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Volume 20 Number 1 2022
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Volume 20 Number 1 2022
Conservation and Society 20(1): 1-11, 2022
INTRODUCTION
Illegal trade in wildlife has been associated with the decline
of multiple species and loss of biodiversity worldwide
(Vié et al. 2009), particularly large-bodied mammals that are
more vulnerable to overexploitation (‘t Sas-Rolfes et al. 2019).
Commercial farming can be an eective conservation strategy
for certain species, providing sustainable and legal sources
of products (Bulte and Damania 2005). However, for many
species the sustainability of commercial wildlife farming is
the subject of debate due to uncertainty around conservation
outcomes (Crudge et al. 2018; Challender et al. 2019; Turvey
et al. 2021).
The Asiatic black bear (Ursus thibetanus) is a CITES
Appendix 1 listed species judged to be threatened by trade.
The species is hunted throughout its range, in part to supply
to the market for bear gallbladders and bear bile for use in
Article
How Will the End of Bear Bile Farming in Vietnam
Inuence Consumer Choice?
Elizabeth O. Davisa,#, Diogo Veríssimoa,b, Brian Crudgec,d, Son H. Same, Dung T. Caoe, Po V. Hoe,
Nhung T.H. Dange, Tu D. Nguyene, Hien N. Nguyene, Trung T. Caoe, Jenny A. Glikmana,f
aSan Diego Zoo Wildlife Alliance, Escondido, California, USA
bDepartment of Zoology, University of Oxford, Oxford, UK
cFree the Bears, Luang Prabang, Lao PDR
dDepartment of Natural Resources and Environmental Health, University of South-Eastern Norway, Bø, Nordland County, Norway
eVinh University, Thành Phố Vinh, Nghệ An, Vietnam
fInstituto de Estudios Sociales Avanzados, Cordoba, Spain
#Corresponding author. E-mail: edavis@sdzwa.org
Abstract
The Vietnamese Government committed to closing all bear farms in the country by 2022. Some researchers have
expressed concerns that ending the commercial farming of bears, while demand for bear bile persists, could lead
to increased hunting pressure on wild bear populations. In this article, we used mixed methods of questionnaires,
Discrete Choice Experiments (DCEs), and interviews to investigate current consumer demand for bear bile in
Vietnam, with a specic aim of understanding the potential for consumers to seek out wild bear bile. We sampled
at seven areas across the country of Vietnam (total respondents = 2,463). We found low use of farmed and wild
bear bile. Despite widespread belief in farmed and wild bear bile’s ecacy, we found that individuals were
apathetic about continuing to use bear bile. Coupled with a strong preference for using synthetic bear bile over
wild and farmed bear bile found in the DCEs, we posit that bear bile consumers in Vietnam will be willing to
use non animal-based products, including bear bile plant and Western medicine, to treat future ailments.
Keywords: choice experiment; specialized questioning techniques; Ursus thibetanus; Helarctos malayanus;
wildlife farming
Abstract in Vietnamese https://bit.ly/31UPa82
Access this article online
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Website:
www.conservationandsociety.org.in
DOI:
10.4103/cs.cs_74_21
Copyright: © Davis et al. 2021. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use and distribution of the article, provided the original work is cited. Published by Wolters Kluwer - Medknow, Mumbai | Managed and supported by the Ashoka
Trust for Research in Ecology and the Environment (ATREE), Bangalore. For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com
2 / Davis et al.
traditional medicine across Asia (Foley et al. 2011; Burgess et
al. 2014; Garshelis and Steinmetz 2020). Asiatic black bears
produce relatively high concentrations of ursodeoxycholic
acid (UDCA), the medicinal component of bear bile
(Garshelis and Steinmetz 2020). Despite the widespread
availability of herbal alternatives and synthetic UDCA, demand
for natural bear bile persists, leading to the exploitation of this
species (Garshelis and Steinmetz 2020). Although Asiatic black
bears are the primary target for traditional medicine, sun bears
(Helarctos malayanus) in Vietnam are also hunted for this
purpose (Crudge et al. 2019), although there is currently no
scientic evidence that sun bear bile has the same medicinal
properties as Asiatic black bear bile.
Since the 1970s Asian bears have been kept in captivity
for the purposes of bile extraction (Feng et al. 2009; Scotson
et al. 2017; Crudge et al. 2018; Livingstone et al. 2018).
Hunting continues, however, and populations across the
species’ ranges are estimated to have declined by 30% over
the past 30 years (Scotson et al. 2017; Garshelis and Steinmetz
2020). The conservation potential of commercial farming is
dependent on consumers accepting the farmed product as a
suitable substitute (Phelps et al. 2014). Research in China and
Vietnam—the primary bear bile farming nations—suggests
that there is a preference and willingness to pay more for wild
bear bile than farmed (Drury 2009; Dutton et al. 2011). It is
further suggested that the widespread availability of farmed
bear bile may ultimately increase pressure on wild populations
through a broadening of the customer base and an increase in
non-traditional uses of the product (Drury 2009; Garshelis
and Steinmetz 2020). Indeed, there is no published literature
on consumer segmentation of bear bile users in Vietnam, e.g.
use of wild and/or farmed bear bile based on income and/or
status. However, Drury (2009) documented her sample of
middle-class to upper-class Hanoians as using farmed bear
bile, and the use of farmed bear bile was widespread in the
urban samples of Davis et al. (2019). In both studies, there was
a documented preference for wild bear bile, yet persistent use
of farmed bear bile.
Following the introduction of legislation in Vietnam in
2005, prohibiting bile extraction and the restocking of farms
with wild bears, the number of bear farms declined steadily
mainly due to the poor husbandry conditions in which the
bears are kept, which severely shorten bears’ natural lives
(Crudge et al. 2018; Bando et al. 2019). It should be noted
that although extraction and sale of bear bile was prohibited
in Vietnam, it remained widely available (Willcox et al.
2016). Indeed, at its peak in 2006—the year after bile
extraction was banned in Vietnam—the number of bears in
farms in Vietnam was over 4,000 (Crudge et al. 2018). At
the 2012 IUCN World Conservation Congress, members
recommended the phasing-out of bear bile farming in four
nations, including Vietnam, and a review of the situation
in China (Garshelis and Scotson 2012). In China, where
there are estimated to be >17,000 bears in bile farms, it is
suggested that farming should continue in order to prevent
an increase in poaching pressure to meet continued demand
(Haikui and Zhi 2007). In contrast to China, where there is some
evidence of captive breeding (Garshelis and Steinmetz 2020),
in Vietnam captive breeding was negligible and most
bile farms were stocked and restocked with wild bears
(Crudge et al. 2018). In 2017 the government of Vietnam
committed to phasing out bear bile farming over a ve-year
period (Animals Asia 2017). The Vietnamese Traditional
Medicine Association also committed to practitioners no longer
prescribing bear bile by 2020. It is currently reported that there
are fewer than 400 bears remaining on bile farms in Vietnam
(ENV 2020), while wild bear populations have been extirpated
or are severely depressed in much of their remaining habitat
throughout the country (Crudge et al. 2016).
Our objective in this study was to understand whether the
reduced availability of farmed bear bile, and the eventual full
closure of bear farms, could lead to a rise in demand for wild
bear bile in Vietnam. To accomplish this objective, we used
mixed methods including questionnaires, DCEs, specialized
questioning techniques (SQTs), and qualitative interviews,
to gain a broad, deep, and accurate understanding of bear
bile use currently across Vietnam. While DCEs explore
preferences, which do not directly equal “demand”, they are
a part of the “purchasing process” that is the basic structure
of demand (Veríssimo and Wan 2019). Building on the
structure of the “decision-making process” that constitutes
demand, the demand for wildlife also encompasses various
inuential factors, such as social norms, age, beliefs, etc.
(Veríssimo et al. 2020). Thus, the mixed methods used in
this paper reflect established literature in their utility in
understanding these various aspects of demand (Davis et al.
2020a, Hinsley et al. 2021).
MATERIALS AND METHODS
Study areas
To gain a wide picture of bear bile use and complexity
in Vietnam, we chose seven study areas that we believed
encapsulated dierent and important attributes of Vietnam:
whether bear farms were in the area at the time of sampling,
whether wild bear populations were likely to be near, and
where the areas were located geographically in Vietnam,
i.e. north, centre, south (Figure 1). These attributes were
chosen because they could potentially inuence how bear
bile is consumed, and in what quantity it is consumed in an
area (examples of attributes can be found in Supplementary
Material I).
Study participants
We investigated the use of bear bile among dierent ethnic
groups, including the dominant Kinh ethnic group, as well as
the Co Tu, the Hmong, the Dao, and the Thai. We conducted
surveys and interviews in both urban areas (e.g. Da Nang City
(Central Vietnam)) and in rural areas (e.g. Lào Cai Province
(Northern Vietnam)).
Bear bile use in Vietnam / 3
Survey instrument design
The survey instrument was broken into three sections. Section
A was composed of closed-ended questions, including
the SQT of Unmatched Count Technique (UCT), while
Section B was the DCE. The DCE followed the methods of
Veríssimo et al. (2014a), Hinsley et al. (2015), and others
who have explored similar issues within conservation. In
Supplementary Material I we explain the SQTs and DCEs
in greater detail.
Section C included direct questions about use of wildlife
products, synthetic bear bile, and bear bile plant in the past
twelve months. In the survey, the project team ensured that the
denitions of each product were clear. Wild animal products
were translated as “wild” (i.e. not farmed, not processed
in a lab), while synthetic bear bile was translated to mean
chemically-made bear bile, which is known to most Vietnamese
as an accessible product available in local pharmacies.
‘Bear bile plant’ is well known to be a specic organic plant
product in Vietnam and is a popular form of herbal medicine
(Davis et al. 2019a).
Section C of the survey also included the qualitative
component, and the SQT of Nominative Technique
(NT). Specific details of each section can be found in
Supplementary Material I, with descriptions of each SQT.
Socio-demographic questions were split between the beginning
and end of the instrument; more sensitive demographics
such as monthly income were placed at the end. In addition,
the research team was actively encouraged and specically
trained to write down additional notes about the context of
the interview, e.g. if other individuals were present, as well as
additional information that came up during broader discussions
during the surveys, and whether they believed the respondent
was trustworthy. This information was used to assess the
reliability of the overall dataset.
Sampling method
Quantitative sections
In each study area, teams of two research assistants walked
dierent streets each day and surveyed every fourth household
on their left. This sampling was used due to the scattered
distribution of households and to reach our target sample size
in rural areas. One person in each household was surveyed,
and all respondents were over 18. Male/female respondents
were alternated.
Qualitative interviews
Respondents who directly reported to ever using bear bile were
asked whether they would like to participate in a qualitative
interview following the quantitative section, which would ask
them more detailed questions about their use. The research
assistants attempted to gain an equal distribution of men
and women; however, as women are known to underreport
behaviour that could be considered sensitive and/or undesirable
(Durant et al. 2002), women were underrepresented in the
qualitative interviews in some sites. Due to time constraints,
research assistants stopped interviewing bear bile users once
they reached a threshold of approximately 30 interviews in
each study area.
Choice experiments
The choice experiment was conducted within the
main body of the questionnaire; however, respondents
were randomly assigned to one of four choice blocks
(Supplementary Material I) to investigate two potential
scenarios regarding bear bile purchase. These two scenarios
were: 1) buying medicine for a family member to treat a
bruise and 2) buying medicine to treat a sprained ankle.
Scenario 1 was selected according to the prior research and
experience of the author team, who found that individuals
may buy and/or give bear bile to bruised family members
(Davis et al. 2019a, 2020a,b and Ho et al. forthcoming).
Scenario 2 was selected as an alternative to Scenario 1 being
an individual purchase for their own ailment, and for being a
comparative ailment in severity and treatment with bear bile
in Vietnam (Davis et al. 2019a). Both ailments were selected
to be comparatively minor because bear bile is generally used
for comparatively minor ailments, particularly in Vietnam
(Davis et al. 2019a). Porcupine stomach was included in
the choice experiment as a comparable wildlife product:
(1) because research in Laos and Cambodia (Davis 2020;
Figure 1
Map of the study areas in Vietnam (created by Jenna Stacy-Dawes)
4 / Davis et al.
Davis and Glikman 2020), and anecdotal evidence in Vietnam,
demonstrated that porcupine stomach is used in traditional
medicine to treat similar ailments as bear bile/gallbladder;
and (2) because porcupines are available in Vietnam in both
farmed and wild forms (Brooks et al. 2010).
Each research assistant had an anonymous ID sheet that
also had a corresponding choice experiment scenario block.
This was then stratied by the known Vietnamese population
proportions of age and gender (The World Factbook 2021)
and systematically and randomly assigned for each person,
e.g. a respondent would be assigned ID #1785 and Scenario
1: Block D, Scenario 2: Block A. The ID was linked to the
scenario and block simply as a way for the enumerators to
easily assign the dierent blocks to each respondent. Blocks
were assigned based on probability, with 25% of the sample
assigned to each block.
Data analysis
Quantitative analysis
Data was entered into Google Forms by the CERD research
team after completing each site, and checked periodically
by the CERD team, as well as by the lead author. We
analysed all data using R (R Core Team 2020). Generally, we
calculated condence intervals using the standard equation;
in the case of the UCT double distribution confidence
intervals, we used a function we wrote for the purpose in
R (Supplementary Material VI). Confidence intervals
were used in place of null hypothesis signicance tests, as
condence intervals inherently indicate whether distributions
overlap (i.e., statistically insignicant dierence) or do not
overlap (i.e. statistically signicant dierence) (Kline 2004);
therefore, they provide “statistical clarity” compared to
commonly used (and misused) null hypothesis signicance
tests (Dusho et al. 2019).
We used R to calculate descriptive statistics, e.g. percentage
of individuals who directly admitted to using bear bile, and
relied on the dplyr package for much of this descriptive analysis
(Wickham et al. 2020). For the creation of the demographics
table (Supplementary Material VII) we used the package
gt (Iannone et al. 2020). We calculated the SQTs using the
formulas found in Davis et al. (2019b, 2020c).
Choice experiments
We analysed the data using LIMDEP and NLOGIT 4.0. We
assessed preferences of respondents using Random Parameter
Logit (RPL). This model type allows for the investigating of
how individual respondent characteristics impact preferences,
which can help us better understand heterogeneity amongst
respondents. This is accomplished through specifically
investigating the variance and the mean coefficient. For
example, for an attribute to be meaningless, both the mean
coecient and the variance must be “insignicantly dierent”
from zero; if the variance is signicant, the researcher can only
infer that a “diversity of preferences” exist within the sample
(Rigby and Burton, 2003).
Qualitative analysis
The qualitative interviews were translated from Vietnamese
into English by a member of the CERD sta, and analysed
by the lead author following the standard process of coding
and grouping codes into generalisable themes (Bernard 2017).
The themes found in the qualitative data were grouped around
existing themes that the author team had chosen to investigate,
such as behavioural intentions around bear bile farming. This
was done per study area, in recognition of the diversity of
contexts within Vietnam. This recognition was founded both
on a personal experience of Vietnam (e.g., the Vietnamese
author team’s lived experiences), and quantitative data, which
showed clear dierences across study areas.
RESULTS
Demographics
Quantitative interviews were conducted with a total of 2,463
respondents in Lào Cai (n = 383), Hai Phong (n = 402), Nghệ
An (n = 435), Da Nang (n = 194), Quảng Nam (n = 200),
Tây Ninh (n = 423), and Đồng Nai (n = 426). The sample
was predominantly male (54%), with a mean age of 42.
Most of the sample had lived the majority of their lives
within the study area, and had high school/secondary school
(in Vietnamese, Trung học phổ thông (THPT)) as their highest
level of education. The sample was primarily Kinh, and the
most common religion was ancestor spirit worship. Most of the
sample stated that their income was between 0 to 10 million
Vietnam Dong a month, equivalent to ca. 0 USD to 432.6 USD.
Further details on demographics of the full sample can be found
in Table S.3, Supplementary Material VII.
Qualitative interviews were conducted with a subsample
of 173 respondents of the full sample of 2,463 respondents;
these respondents were sampled from individuals who reported
having used bear bile. We interviewed 32 self-stated bear bile
consumers in Lào Cai, 25 in Hai Phong, 36 in Nghệ An, 27 in
Quảng Nam/Da Nang (treated as one site for the interviews,
due to their close proximity), 25 in Tây Ninh, and 28 in Đồng
Nai. The sample was predominantly male (79%).
Estimates of bear bile use prevalence
Direct reporting of bear bile use in the past twelve months
Of the 2,463 respondents, 771 (31.3%) stated that they had
used bear bile/gallbladder in their lifetime, and of those users,
46.3% (357/771) had used both farmed and wild bear bile. Of
those users, only 4.5% (16/357) (0.7% of the full sample of
n = 2,463) directly reported using both wild and farmed bear
bile in the past twelve months.
A small percentage (5%) of respondents stated that they
had consumed farmed bear bile in the past twelve months
(CI: 4.4%–6.1%, SE: 0.5%, n = 129/2,463), while 3.8% of
the respondents stated that they had consumed synthetic bear
bile in the past twelve months (CI: 3%–4.6%, SE: 0.4%,
n = 93/2,463). Both of these estimates were three times higher
Bear bile use in Vietnam / 5
than the number of individuals who stated that they had
directly consumed wild bile in the past twelve months, 0.9%
(CI: 0.5%–1.3%, SE: 0.2%, n = 22/2,463).
Direct estimates of bear bile, porcupine stomach, and bear
bile plant use, in the past twelve months
Across all sites, except from Nghệ An, no respondents reported
using wild bear bile in the past twelve months (total n = 2,463,
Table S.4 in Supplementary Material VII). In Nghệ An, 5%
of respondents (3.1%–7.3%) admitted to having used wild bear
bile. However, it was more common for respondents to admit
to using farmed bear bile. In Nghệ An, 22.9% (18.9%–26.8%)
admitted to using farmed bear bile in the past twelve months,
which did not overlap with the 95% condence interval for
admitting to using wild bear bile (Table S.4). In Quảng Nam
and Da Nang, which are closely neighbouring areas to one
another, no respondents admitted to using farmed bear bile.
Direct reporting of synthetic bear bile use was lower than
reporting of farmed bear bile use in every province apart from
Tây Ninh. In Nghệ An, 14.5% (11.2%–17.9%) of respondents
admitted to using synthetic bear bile, which was signicantly
lower than admittance of farmed bear bile use in the area. In
Lào Cai, Da Nang, and Quảng Nam, no respondents reported
using synthetic bear bile (Table S.4).
Respondents reported using bear bile plants in all of the study
areas, with an overall estimate of 15.7% (14.3%–17.2%). The
highest use was in Nghệ An and the lowest in Hai Phong. Of the
sample, 3.1% (2.4%–3.7%) of respondents directly admitted
to using porcupine stomach, with the highest admittance in
Nghệ An, and the lowest equally in Da Nang and Hai Phong,
with one person in each site admitting that they had used
porcupine stomach, and condence intervals overlapping with
zero (Table S.4).
UCT estimates
Prevalence estimates of farmed bear bile, wild bear bile, and
porcupine stomach use all overlapped with 0%, across the
sample. The prevalence estimates of farmed bear bile use
across the 2,463 respondents was -1.8% (-8.5%–4.9%). For
wild bear bile, the estimate was 0.3% (-6.8%–7.4%), and for
porcupine stomach the estimate was 3.2% (-4.2%–10.6%).
Most of the UCT prevalence estimates for wild bear bile
(5 out of 7 study areas) and farmed bear bile (4 study areas)
were negative per study area, while slightly less than half were
negative for porcupine stomach (3 study areas) (Figure S.2,
Supplementary Material VII). All overlapped with 0%, apart
from in Nghệ An. In Nghệ An, respondents were found to use
porcupine stomach signicantly over 0 (24%, 3.1%–44.9%).
NT estimates
When using NT, the highest estimated prevalence of all types
of bear bile consumption in the past twelve months was
found in Nghệ An, with an estimated prevalence of 33.8%
(29.8%–37.8%). The lowest estimated prevalence was found in
Quảng Nam, at 0%. The other study areas were all signicantly
lower than Nghệ An, with the highest prevalence estimated
to be 1.7% in Đồng Nai (0.8%–2.6%), followed by Da Nang
at 1.5% (0.1%–2.9%), Tây Ninh at 1% (0.3%–1.7%), Hai
Phong at 0.8% (0.1%–1.5%), and nally Lào Cai at 0.2%
(-0.2%–0.7%), which overlapped with 0%.
Beliefs
More than 50% of respondents believed that, “It is easy to nd
places to buy bear bile/gallbladder”, in Hai Phong, Lào Cai,
Nghệ An, and Đồng Nai. Da Nang was the most equivocal
about bear bile/gallbladder’s accessibility, while in Tây Ninh
respondents were least likely to agree that bear bile/gallbladder
was easily accessible.
Respondents in Nghệ An were most likely to believe that
farmed bear bile has medicinal value, while respondents in
Lào Cai were least likely to agree with that statement. Da
Nang and Quảng Nam followed Lào Cai respondents with less
strong beliefs in farmed bear bile having medicinal value, while
respondents in Đồng Nai and Tây Ninh were comparatively
more likely to believe that farmed bear bile has medicinal
value. Finally, respondents in Hai Phong were equivocal about
the medicinal value of farmed bear bile.
Respondents in Lào Cai, Nghệ An, and Đồng Nai were most
likely to believe that wild bear bile has medicinal value, with
Lào Cai having the strongest agreement with the statement.
Respondents in Quảng Nam and Da Nang were most equivocal
about the statement that “wild bear bile has medicinal value”,
while respondents in Hai Phong were most likely to disagree
with that statement, compared to other study areas. Nearly
half of all respondents in Tây Ninh agreed with the statement,
but another half of respondents were split between feeling
equivocal, and disagreeing with the statement.
Choice experiments
Buying medicine for a family member with a bruise
Regarding Scenario 1, our results (Supplementary
Material VIII) show that respondents preferred synthetic bear
bile followed by natural (wild or farmed) bear bile. Porcupine
stomach was avoided by most consumers, with many also
preferring not to choose any of the alternatives provided. In
terms of natural (not synthetic) bear bile, respondents preferred
wild sourced bear gallbladder at the lowest possible price. We
also investigated in more detail potential heterogeneity around
preferences, in particular for wild versus farmed bear bile, and
potential dierences between users and non-users. In terms of
location, respondents from Nghệ An Province, as well as those
that identied as male, were more likely to prefer wild sourced
bear bile. However, respondents from the Kinh ethnicity, as
well as those with higher levels of education, preferred giving
bile from farmed bears to bruised family members. We found
no dierences in choice between self-reported users and
non-users.
Buying medicine to treat a sprained ankle
Regarding Scenario 2, our results (Supplementary
Material VIII) align with those above, with respondents
6 / Davis et al.
preferring synthetic bear bile followed by wild bear bile.
Porcupine stomach was avoided by most consumers, with
many preferring not to choose at all. In terms of natural bear
bile, respondents preferred bear gallbladder at the lowest price,
but the source was not important. We also investigated in more
detail potential heterogeneity around preferences, in particular
for wild versus farmed bear bile and potential dierences
between users and non-users. In terms of location, respondents
from Nghệ An Province, as well as younger respondents and
those respondents who believed primarily in ancestor spirits,
were more likely to prefer wild sourced bear bile. However,
respondents from the Kinh ethnicity, as well as those with
higher levels of education, preferred bile from farmed bears.
We found no dierences in preferences between self-reported
users and non-users.
Qualitative results
The qualitative results of our study conrmed the research
team’s experience in this eld that bear bile is purchased for
two primary groups: one’s family members and/or close friends,
and for oneself. We found that in every study area, except the
northern study areas of Lào Cai and Hai Phong, interviewed
bear bile consumers were roughly equally split in whether
they had been given bear bile, or purchased it themselves. In
Lào Cai and Hai Phong, a number of respondents cited having
drunk bear bile socially; although social bear bile consumption
occurred in the other study areas as well, the extent was more
pronounced in both of these areas. Social bear bile consumption
was generally male-dominated in our sample, yet a young
woman in southern Vietnam did describe having been invited
to drink bear bile alcohol:
The rst time [I used] bear bile was in university [about 6
years ago], a friend invited to drink bear bile alcohol.
(—26-year-old female, Bachelor’s degree, Kinh, Tây Ninh)
Another woman (64-year-old, secondary school, Kinh, Nghệ
An) who traded bear bile and other wildlife products described
drinking bear bile with her clients, possibly as a strategy to
both encourage clients to purchase more of the product, and
to arm the quality of the product.
The way bear bile was stated to be used varied across
Vietnam, although use was cited to be predominantly for
medicinal purposes and/or social drinking. Use was often
pluralistic, with individuals using bear bile for medicinal
purposes, social drinking, and to build social capital
(e.g., through giving it to others), or any combination of the
three. This is well-illustrated below:
[I] use for drinking alcohol with counterparts or customers,
gift to counterparts, [and] rub on [my] skin.
(—33-year-old male, PhD, Kinh, Nghệ An)
In Tây Ninh, Nghệ An, Hai Phong, and Lào Cai bear bile
for social drinking was the predominant situation described,
although predominant here generally means that it was only
used for this purpose by a little over half of the sample. Only in
Quảng Nam and Đồng Nai was bear bile used more generally
for medicinal purposes.
Bear bile for medicinal purposes fell into four categories.
Predominantly, it was used for treating severe bruises, such
as those resulting from trac accidents. Secondarily, it was
used to treat general joint pain. Thirdly, it was used to treat
stomach aches, when taken in some warm water. Fourthly, bear
bile was used for postpartum treatment by women of the Thai
and Hmong in Lào Cai Province, near the border of China.
We found that the use of bear bile could be passive—e.g.,
given to an individual after an accident, or active—e.g., where
the individual sought bear bile to use. Two examples are given
below, of these dierent types of uses:
[I] use [bear bile] a lot of times, because it’s based on [my]
job: Drinking alcohol and taking as a gift. (Passive)
(—46-year-old male, Bachelor’s degree, Kinh, Nghệ An)
[I] ask my friends to buy [farmed] bear bile in the hometown,
they ship by car, [and] can receive after a week of ordering
(buy 50cc bear bile costing 3 million dong [~130 USD] each
time). (Active)
(—47-year-old male, Business person, Kinh, Hai Phong)
In the rst anecdote, the individual notes that drinking bear
bile was a passive part of the job, while the second anecdote
describes an active process where the user was seeking out
bear bile. However, we found general apathy about the decline
of bear bile use in Vietnam. For example, the individual who
gave the anecdote about the active purchase of bear bile stated,
“won’t use bear bile anymore” when asked what he would do
after bear farms are gone in Vietnam. This sentiment was shared
across sites, e.g., “I don’t use much bile anyway” (57-year-old
Kinh male, Quảng Nam). We did record opposing sentiments,
with sadness expressed over the perceived loss of an eective
medicine (“No medicine can cure bruises as fast as bear bile”—
36-year-old woman, Bachelor’s degree, Kinh, Đồng Nai). Only
a few individuals expressed hostility towards the government’s
actions to end bear farming, e.g., a man from Nghệ An who stated:
Don’t care about prohibition. If needed, there would still
[be] bear bile. The government can ban all the bear farms.
(—33-year-old, Kinh, Bachelor’s degree)
Respondents were generally not explicit about where they
obtained the bile they gave to relatives. For e.g., one respondent
in Lào Cai (43-year-old college-educated male, Kinh) said that
he “gave to family members”. Previously, he had stated that he
had been given it as a gift by “local people” (i.e., people living
in rural areas), with the implication that the bile was likely from
wild bears. Respondents in Lào Cai generally were not aware of
bear farms in the area (72%) or were certain that none existed
(28%). Indeed, one individual in Lào Cai (43-year-old male,
Bachelor’s degree, Kinh) said that he had sought out farmed
bear bile in Nghệ An, ~572 km south, after getting a taste for
bear bile when given it by a friend for the rst time.
The receivers of bear bile, i.e. bruised family members, in
our choice experiment scenario, were generally unaware where
the bile had come from. Said one respondent in Quảng Nam:
[I] was given 1 cc of bear bile by a relative for rubbing,
didn’t know [if] it was wild or farmed bear bile ([and] can’t
remember when).
(—57-year-old Kinh male, secondary school)
Bear bile use in Vietnam / 7
Another in Đồng Nai described the gift of a friend rather
than a relative:
The last time using bear bile was after an accident
(3 years ago), [I] had big bruises on legs and face. Doctor gave
medication but it healed slowly and traditional herbs [as well].
A neighbour visited and brought alcohol bear bile for rubbing.
(—55-year-old Kinh female, college)
No bear bile consumers interviewed explicitly mentioned
using synthetic bear bile to treat bruises, in any study area,
despite a question that explicitly asked where the individuals
had obtained the bile from. Instead, individuals stated that
when they purchased the bile themselves, it was generally
from a friend or a bear farm, with the implication that they
were seeking out trustworthy vendors of farmed or wild bile
from which to purchase bear bile. However, some respondents
did state that they bought bear bile at a shop, which could
imply that those individuals were purchasing synthetic bear
bile from a pharmacy; equally, it could imply that farmed or
wild bear bile was for sale at a pharmacy or at other brick and
mortar shops.
DISCUSSION
Current use of bear bile
With the decline of bear bile farming in Vietnam, there is
concern among conservationists that some committed users
will seek out wild bear bile and place pressure on beleaguered
bear populations (Crudge et al. 2018). Indeed, this is one
argument used to support the continuation of bear bile farming
in China (Garshelis and Steinmetz 2020). Here, we showed that
desire for wild bear bile is unlikely to result in increased bear
hunting pressure in Vietnam. Bile farming has declined over
a 15-year period (Crudge et al. 2018), and a desire for wild
bear bile was found only in Nghệ An, Central Vietnam, where
the highest levels of bear bile consumption currently occur
(22.9% (18.9%–26.8%)). In our six other study areas, we found
a strong stated preference through the DCE for synthetic bear
bile over any other alternative. Preference patterns were not
inuenced by past consumption, meaning that previous users
of wild and/or farmed bear bile were equally likely to choose to
use synthetic bear bile. However, the coecient in Scenario 1
(“buying medicine for a family member who has a bruise”) for
price was smaller than for source, which suggested that source
overrode price for this particular scenario, further indicating
that source does matter in some situations. Nonetheless, the
DCEs broadly suggest that wild bile is increasingly niche
and phasing out farming is not likely to bring a resurgence of
wild bear bile use. This is particularly noteworthy in light of
the belief in wild bear bile’s medicinal ecacy found in over
50% of the area’s sample in Lào Cai, Nghệ An, and Đồng Nai,
and approaching 50% in Hai Phong and Tây Ninh (Figure 2).
We found that only 0.7% of the full sample (16/2,463)
admitting to using both products within the last twelve months.
Of both products, farmed bear bile was used more often than
any other bile option. This may be because farmed bear bile is
still fairly accessible in certain areas, e.g., in Nghệ An where
bile farms persist. Indeed, bear bile/gallbladder was generally
believed to be accessible, by respondents across study areas,
with over 50% of the sample thinking it was easily accessible
in four out of our seven study areas (Hai Phong, Lào Cai,
Nghệ An, and Đồng Nai), and approaching 50% in Tây Ninh
(Figure 2). Across the sample, respondents did not mention
signicant barriers to obtaining bear bile, and instead would
mention having been given it by a friend, having purchased
the bile alcohol at a restaurant, having it at an acquaintance’s
house, and other casual situations. As a contributing factor, we
found that farmed bear bile largely mirrored wild bear bile in
the belief in its ecacy, across study areas (Figure 2). With
wild bear bile, it was only in Da Nang and Quảng Nam that
respondents largely disagreed (or did not know enough to state
a belief) that farmed bear bile has medicinal ecacy.
Although no respondents in Quảng Nam, Central Vietnam
directly admitted to having used bear bile in the twelve months
before they were interviewed, lifetime users of bear bile in
Quảng Nam were more likely to admit to using bear bile for
medicinal purposes, compared to more predominantly social
bear bile alcohol drinking areas such as Hai Phong, Northern
Vietnam. Possibly, this could be due to a gender bias—alcohol
consumption in Vietnam tends to be a male-dominated act
(Drury 2011; Lincoln 2016), and very few women were
interviewed about their use in areas such as Hai Phong where
bear bile alcohol consumption was logged more frequently.
Although at least two women were comfortable admitting to
having used bear bile alcohol for social drinking, others may
have felt uncomfortable admitting to the (illegal) act in light of
the greater social pressure women feel to present themselves
favourably, worldwide (Fisher 2013; Klein et al. 2019; Moran
et al. 2018). Importantly, one of the women interviewed not
only consumed bear bile alcohol socially, but had also traded
wildlife throughout Vietnam, until she was caught. Her
experience supports prior work that has shown that women
can and are important in facilitating and perpetuating wildlife
trade, although they are often overlooked in wildlife trade
research and discourse (Agu and Gore 2020). In rural areas
worldwide, women often occupy the role of ‘trader’, which
means they are perfectly suited to trac wild products that
their male partners and kin may poach (Agu and Gore 2020).
Moreover, emerging research has shown that women can be
primary consumer groups for some wildlife products, and in
certain contexts (Davis et al. 2020b; Doughty et al. 2021).
One possible explanation for the high stated use of bear bile
in Nghệ An, Central Vietnam is due to the legacy of bear bile
farming in the region (Crudge et al. 2018). This accessibility
to bear bile may have ingrained the practice within the
community, even as bear farms are increasingly shut down
in the province (T. Cao, pers. obs.). However, Hai Phong
in northern Vietnam had (and has) a similar number of bear
farms (Crudge et al. 2018), but according to our results has low
bear bile consumption. Why Nghệ An specically has greater
consumption of bear bile is an opportunity for further research,
grounded in qualitative, exploratory methods.
8 / Davis et al.
Consumer preferences
We found a strong preference for synthetic bear bile over
alternatives within the DCE. This result is somewhat
surprising in light of our other nding that there was low
actual consumption of synthetic bear bile, across study areas.
Additionally, our qualitative results illustrated that there are
persisting contexts of bear bile consumption where synthetic
bear bile use is theoretically unlikely, such as the socialised
consumption of bear bile alcohol, which prior research
has shown tends to consist of wild or farmed liquid bile
(Drury 2011). While our qualitative interviews did not uncover
a preference for synthetic bear bile, it should be noted that those
results come from a sub-sample of self-reported consumers,
which is not directly comparable.
Choice preferences may also reect how opportunistic bear
bile consumption is in Vietnam. Although our qualitative
results did show that bear bile consumption can be an active
choice, these results were largely conned to Quảng Nam,
where use was more predominantly medicinal; respondents in
our other study areas largely had received bile opportunistically
either when given it following an accident, or when socially
drinking. However, it is worth noting that some respondents,
after opportunistically receiving bear bile, then actively sought
bear bile out for continued consumption following their
initial consumption ‘event’. Nonetheless, considering that
source was not found to be important in one DCE scenario
(Buying medicine for a family member with a bruise), and
a found, general lack of strong preference for natural bile
(wild or farmed), it is unlikely that many Vietnamese are
committed to natural bear bile. Furthermore, this is supported
by our nding that respondents were largely apathetic about
the Government of Vietnam’s goals to eliminate bear farming,
giving responses such as “don’t really care” and “just won’t
use [bear bile]”.
We found that approximately 16% of our sample had used
bear bile plant, which was the highest overall estimate of use
of a particular product (compared to e.g., farmed bear bile, at
5% of the sample). Even before bear bile farms began closing,
the Vietnamese government was encouraging the use of herbal
traditional medicines as a means of increasing ‘self-reliance’
within rural communities (Naono 2014). Also, as bear
farming’s popularity has waned, bear-focused NGOs have been
campaigning to encourage the use of herbal alternatives, such
as bear bile plant, instead of bear bile (Animals Asia 2018).
However, while it may be tempting to argue that bear bile
plant can be a natural and seamless replacement for bear
bile, preliminary research in Vietnam has shown that bear bile
plant may be perceived as less eective compared to bear bile
(Davis et al. 2019a).
Limitations
The SQTs employed in this study did not seem to have
an eect in overcoming biases, possibly due to deceit in
answering the SQTs (Davis et al. 2019b). However, the
results from the qualitative interviews, and the research
team’s own experience in Vietnam, has shown that despite
its illegality, bear bile use is fairly open and normalised.
It is therefore unlikely that there are any strong biases
precluding honest answers. Another explanation for the poor
SQT results could be the experiences of the research team,
who found that individuals preferred being interviewed over
being surveyed. Respondents were more likely to nd the
survey to be too long and “boring”, which impacted their
desire to answer every question, and to answer the questions
accurately. Consequently, the respondents may not have been
attempting to actively deceive the researchers, but a lack of
attention and buy-in may have caused inaccurate responses
to be given.
A limitation of this study is that ‘bear bile plant’ was
not oered as one of the possible alternatives in the choice
experiment, despite consistent use of bear bile plant across
the sample. This choice was made for three reasons. One,
porcupine farming in Vietnam is a conservation concern
(Brooks et al. 2010) and two, DCEs can only accommodate
Figure 2
Belief statements about availability of bear bile, and medicinal ecacy for farmed and wild bear bile (total n = 2,463)
Bear bile use in Vietnam / 9
a limited number of attributes and levels before they put
too much cognitive strain on respondents which can lead to
lower quality data (Caussade et al. 2005). Finally, animal
medicinal products can occupy a ‘ ‘spiritual’ and supernatural
liminal space that plant medicinal products do not enter
(Alves and Alves 2011).
Another limitation of our study is the lack of qualitative
insight into bear bile consumption by women. Likely due to
the social stigma women feel about admitting to sensitive
behaviours that may be illegal and/or socially undesirable
(Durant et al. 2002), women were underrepresented in our
qualitative interviews. This may be why we found more use
of bear bile alcohol in social/business settings in certain study
areas, such as Hai Phong, and could also explain the lack of
contextual evidence regarding the use of synthetic bear bile.
An avenue for fruitful future research in Vietnam, therefore,
could be a qualitative study of bear bile consumption by
women.
CONCLUSION
It’s unlikely that there will be greater consumption of
wild bear bile in Vietnam. This is important in light of the
documented and continuing debates centred around the
farming of bears that argue that a loss of farmed bear bile
may mean an increase in demand for wild bear bile. Instead,
we show that a decline in farmed bear bile availability can
simply mean that consumers shift towards products that are
believed to have similar benets, and that are cheap and easy
to acquire, such as synthetic bear bile and bear bile plant.
However, we note that consumer preferences are highly
complex, and substitutes for unsustainable and/or illegal
animal medical products are subject to the same complexities.
Consumer research in China and other bear bile farming
nations will determine if there is potential to phase out the
practice of bear bile farming without risking a substantial
increase in hunting pressure. As with any conservation eort,
attempts to market bear bile substitutes should be spatially-
unique and reective of the local, documented consumer
preferences.
Supplementary material can be accessed at: https://bit.
ly/2YSm87t
Author contribution statement
Davis, E. conceived and designed the study; trained the
research team; analysed the data; drafted the manuscript; and
did a critical revision of the manuscript. Veríssimo, D. designed
the study; analysed the data and did a critical revision of the
manuscript. Crudge, B. designed the study; trained the research
team and did a critical revision of the manuscript. Sam H. Son
was involved with data collection and the critical revision of the
manuscript. Cao T. Dung was involved with data collection and
the critical revision of the manuscript. Ho V. Po was involved
with data collection and the critical revision of the manuscript.
Dang T. H. Nhung was involved with data collection and the
critical revision of the manuscript. Nguyen D. Tu was involved
with data collection and the critical revision of the manuscript.
Nguyen N. Hien was involved with data collection and the
critical revision of the manuscript. Cao T. Trung assisted with
the design of the study; trained the research team and did a
critical revision of the manuscript.
Glikman, J.A. conceived and designed the study and did a
critical revision of the manuscript.
Acknowledgements
This work could not have happened without the skills and
expertise of the translators, Ms. Vu Phuong Hoa and Ms. Ho
Ha My. This work was made possible with the support of
the Government of Vietnam, who granted permission for the
project to be conducted. The Government of Vietnam also gave
essential support to one of their educational arms, Trường Đại
Học Vinh (Vinh University), in conservation eorts. We also
gratefully acknowledge the insights of Prof. Quang and Prof.
Hoi, as well as the assistance of Drs. Châu and Liên, and Ms.
Lim Thona in the training process.
Declaration of competing/conicting interests
E.O. Davis works for the San Diego Zoo Wildlife Alliance
(SDZWA), a global conservation organisation. B. Crudge
works for Free the Bears Fund, Inc., a bear rescue and
conservation organisation.
Financial disclosures
This research was supported by SDZWA’s postdoctoral
program; no other funding was received.
Research ethics approval
Every respondent was assured of their anonymity and
the condentiality of the survey and told that they could
drop out of the interview at any point, and for any reason.
Every interview was anonymised, to ensure participant
condentiality. This project obtained ethical approval from
the Miami University of Ohio Institutional Review Board
#02106e, and permission for conducting the work was granted
by both the Government of Vietnam, and specic provincial
governments in Vietnam.
Data availability
The data is not accessible due to privacy restrictions.
Preprint archiving
The preprint of this article can be found here: https://osf.io/
preprints/socarxiv/quyf2/
10 / Davis et al.
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Received: 19-May-2021; Revised: 05-Aug-2021; Accepted: 19-Aug-2021; Published: 18-Nov-2021