Lena Savoie
Alcohol consumption is a major cause of death worldwide, with around 3 million deaths per year linked to drinking. In China, alcohol consumption is associated with a higher risk of 61 diseases in Chinese men, with liver cirrhosis, gout, and cataracts among them. Observational studies of over 500,000 Chinese adults found that 33% of men drank alcohol regularly, and that alcohol intake was linked to a higher risk of death overall, as well as from major diseases. China has one of the highest numbers of liver disease cases globally, and alcohol-related liver disease is a growing problem. The country's drinking culture, social norms, and career advancement expectations all contribute to high alcohol consumption, especially among men. These factors, combined with a lack of awareness about the health risks of alcohol, result in a high number of alcohol-related deaths in Chinese men.
| Characteristics | Values |
|---|---|
| Alcohol-related deaths worldwide | ~3 million annually |
| Alcohol-related deaths in China | 83,000 liver cirrhosis deaths, 88,000 road traffic deaths, 78,000 cancer deaths each year |
| Percentage of Chinese men who drank alcohol regularly | 33% |
| Percentage of Chinese men who drank alcohol in the past 12 months (as of the publication of the source) | 85% |
| Average alcohol consumption per year by Chinese men (as of the publication of the source) | 11.2 liters |
| Diseases associated with alcohol consumption in Chinese men | 61, including 33 not defined by the World Health Organization as alcohol-related |
| Examples of diseases associated with alcohol consumption in Chinese men | Cataract, gout, liver cirrhosis, stroke |
| Alcohol use disorder (AUD) | Second most important mental disorder in China after depression |
| Alcohol industry in China | One of the largest light industries, a major source of government revenue |
| Alcohol in Chinese culture | Associated with classical poetry, social events, career advancement |
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What You'll Learn
- Alcohol consumption in China has increased sharply in recent decades
- Alcohol is deeply rooted in Chinese culture and is seen as a symbol of happiness
- Alcohol is linked to higher risks of many diseases, including liver cirrhosis and cancer
- Alcohol taxation and price policies can be used to reduce alcohol consumption
- Men in China have higher rates of alcohol use disorder than women
Alcohol consumption in China has increased sharply in recent decades
One study revealed that among Chinese men, those who reported consuming alcohol in the past 12 months increased from 59% to 85% between 1990 and 2017. Additionally, yearly per-capita alcohol consumption among Chinese men rose from 7.1 to 11.2 litres during the same period. This increase in alcohol consumption has been predicted to continue in the coming years.
The surge in alcohol consumption in China can be attributed to various factors. One contributing factor is the reduction in alcohol import duties and tariffs, with many alcoholic products receiving tariff-free status due to treaties signed after China joined the World Trade Organization. For example, wine imports from New Zealand and Chile have been exempt from tariffs since 2012 and 2015, respectively. This has resulted in an increase in wine imports and a corresponding rise in per-capita wine consumption in China.
Additionally, China's alcohol control policies and regulations have evolved over the past few decades. In 2012, an "Anti-corruption" regulation was introduced, which included a ban on drinking among military personnel and restrictions on government officials consuming alcohol while working. This campaign led to a rapid decline in the sale of luxury alcohol products and a decrease in frequent drinking among government officials. The typical consumer profile of baijiu, a type of Chinese liquor, also changed as a result.
While alcohol consumption has increased overall, there has been a recent decline in Chinese alcohol production between 2016 and 2023. This decrease in production has resulted in a reduction in domestic wine production due to international competition in the wine market. Despite this, alcohol consumption in China continues to pose significant public health challenges, with weak regulatory frameworks exacerbating alcohol-related harms.
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Alcohol is deeply rooted in Chinese culture and is seen as a symbol of happiness
Alcohol consumption is a major risk factor for poor physical and mental health, accounting for about 3 million deaths and over 130 million disability-adjusted life years worldwide annually. Observational analyses from the China Kadoorie Biobank found that alcohol consumption was associated with higher risks of 61 diseases in Chinese men, with most of these associations confirmed by genetic analyses. Alcohol consumption among Chinese men has increased in recent years, with 33% drinking alcohol regularly.
The period between the Han and Tang dynasties has been described as a "golden age" for alcohol, when it was commonly consumed alongside mineral drugs. Socializing among the gentry often involved "drinking guests" (jiuke), and a symposium beginning with drinking huangjiu might include playing the zither and chess, Zen meditation, calligraphy and painting, drinking tea, alchemy, and reciting poetry. Distillation may have been practiced in China as early as the later Han dynasty, but the earliest evidence so far discovered dates to the Jin and Southern Song dynasties.
Today, alcohol continues to play an important role in Chinese culture, where it is consumed during group meals and other social events, such as KTV, business functions, weddings, and birthdays. Alcohol is also used to celebrate special occasions, like the Chinese New Year, the Mid-Autumn Moon Festival, and other festivals. Drinking has always been a way to actively build relationships in Chinese society, whether with friends, family, partners, or even professional relationships in the workplace. A famous Chinese proverb, “酒逢知己千杯少 (Jiǔ féng zhījǐ qiān bēi shǎo), translates to “with a close friend, a thousand cups of wine is far too little”, capturing the importance of alcohol in Chinese culture.
Baijiu, a clear fermented spirit made from sorghum, rice, or wheat, is the most popular alcohol in China. It has strong cultural associations with health, happiness, and prosperity. The proper way to receive or offer a glass of alcohol in China is always with both hands, and it is considered rude not to at least take a sip when offered a toast.
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Alcohol is linked to higher risks of many diseases, including liver cirrhosis and cancer
Alcohol consumption is a major risk factor for poor physical and mental health, accounting for about 3 million deaths worldwide each year. Observational analyses from the China Kadoorie Biobank found that alcohol consumption was associated with higher risks of 61 diseases in Chinese men, with most of these associations confirmed by genetic analyses.
Among men, alcohol intake was positively associated with 61 diseases, including 33 not defined by the World Health Organization as alcohol-related. Alcohol intake was also positively associated with specific diseases such as liver cirrhosis. Cirrhosis is a stage of alcohol-related liver disease (ARLD) where the liver has become significantly scarred. Even at this stage, there may not be any obvious symptoms. It is generally not reversible, but stopping drinking alcohol immediately can prevent further damage and significantly increase life expectancy. The liver is very resilient and capable of regenerating itself. However, prolonged alcohol misuse over many years can reduce its ability to regenerate, resulting in serious and permanent damage.
Excessive alcohol consumption can also lead to liver cancer. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol is a Group 1 carcinogen (cancer-causing substance). Epidemiologic studies have shown that people who drink alcohol are at a higher risk of certain cancers than those who do not. Even light drinkers can be at increased risk of some cancers. For example, women who have just one drink per day have a higher risk of breast cancer than those who drink less than once a week. The risk is even greater for heavy drinkers and binge drinkers.
In summary, alcohol is linked to higher risks of many diseases, including liver cirrhosis and cancer. The harmful use of alcohol can lead to serious health problems and even death. It is important to drink in moderation or abstain from alcohol altogether to reduce the risk of alcohol-related diseases.
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Alcohol taxation and price policies can be used to reduce alcohol consumption
Alcohol consumption is a major risk factor for poor physical and mental health, accounting for about 3 million deaths and over 130 million disability-adjusted life years worldwide in 2016. Observational analyses from the China Kadoorie Biobank found that alcohol consumption was associated with higher risks of 61 diseases in Chinese men, with most of these associations confirmed by genetic analyses. Among men, alcohol intake was positively associated with 61 diseases, including 33 not defined by the World Health Organization as alcohol-related, such as cataracts and gout.
One way to control alcohol consumption is to introduce a legal minimum price per gram of alcohol. This approach establishes a floor for the price of alcohol, thus preventing the sale of very inexpensive products. This strategy can be particularly effective in reducing the total alcohol intake of heavy consumers of cheap alcohol. Influencing the prices of the cheapest and most consumed alcoholic drinks on the market by raising the lowest prices has a potentially larger impact on total consumption than increasing the prices of more expensive alcoholic drinks that have a limited market.
However, increased taxation may meet resistance from consumer groups and economic operators. Additionally, increased taxes do not necessarily mean increased prices when alcohol producers and retailers offset tax increases by reducing prices. Direct and indirect price promotions, discount sales, sales below cost, and flat rates for unlimited alcohol consumption or other types of volume sales have the effect of reducing the price of alcohol, increasing consumption and harm. These promotions should be restricted or banned.
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Men in China have higher rates of alcohol use disorder than women
Alcohol consumption is a major risk factor for poor physical and mental health, accounting for about 3 million deaths and over 130 million disability-adjusted life years worldwide in 2016. Observational analyses from the China Kadoorie Biobank found that alcohol consumption was associated with a higher risk of 61 diseases in Chinese men, with most of these associations confirmed by genetic analyses. At baseline, 33% of men drank alcohol regularly, and alcohol intake was positively associated with diseases such as cataracts, gout, liver cirrhosis, and stroke.
Alcohol use disorder (AUD) is a common mental disorder with substantial disease burden implications worldwide, including in China. A systematic review of 38 studies published before 2010 reported that the prevalence of AUD in China was 10.1% in men and 0.1% in women. Other studies have found that one-fourth of men who drank alcohol in China had AUD, which was associated with a lower quality of life and a higher risk of all-cause mortality. AUD was also found to be more prevalent in younger men, urban residents, and higher socioeconomic groups.
The higher rate of AUD in Chinese men may be due to several factors. Firstly, China's drinking culture differs from that of high-income countries, and the algorithms used to assess the health burden related to AUD may not accurately capture the unique context of drinking in China. Secondly, alcohol consumption has increased steadily in China in recent decades, particularly among men. Between 1990 and 2017, the percentage of Chinese men who reported consuming alcohol in the past 12 months increased from 59% to 85%, and yearly per-capita alcohol consumption increased from 7.1 to 11.2 liters.
The lack of systematic research and targeted policy initiatives to address AUD in China is concerning. National policies or strategies are urgently needed to control alcohol-related harms, reduce its affordability and accessibility, encourage behavioral intervention for drinkers, and improve treatment accessibility.
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Frequently asked questions
Alcohol consumption has been a part of Chinese culture for thousands of years and is often associated with celebration and socialising. In recent decades, per-capita alcohol consumption in China has increased sharply, leading to a rise in alcohol-related problems and deaths.
In 2010, per capita alcohol consumption in China was 6.7 litres, which is higher than in many high-income and middle-income countries such as the UK, the USA, Sweden, Germany, Australia, and New Zealand.
Alcohol consumption has been linked to a higher risk of various diseases in Chinese men, including liver cirrhosis, cancer, cardiovascular disease, infectious diseases, and injuries. Alcohol use has also been associated with mental health issues and social problems such as violence and unintentional injuries.
Men in China have more social opportunities to drink than women due to cultural and social norms. As a result, the rates of alcohol use disorder are significantly higher in men (9.3%) than in women (0.2%).
There have been calls for effective policies to curb the trend of alcohol consumption and reduce alcohol-related harm. Some suggestions include increasing taxation or implementing price policies, developing a national alcohol plan that considers the unique cultural context, and establishing a public health-oriented commission to control the alcohol market and reduce consumption.
