Lena Savoie
Alcohol consumption in China has been on the rise, with researchers claiming that the increase in drinking in China and India is responsible for the significant rise in global alcohol consumption over the last 30 years. Chinese per-capita alcohol consumption has increased sharply, with men drinking more than 11 litres of alcohol and women drinking three litres, for an average of just over seven litres. This represents a jump of nearly 70% from China's consumption in 1990. Alcohol use in China has severe health implications, with alcohol being a causal factor in more than 200 diseases and injury conditions.
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What You'll Learn
Alcohol-related health issues
Alcohol consumption in China has been increasing rapidly. In 2010, per capita alcohol consumption was 6.7 litres, up from 2.5 litres in 1978. This increase in alcohol consumption has resulted in a toll of death and disease. Alcohol use is attributed to more than 200 diseases and injury conditions, and alcohol-related mortality is on the rise.
Liver and Cardiovascular Diseases
Alcohol use can lead to liver and cardiovascular diseases. In fact, alcohol-related harm is one of the leading causes of preventable death, contributing to about 4.3 million emergency department visits and over 178,000 deaths in the US each year. The harms related to both acute and chronic effects of alcohol can impact multiple organs and body systems, including the brain, gut, pancreas, lungs, and cardiovascular system.
Mental Disorders
Alcohol consumption can also contribute to mental disorders. Excessive alcohol use can negatively impact mental health and has been linked to cognitive, social, and behavioural deficits, as well as motor and coordination problems. Additionally, alcohol use can worsen existing mental health conditions and create challenges in managing other health conditions such as hypertension, atrial fibrillation, diabetes, and recurrent lung infections.
Cancers
Alcohol is a carcinogen and is associated with an increased risk of various cancers, including those of the oral cavity, pharynx, larynx, oesophagus, colon, rectum, liver, and female breast. Even low levels of alcohol consumption can increase the risk of certain cancers, with breast cancer risk rising with less than one drink per day.
Injuries and Accidents
Excessive alcohol use can lead to injuries and accidents, including motor vehicle crashes, falls, drownings, and burns. Alcohol intoxication can also increase the risk of unintentional injuries and violence. These acute effects of alcohol can have serious and sometimes deadly consequences.
Overall, the increasing level of alcohol consumption in China has resulted in a range of health issues, including liver and cardiovascular diseases, mental disorders, cancers, and injuries. Addressing these alcohol-related health issues requires a comprehensive approach, including public health interventions, alcohol control policies, and intervention strategies at the provincial level.
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Alcohol taxation
Alcohol consumption in China has increased dramatically since the 1980s, outpacing the growth in many other countries. This has resulted in a range of social and health issues, including liver and cardiovascular diseases, mental disorders, cancers, violence, and unintentional injuries. In response, the Chinese government has implemented various alcohol control policies, including taxation measures.
The impact of alcohol taxation on consumption levels in China is evident. When taxes were increased in 2001, alcohol production and consumption decreased. However, the subsequent tax reduction in 2006 led to a steep rise in consumption. This suggests that higher taxes can be an effective tool in reducing alcohol consumption and related harms. Additionally, the low rate of alcohol taxation in China compared to other countries and the lack of proportionality to alcohol content are notable.
To address the issues effectively, China needs a unified national alcohol law and regulations. The current alcohol supervision and management system in China focuses on aspects such as production, taxation, distribution, advertisement, minimum purchase age, and public health warning labels. While alcohol taxation has been utilized as a tool, the lack of a comprehensive national strategy has resulted in varying levels of effectiveness across different regions. Establishing a public health-oriented commission or agency specifically tasked with controlling the alcohol market and reducing consumption levels could be a crucial step forward.
Furthermore, the diversified demographics and geographic characteristics of alcohol consumers in China highlight the importance of adopting alcohol control policies and intervention strategies at the provincial level. By considering the unique characteristics of each province, more targeted and effective measures can be implemented to reduce alcohol-related mortality and disability. In conclusion, while alcohol taxation has played a role in China's efforts to curb alcohol consumption, a more comprehensive and unified national strategy, along with provincial-level interventions, is necessary to address the growing social and health issues associated with alcohol use in the country.
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Alcohol control policies
Alcohol consumption in China has increased sharply in recent decades. In 2017, men in China drank more than 11 litres of alcohol, while women drank three, for an average of just over seven litres. This represented a jump of nearly 70% from China’s consumption in 1990. By 2030, Chinese adults are projected to drink more than 10 litres on average.
The increase in alcohol consumption in China has been attributed to rapid economic growth and deregulation. Alcohol use is a causal factor in more than 200 diseases and injury conditions and is the leading risk factor for premature mortality and disability among people aged 15–49 years. In China, alcohol use resulted in 381,200 deaths in 2013, reducing overall life expectancy by 0.43 years.
- Taxation: Taxation on the sale of alcoholic drinks is a widely adopted alcohol control policy. In 2001, China added a volumetric tariff of ¥0.5 per 500g or 500ml to the existing alcohol tax, leading to a decrease in alcohol production and consumption. However, in 2006, the government lowered the tax on spirits, resulting in a steep rise in consumption. China's low rate of alcohol taxation compared to other countries and lack of proportionality to alcohol content are notable.
- Drink-driving laws: Drink-driving is a significant risk factor for road traffic accidents. China implemented a Road Traffic Safety Law in 2003 and outlined tiered blood alcohol concentration (BAC) limits in 2004.
- Sales to minors: China has no enforceable legal drinking age and does not regulate the sale of alcoholic products.
- Marketing controls: The World Health Organization (WHO) recommends limiting alcohol advertising. In 2001, the Chinese government limited the proportion of sales revenues that could be used for advertising to 20%.
- Licensing and regulation of availability: The WHO also recommends limiting the availability of alcohol.
- Public health initiatives: A public health-oriented commission could be established to develop controls over the alcohol market and strategies for reducing consumption, drawing on the WHO Global Strategy for Reducing Harmful Use of Alcohol.
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Alcohol consumption by type
Alcohol consumption in China has been on the rise. Research shows that by 2030, China will surpass the US for per capita alcohol intake. In 2017, men in China drank more than 11 litres of alcohol, mostly in the form of spirits and beer, while women consumed three litres, for an average of just over seven litres. This represented a jump of nearly 70% from China's consumption in 1990.
In 2015, the prevalence of alcohol use in the preceding year was 41.3% among Chinese people aged 18 years and above. There was a significant difference in alcohol use between urban and rural areas, which was largely due to behaviour changes among women but not among men. Among women, an increase was observed in the prevalence of current drinking from 2007 to 2015 in urban areas (14.9% vs. 23.7%, respectively) but not in rural areas (15.1% vs. 15.2%, respectively). The prevalence of current alcohol use was higher among the Han population, urban residents, higher-educated individuals, and those with a higher income level. However, the average level of daily pure alcohol intake was lower among these subgroups.
In 2007, a study was conducted on 18- to 60-year-old men in Hunan and Henan provinces, which found that the median daily consumption of pure alcohol in Hunan and Henan were 16.5 ml and 17.9 ml, respectively. In Hunan, the most commonly consumed alcoholic beverage was homemade rice wine, which was produced by farmers themselves and not subject to taxation. In Henan, the most consumed alcoholic drinks were beer and distilled spirits, which are comparatively more expensive. In both provinces, consumption of high- or low-content distilled spirits was associated with a higher risk of heavy drinking and frequent acute intoxication.
In 2021, beer maintained its dominant position among Chinese alcohol consumers, with a consumption share of nearly 79 percent. Due to the COVID-19 pandemic, alcohol consumption for social occasions decreased, especially for wine and spirits.
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Alcohol consumption during COVID-19
Alcohol consumption is an important aspect of Chinese culture, and alcohol use has been traditionally accepted in China. People with stress, anxiety, and depression may consume more alcohol. During the COVID-19 outbreak, more people reported symptoms of anxiety and depression, suggesting that alcohol consumption may increase during the pandemic.
An online retrospective survey of 2,229 participants was conducted to investigate drinking behaviours before and during COVID-19. The survey assessed risky drinking, hazardous drinking, and the association between high-risk drinking and mental health problems using the Alcohol Use Disorders Identification Test (AUDIT) and the 21-item Depression Anxiety Stress Scales (DASS−21). The results showed a slight decrease in alcohol consumption during COVID-19, with an average consumption of 3.4 drinks compared to 3.5 drinks before the pandemic.
Interestingly, the survey also found gender differences in drinking behaviours. Males consumed more alcohol and engaged in more risky and hazardous drinking than females, both before and during COVID-19. This highlights the importance of developing effective public health strategies to prevent harmful alcohol consumption, especially among males.
While overall alcohol consumption in China decreased during the epidemic, a survey of residents from Hubei Province reported higher rates of hazardous (33.5%) and harmful (11.1%) alcohol use compared to other provinces. The increased rate of problematic drinking in Hubei may be attributed to the distress and mental health impact of the pandemic.
The COVID-19 restrictions also impacted Chinese wine consumer behaviour. Wine Intelligence's China COVID-19 Impact Report revealed that China's 50 million drinkers of imported wine found more occasions to drink wine during the pandemic, particularly at home. The report also indicated that Chinese wine drinkers were increasingly using online delivery services to purchase wine, contributing to the growth of the online retail channel for wine sales.
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Frequently asked questions
Alcohol consumption in China has been increasing since 1978, when per capita alcohol consumption was 2.5 litres. By 2010, this had risen to 6.7 litres, and by 2015, the average level of daily pure alcohol intake among drinkers was 15.1 litres. This is higher than in many other countries, including the UK, the USA, Sweden, Germany, Australia and New Zealand.
In 2015, the prevalence of current alcohol use was 41.3% among the Chinese population aged 18 years and above. This is a slight increase from 2007, when the prevalence of current alcohol use was 35.7% among the Chinese population aged 18-69 years.
In 2017, a higher percentage of adults in Europe and North America consumed alcohol than in other parts of the world. For example, men in France drank the equivalent of 19 litres of pure alcohol, while the average in the United States was just under 10 litres. However, alcohol consumption in China has been increasing at a faster rate than in many other countries. Between 1990 and 2017, global consumption rose by 10%, and China represented a large part of this increase.
Alcohol control policies and intervention strategies can significantly impact alcohol consumption levels. For example, changes in alcohol taxation have been shown to affect consumption levels in China. Additionally, social factors such as the COVID-19 pandemic and associated restrictions on social gatherings have led to a decrease in alcohol consumption for social occasions, particularly for wine and spirits.
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