem and designing effective interventions. Drawing from cross-sectional data from a South African university, we examined the prevalence and correlates of sexual violence among adolescent girls and young women (AGYW). Methods We analysed data of 451 AGYW selected using stratified sampling. Sexual violence was defined as any sexual acts, and attempt to obtain sexual acts without consent. We used adjusted and unadjusted logistic regression models to examine the factors associated with exposure to sexual violence while controlling for relevant covariates. Results The lifetime and past-year prevalence of sexual violence was 37.9% and 25.3%, respectively. A higher prevalence of sexual violence was reported by heavy episodic drinkers of alcohol (lifetime 48.4% and past year 34.0%), those who received insufficient financial support (lifetime 58.0% and past year 35.8%) compared to non-users of alcohol (lifetime 27.2% and past year 17.2%),) and those who received adequate financial support (lifetime 20.8% and past year 13.1%). AGYW who reported heavy episodic use of alcohol had higher odds of reporting lifetime (AOR: 1.86; 95% CI: 1.07–3.25) and past year (AOR: 2.03; 95% CI: 1.10–3.75) experience of sexual violence compared to non-users. However, individuals who received adequate family financial support were 76% and 65% less likely to report lifetime and past year experience of sexual violence than those who received inadequate family financial support. Also, AGYW who rated themselves as very religious were 80% and 75% less likely to report lifetime and past year experience of sexual violence compared to those who were not religious. Conclusion Our study shows that sexual violence affects a large proportion of girls, requiring intervention that not only focuses on increasing social support for survivors, facilitating reporting, and ensuring perpetrators are convicted, but also target alcohol use reduction and poverty alleviation.
... Harmful alcohol consumption can take the form of high total levels of drinking or binge drinking (episodic excessive drinking), each with its own pattern of determinants and different health consequences [13]. According to the World Health Organization (WHO), SSA is characterized by binge drinking, which signi cantly contributes to poor health-related quality of life in the region [5,14,15]. The prevalence of binge drinking in SSA is among the highest in the world, at over 60% of current drinkers [5]. ...
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Background: The burden of disease attributable to tobacco smoking and harmful alcohol consumption poses a major threat to sustainable development in most low- and middle-income countries. However, evidence on tobacco use and harmful alcohol consumption to inform context-specific interventions addressing these harmful social behaviours is limited in the African context. This study aimed to determine the social risk factors associated with daily tobacco smoking and binge drinking in Zambia. Methods: The study stems from nationwide population-based representative survey data collected using the World Health Organization’s STEPwise approach for non-communicable disease risk factor surveillance in 2017 among 18–69-year-old Zambians. The main outcomes were daily tobacco smoking and binge drinking, and the demographic and socioeconomic variables included sex, marital status, age, residence, level of education and occupation. Prevalence ratios were calculated using log-binomial regression analysis. Results: Overall, 4302 individuals (weighted percentage 49.0% men and 51.0% women) participated in the survey. The prevalence of daily tobacco smoking was 9.04%, and 11.6% of participants engaged in binge drinking, both of which were higher among men than women (17.1% vs. 1.28% and 18.6% vs. 5.29%, respectively). The risk of daily tobacco smoking was significantly higher in men (PR 14.3; 95% CI [9.74, 21.0]) than women, in the >45-year-old group (PR 1.44; 95% CI [1.03, 1.99]) compared to the 18–29-year-old group, and in those with no education (PR 2.70; 95% CI [1.79, 2.99]) or primary education (PR 1.86; 95% CI [1.22, 2.83]) compared to those with higher secondary or tertiary education. The risk of binge drinking was 3.67 times higher (95% CI [2.83, 4.76]) in men than in women. Significantly lower levels of binge drinking were observed among rural residents (PR 0.59; 95% CI [0.46, 0.77]) compared to urban residents and students/homemakers (PR 0.58; 95% CI [0.35, 0.94]) compared to the employed. Conclusion: This study shows huge differences between men and women regarding tobacco smoking and binge drinking in Zambia. A high occurrence of tobacco smoking was observed among men, older members of society and those with lower levels of education, while binge drinking was more common in men and in those living in urban areas. There is a need to reshape and refine preventive and control interventions for tobacco smoking and binge drinking to target the most at-risk groups in the country.
... Also, victims of sexual violence may turn to alcohol to cope with the trauma of the incident [44]. Studies have shown that alcohol use and abuse is common among young people in South Africa [47,48]. Thus, the high prevalence of sexual violence could somewhat be attributed to the abuse of alcohol. ...
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Background: There is a window of opportunity to address the menace of sexual violence in South Africa, given the formation of the ministerial task team commissioned by the president in 2019 following the brutal rape and murder of a female university student in Cape Town. Epidemiological data on the prevalence and factors associated with sexual violence is critical to understanding the magnitude of the problem and designing interventions towards reversing the trend of sexual violence in the country. Drawing from cross-sectional data from a South Africa university, we examined the prevalence and correlates of sexual violence among adolescent girls and young women (AGYW). Methods: We analysed data of 451 AGYW selected using stratified sampling. Sexual violence was defined as any sexual acts, and attempt to obtain a sexual act without consent. We used adjusted and unadjusted logistic regression models to examine the factors associated with exposure to sexual violence while controlling for relevant covariates. Results: The lifetime and past year prevalence of sexual violence was 37.9% and 25.3%, respectively. A higher prevalence of sexual violence was reported by heavy episodic drinkers of alcohol (lifetime 48.4% and past year 34.0%), those who received insufficient financial support (lifetime 58.0% and past year 35.8%) compared to non-users of alcohol and those who received adequate financial support. AGYW who reported heavy episodic use of alcohol were twice more likely to report experiencing sexual violence compared to non-users. However, individuals who received adequate family support were 76% and 65% less likely to report lifetime and past year experience of sexual violence compared to those who received inadequate family support. Also, AGYW who rated themselves as very religious were 80% and 75% less likely to report lifetime and past year experience of sexual violence compared to those who were not religious. Conclusion: Our study shows that sexual violence affects a large proportion of girls, requiring intervention that not only focuses on increasing social support for survivors, facilitating reporting, and ensuring justice is served, but also target alcohol use reduction and poverty alleviation.
... Also, it appears that people believe that they can not use their medication as well as take alcohol making them to sometimes forgo ART in order to take alcohol [25,26]. Young people are more likely to use alcohol compared to adults [27], and this may explain why adherence is poor among young women compared to older adults. Screening for alcohol use may help to identify mothers with adherence challenges who might require adherence counselling during postnatal care and child immunisation. ...
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Background Adherence to antiretroviral therapy (ART), especially during the postpartum period, remains a major challenge in the efforts towards eliminating mother-to-child transmission of HIV. This study examined the levels and determinants of postpartum adherence to ART among mothers with HIV in the Eastern Cape, South Africa. Methods In this cross-sectional analytical study, we interviewed 495 postpartum women with HIV between January and May 2018. We measured postpartum adherence using six questions probing participants’ adherence behaviours since child birth. We categorised the adherence behaviours into complete adherence (mothers who reported no missed episode(s) of ART since child birth) and suboptimal adherence (mothers with any missed episode(s) of ART). Adjusted and unadjusted logistic regression models were used to examine the determinants of postpartum adherence to ART. Results Overall, 63.9% reported complete adherence during the postpartum period but the rates varied by socio-demographic and behavioural characteristics. The adjusted logistic regression analysis showed that younger mothers were 70% less likely to report complete adherence to ART compared to mothers aged 40 and above. Likewise, mothers who currently use alcohol were 53% less likely to report complete postpartum adherence to ART compared to those who did not use alcohol. However, mothers who knew their partner’s status were twice more likely to report complete postpartum adherence compared to those who did not. There was no statistically significant relationship between ART adherence and breastfeeding durations. Conclusion Postpartum adherence to ART is suboptimal in the study setting, and younger mothers and those who use alcohol have a lower odds of complete adherence. Knowing a partner’s status improves adherence, but infant feeding practices did not influence postpartum adherence behaviours. It is critical to design and strengthen interventions which target young mothers and alcohol users. Also, HIV sero-status disclosure should be encouraged among mothers to facilitate partner support.
... Commercial taxi drivers in this setting does not just drink, they binge drank. Generally in this setting, a high prevalence of binge drinking has been reported (Owolabi, et al., 2017a). The high prevalence of binge drinking among commercial drivers is unsurprising and a concern, given the fact that drinking while driving is associated with injuries and deaths related to road traffic accidents. ...
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BACKGROUND: Commercial drivers have been identified as eliciting behaviours that promote non- communicable diseases and road traffic accidents. The aim of the study is to determine the prevalence and pattern of alcohol use, smoking and physical inactivity among commercial taxi drivers in Buffalo City Metropolitan Municipality, South Africa. METHODS: A cross-sectional study was conducted among 403 commercial drivers using the face-to-face interviews method. The WHO STEPwise questionnaire was used to obtain the demographic data, self-reported rate of alcohol consumption, tobacco use and physical inactivity. RESULTS: The participants’ mean age was 43.3 ± 12.5 years. About 30% of the participants were daily smokers, 37% consumed alcohol regularly and only 18% were physically active, whilst 82% were physically inactive. CONCLUSION: The prevalence of alcohol use, smoking and physical inactivity is high among commercial drivers in East London. Workplace health education on the health effects of these lifestyles’ risky behaviours on individuals and the general public should be given to the drivers.
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Aim: Tobacco use increases the risk of cardiovascular disease, premature death and certain cancers. This study investigated the prevalence and determinants of tobacco use among adults in Buffalo City Metropolitan Municipality (BCMM), South Africa. Methods: This study forms part of the cardio-metabolic risk survey carried out at the three largest outpatient clinics in BCMM. This multi-centre cross-sectional survey utilised the relevant items of the WHO STEPwise questionnaire to obtain information on demographic and behavioural characteristics of 1 107 participants. A total of 109 participants were excluded as a result of incomplete data. Thus, 998 participants (male = 327; female = 671) were included in the analysis. Self-reported, current use of any tobacco product was defined as tobacco use while secondary smoking was defined as exposure of non-smokers to environmental tobacco smoke, either at home or in the workplace. Results: Of all the study participants, 150 (15%) were current tobacco users and 335 (39.5%) of the non-smoking participants were exposed to secondary smoking. The majority of the tobacco users were males (70.7%) compared with females (29.3%). The commonest form of tobacco use was the manufactured cigarette. The mean age at initiation of smoking was 18.3 ± 5.1 and 22.6 ± 8.0 years for men and women, respectively. Only male sex (p = 0.000), single status (p = 0.003), no formal education (p = 0.007) and self-employment (p = 0.043) were significantly associated with tobacco use. Conclusion: High prevalence of tobacco use, especially cigarette smoking, in BCMM is worrisome given its strong association with cardiovascular events and cancers. The district health authorities should prioritise smoking cessation measures at the primary health care level.
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Objectives This study examined hypertension prevalence, awareness, treatment and control and their determinants among adults attending health facilities in Buffalo City Metropolitan Municipality (BCMM) in the Eastern Cape. Design A cross-sectional analytical study. Settings The three largest outpatient clinics in BCMM. Participants Ambulatory adults (aged 18 years and over) attending the study settings during the study period (n=998). Primary outcome measure The prevalence of hypertension (systolic blood pressure (BP) of ≥140 mm Hg and/or a diastolic BP of ≥90 mm Hg or current medication for hypertension), the awareness of it (prior diagnosis of it) and its treatment and control (Eighth Joint National Committee Criteria of BP <140/90/90 mm Hg). Secondary outcome measure Associated factors of hypertension, hypertension unawareness and uncontrolled hypertension. Results Of the 998 participants included, the prevalence of hypertension was 49.2%. Hypertension unawareness was reported by 152 participants (23.1%) with significant gender difference (p=0.005). Male sex, age <45 years, higher level of education, single status, current employment, higher monthly income, current smoking, alcohol usage, absence of diabetes and non-obese were significantly associated (p<0.05) with hypertension unawareness. Of the participants who were aware of having hypertension (n=339), nearly all (91.7%, n=311) were on antihypertensive medication and only 121 participants (38.9%) achieved the BP treatment target. In the multivariate logistic regression model analysis, ageing (95% CI 1.9 to 4.4), being married (95% CI 1.0 to 2.0), male sex (95% CI 1.2 to 2.3), concomitant diabetes (95% CI 1.9 to 3.9), lower monthly income (95% CI 1.2 to 2.2), being unemployed (95% CI 1.0 to 1.9) and central obesity (95% CI 1.5 to 2.8) were the significant and independent determinants of prevalent hypertension. Conclusion The prevalence and awareness of hypertension was high in the study population. In addition, the suboptimal control of BP among treated individuals, as well as the significant cardiovascular risk factors, warrant the attention of health authorities of BCMM and the country.
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Background To examine changes in men‘s and women’s drinking in Norway over a 20-year period, in order to learn whether such changes have led to gender convergence in alcohol drinking. Methods Repeated cross-sectional studies (in 1984–86, 1995–97, and 2006–08) of a large general population living in a geographically defined area (county) in Norway. Information about alcohol drinking is based on self-report questionnaires. Not all measures were assessed in all three surveys. ResultsAdult alcohol drinking patterns have changed markedly over a 20-year period. Abstaining has become rarer while consumption and rates of recent drinking and problematic drinking have increased. Most changes were in the same direction for men and women, but women have moved towards men’s drinking patterns in abstaining, recent drinking, problematic drinking and consumption. Intoxication (among recent drinkers) has decreased in both genders, but more in men than in women. The declines in gender differences, however, were age-specific and varied depending on which drinking behavior and which beverage was taken into account. Conclusions There has been a gender convergence in most drinking behaviours, including lifetime history of problem drinking, over the past 2–3 decades in this Norwegian general population, but the reasons for this convergence appear to be complex.
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Sensation seeking is a personality trail which person willing to gain new experiences; the main aim of this study was to determine the role of sensation seeking on cigarette smoking and alcohol drinking among male students in Kermanshah University of Medical Sciences. This cross-sectional study was conducted among 300 male medical college students, during 2014 in Kermanshah University of Medical Sciences which were randomly selected with the proportional to size among different faculty. A standard self-report questionnaire was applied for collecting data and data were analyzed by SPSS-21 using t-test, one way ANOVA and bivariate correlations statistical tests at 95% significant level. Cigarette smoking and alcohol drinking during 1, 3 and 6 months before the study was reported 10.4, 11.5 and 13.5% (for smoking) and 5.4, 6.2 and 5.5% (for alcohol drinking) by respondents. There was a significant correlation between sensation seeking with cigarette smoking and alcohol drinking (p<0.05). Based on the result, it seems that designing and implementation of intervention programs to reduce negative sensation seeking among the young adults may be useful of the results in order to prevent of substance abuse.
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Aims: To review the contemporary evidence reflecting male/female differences in alcohol use and its consequences along with the biological (sex-related) and psycho-socio-cultural (gender-related) factors associated with those differences. Methods: MEDLINE, PubMed, Web of Science, SCOPUS, PsycINFO, and CINAHL databases were searched for relevant publications, which were subsequently screened for the presence/absence of pre-specified criteria for high quality evidence. Results: Compared to men, more women are lifetime abstainers, drink less, and are less likely to engage in problem drinking, develop alcohol-related disorders or alcohol withdrawal symptoms. However, women drinking excessively develop more medical problems. Biological (sex-related) factors, including differences in alcohol pharmacokinetics as well as its effect on brain function and the levels of sex hormones may contribute to some of those differences. In addition, differences in alcohol effects on behavior may also be driven by psycho-socio-cultural (gender-related) factors. This is evident by variation in the magnitude of differences in alcohol use between countries, decreasing difference in the rates of alcohol consumption in recent generations and other findings. Evidence indicates that both sex and gender-related factors are interacting with alcohol use in complex manner, which differentially impacts the risk for development of the behavioral or medical problems and alcohol use disorders in men and women. Conclusions: Discovery of the mechanisms underlying biological (sex-related) as well as psycho-socio-cultural (gender-related) differences in alcohol use and related disorders is needed for development of personalized recommendations for prevention and treatment of alcohol use disorders and related problems in men and women.
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In the past decade, a sense of urgency has started to pervade alcohol regulation in South Africa. The burden of alcohol-related mortality and morbidity is among the highest in the world, and its effects are made worse by persistent socio-economic and structural inequalities. Moreover, alcohol is also a principle risk factor for infectious and chronic diseases, as well as a tenacious barrier to the achievement of the Millennium Development Goals. Its consumption and negative externalities have therefore become a public health and development crisis. This is despite alcohol's significant contribution to the South African national economy and individual livelihoods signalling an entrenched site of tension in alcohol regulation. However, while liquor has indubitably pernicious consequences, it does also provide a critical vantage point to further geographical engagements with the South African city and contemporary development debates. In so doing, the novel empirical and conceptual agendas set out in the papers also contribute to a broader engagement with the cultural contexts, meanings and settings of drinking practices in rapidly changing urban spaces of the Global South.
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Background Bars and nightclubs are key public venues where young adults congregate and use both tobacco and alcohol, and young adult bar patrons are at high risk for substance use. This study examined the association between cigarette smoking and alcohol use among a random sample of young adult bar patrons from three different cities in the USA. Methods Cross-sectional data was collected from a random sample of young adult bar patrons aged 18–29 in San Diego, CA (N = 1,150), Portland, ME (N = 1,019), and Tulsa, OK (N = 1,106) from 2007–2010 (response rate 88%) using randomized time location sampling. Respondents reported the number of days they smoked cigarettes, drank alcohol, and binge drank in the past 30 days. Multinomial logistic regression was used to analyze the association between smoking (nonsmoker, occasional smoker, and regular smoker) and drinking and binge drinking for each city controlling for age, gender, race/ethnicity, and education. Predicted probabilities of each smoking category were calculated by drinking and binge drinking status. The association between smoking and drinking and binge drinking among combined samples was also analyzed, controlling for demographic variables and city. Results Respondents reported high current smoking rates, ranging from 51% in Portland to 58% in Tulsa. Respondents in Tulsa were more likely to report regular smoking than those in San Diego and Portland, with demographic variables being controlled. Young adult bar patrons also exhibited a strong association between smoking and drinking. In general, as the frequency of drinking and binge drinking increased, the predicted probability of being a smoker, especially a regular smoker, increased in each city. Conclusions Young adult bar patrons consistently reported a high smoking rate and a strong relationship between smoking and drinking, regardless of the different bar cultures and tobacco control contexts in each of the three cities. While smoke-free bar policies were negatively associated with regular smoking, these policies alone may not be enough to influence the association between smoking and drinking, particularly if tobacco marketing continues in these venues, or in the absence of programs specifically addressing the co-use of tobacco and alcohol.
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Introduction Binge drinking, five or more drinks on an occasion for men and four or more for women, marks risky alcohol use. However, this dichotomous variable removes information about higher, more dangerous consumption. This paper examines predictors, consequences, and changes over a decade in drinking one to two times, two to three times, and three or more times standard gender-specific binge thresholds, labeled Levels I, II, and III. Methods In 2001–2002 and 2012–2013, respectively, 42,748 and 36,083 U.S. respondents aged ≥18 years were interviewed in person in cross-sectional waves of the National Epidemiologic Survey on Alcohol and Related Conditions (response rates, 81% and 61%). Respondents were asked their past-year maximum drink consumption per day, categorized as Levels I, II, or III. Predictors and whether Levels II and III were associated with more negative consequences were analyzed in 2012–2013 data. Results In 2001–2002, 23% of adults reported past-year binge drinking, with 15% peaking at Level I, 5% at Level II, and 3% at Level III. In 2012–2013, those percentages increased significantly to 33% binging, and 20%, 8%, and 5% binging at Levels I, II, and III, respectively. After adjusting for alcohol use disorder, the strongest predictor of Level I, II, and III binging, Level III versus I and non-binge drinkers had higher odds of past-year driving after drinking and, after drinking, experiencing physical fights, injuries, emergency department visits, arrests/detentions, and other legal problems. Conclusions Level II and III—relative to Level I—binging is associated with more negative alcohol consequences and may be increasing nationally. Research needs to explore prevention and counseling interventions.
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Excessive alcohol consumption constitutes a significant public health problem for South Africans. Alcohol use by South African (SA) adolescents is characterised mainly by binge/heavy episodic drinking. Levels of binge drinking have been high, but relatively stable, among males since 2002, while there has been a significant increase in binge drinking by females since then. Binge drinking is a major risk factor for a range of alcohol-related harms in SA, including traffic-related accidents and deaths, interpersonal violence, fetal alcohol spectrum disorder (FASD), crime, sexual risk behaviour, HIV, tuberculosis and the resultant burden of all of these on the economy. Clinicians may play a key role in addressing adolescent alcohol use and alcohol-related harm. Such a role may involve screening, brief interventions and referrals to treatment. There are several assessment, screening and diagnostic tools to detect alcohol use and misuse, specifically among adolescents. Furthermore, various pharmacological and psychological approaches are available to treat adolescent alcohol problems. Special issues to consider when dealing with alcohol use problems among adolescents in SA include recognising the risk factors, and acknowledging and addressing the harms associated with alcohol use (including sexual risk behaviour and FASD) and the possible existence of comorbid mental health problems. © 2016, South African Medical Association. All rights reserved.
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Background: Binge drinking accounts for more than half of the estimated 80,000 average annual deaths and three quarters of $223.5 billion in economic costs resulting from excessive alcohol consumption in the United States. Methods: CDC analyzed data collected in 2010 on the prevalence of binge drinking (defined as four or more drinks for women and five or more drinks for men on an occasion during the past 30 days) among U.S. adults aged ≥18 years in 48 states and the District of Columbia; and on the frequency (average number of episodes per month) and intensity (average largest number of drinks consumed on occasion) among binge drinkers. Results: The overall prevalence of binge drinking was 17.1%. Among binge drinkers, the frequency of binge drinking was 4.4 episodes per month, and the intensity was 7.9 drinks on occasion. Binge drinking prevalence (28.2%) and intensity (9.3 drinks) were highest among persons aged 18-24 years. Frequency was highest among binge drinkers aged ≥65 years (5.5 episodes per month). Respondents with household incomes ≥$75,000 had the highest binge drinking prevalence (20.2%), but those with household incomes <$25,000 had the highest frequency (5.0 episodes per month) and intensity (8.5 drinks on occasion). The age-adjusted prevalence of binge drinking in states ranged from 10.9% to 25.6%, and the age-adjusted intensity ranged from 6.0 to 9.0 drinks on occasion. Conclusions: Binge drinking is reported by one in six U.S. adults, and those who binge drink tend to do so frequently and with high intensity. Implications for public health practice: More widespread implementation of Community Guide-recommended interventions (e.g., measures controlling access to alcohol and increasing prices) could reduce the frequency, intensity, and ultimately the prevalence of binge drinking, as well as the health and social costs related to it.