While alcoholism is subjected to extreme scrutiny across societies due to mental and behavioural disorders, alcohol consumption still does not get translated into a health concern in India.
a ccording to latest World Health Organization data, abuse of alcohol leads to 3.3 million deaths worldwide every year which accounts for 5.9 per cent of all deaths. It is also a causal factor in approximately 200 diseases and injury conditions. In addition to health risks, alcohol abuse also results in social and economic consequences. A number of countries have set limits for alcohol consumption considering its adverse health impact. However, India is far behind in not just setting alcohol limits, but also identifying alcohol consumption as a health hazard rather than a social one.
Lancet’s recent article suggests recommendation to lower the 
alcohol limits in many countries to around 100g/week for men and women based on the study they conducted in 19 countries. The study found an increase in all causes of death in cases where the alcohol consumption level is above 100 g/week. Thus, the study supports the claim for reductions of alcohol consumption limits in most existing guidelines across the globe.
At present, in many countries the limits are much higher than 100g/week and it varies for both men and women.
India is seen as the fastest growing market for alcohol consumption in the world with the rise in urban population as well as increase in spending power of middle class population. The alcohol market in India is said to be growing at the Compound Annual Growth Rate (CAGR) of 8.8 per cent and is expected to reach 16.8 Billion liters of consumption by the year 2022. Because of the large population, India is considered one of the largest consumers in the world, but in reality its per capita consumption is much lower than its western counterparts.
Opining on the social consequences of alcohol consumption among young people, Kavita Chauhan, Behavioural Science researcher at London School of Hygiene and Tropical Medicine and Public Health Foundation of India said,
“ There is a need to educate and to communicate with young people on the negative consequences of alcohol consumption. There is a need to engage with the youth to enhance their life skills, generate greater public engagement and awareness about the vulnerabilities and dangers of underage drinking, and of introducing and enforcing regulations that limit it. ”
Studies in India about alcohol consumption have always focused on its social consequences. It has always been seen as a menace which adversely affects the family lives and women especially. This also led to a large social movement called anti-arrack movement in Andhra Pradesh where women protested against local liquor traders due to high alcohol dependence among men of the region which led to issues of domestic abuse and misuse of household income. Even the recent ban of Supreme Court on liquor vends within 500 m of highways has been motivated from increased number of road accidents (due to liquor consumption).
The need of the hour is to look at it from an epidemiological lense, to understand the effect of alcohol consumption on health. The impact on health is largely influenced by reasons for alcohol consumption and in most cases, its culture based. Drinking patterns have been related to acute health outcomes such as injuries as well as chronic diseases. The WHO report 2012 on the alcohol patterns indicates the mortality and morbidity rates in India. Alcohol attribute for death in the cases of liver cirrhosis for about 62.9 per cent males and 33.3 per cent females. It also attributes as a factor in cases of road traffic accidents for about 33.1 per cent males and 2.1 per cent females.
Mapping the Indian states on the basis of alcohol consumption, Tamil Nadu ranks the highest as it accounts for 18 per cent of total consumption followed by Karnataka at 17 per cent. According to 68th report of the National Sample Survey Office (NSSO) on Household Consumption of Various Goods and Services in India data, an average person consumes about 220ml/week in India and the per capita alcohol consumption in rural India increased by nearly 28 per cent, while that of urban India rose by nearly 14 per cent.
In a comparative analysis on alcohol policies in United States and India, Henry Poduthase and Alex J Vellappally suggested,
“Even though there are laws prohibiting illegal production, distribution, and consumption of alcohol. The policy formulators should understand this reality and should focus on developing local government level initiatives to address problem of illegal alcohol.”
When it comes to policies, under Constitution, Directive Principles of State Policy direct that ‘The State shall endeavor to bring about prohibition of the consumption of intoxicating drinks.’ Alcohol consumption is a state subject and thus, each state has its own alcohol legislations. More liberalised atmosphere has been seen in India since 1992-93 with regard to prohibition in certain states. There are some prohibition policies in India regarding Liquor consumption (in terms of age, limit while driving) but there exists no policy which governs the consumption limits. There is a need for a national alcohol policy which recognizes alcohol consumption as a health hazard. It can include measures like imparting general awareness, promoting low alcohol content beverages, addressing issue of illegal production and sale of alcohol. A centralised governing body needs to be constituted which will involve all the stakeholders like medical practitioners, parliamentarians, civil societies to evaluate and monitor all the liquor policies.
