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ORIGINAL ARTICLE
Year : 2022  |  Volume : 49  |  Issue : 2  |  Page : 152-172

A cross-sectional study: Prevalence of alcohol consumption, factors associated, and its effects among undergraduate college students


1 Nursing Officer, Department of Orthopedic; Tutor, College of Nursing, AIIMS, New Delhi, India
2 Tutor, College of Nursing, AIIMS, New Delhi, India

Date of Submission28-Jan-2022
Date of Acceptance19-Apr-2022
Date of Web Publication23-Aug-2022

Correspondence Address:
Hansaram Suthar
College of Nursing, AIIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_15_22

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  Abstract 


Background: Alcoholism is gradually tearing down college students worldwide. This is turning out to be a major social predicament. Alcohol misuse was reported as a strong predictor of students' mental health. Objectives: This study aimed to assess the prevalence of alcohol consumption, factors associated with it, and its effects among undergraduate students. Materials and Methods: A cross-sectional survey was applied on 180 undergraduates at Shekhawati PG College, Rajasthan, India, using stratified random sampling. Structured questionnaire and rating scale were used to collect the data. Results: The finding showed 25.55% prevalence of alcohol consumption with majority of being males (63.04%). Maximum number (47.8%) of the students started alcohol consumption at 18–19 years of age, with reasons being social gathering or marriage party (69.56%), peer pressure and curiosity about the effects of alcohol (13.04%), and drinking habit of the parents (6.52%). Majority of the student (65.21%) drink outside the home and at night time (91.30%). Maximum urge (86.95%) was felt for pleasure (93.47%) on special occasions or party functions. Early onset of consumption made students (28.26%) addicted. Maximum students (78.3%) showed mild effects of alcohol consumption, whereas 21.7% experienced moderate effects of alcohol consumption. Conclusions: The study showed that the most common age to start consuming alcohol was between 18 and 19 years, and common reasons to start included “social activities” and “peer pressure” for majority and for a few “curiosity” and “family influence.” It becomes incumbent on the government, health-care practitioners, and other stakeholders to promote responsible drinking and discourage premature drinking.

Keywords: Alcohol consumption, alcohol effects, prevalence, students, undergraduate


How to cite this article:
Saini JK, Suthar H. A cross-sectional study: Prevalence of alcohol consumption, factors associated, and its effects among undergraduate college students. J Sci Soc 2022;49:152-72

How to cite this URL:
Saini JK, Suthar H. A cross-sectional study: Prevalence of alcohol consumption, factors associated, and its effects among undergraduate college students. J Sci Soc [serial online] 2022 [cited 2022 Oct 3];49:152-72. Available from: https://www.jscisociety.com/text.asp?2022/49/2/152/354263




  Introduction Top


Globally, alcohol consumption is a significant public health concern. It is one of the most important risk behaviors among young adults, including university students. Currently, 26.5% of the global population between the ages of 15 and 19 consumes alcohol. In Europe, the prevalence of alcohol consumption among university students was 46.2% (males) and 28.1% (females) in Bulgaria, 41.1% (males) and 18.1% (females) in Germany, and 20.1% (males) and 10% (females) in Poland. In Japan, approximately 56.8% and 47.8% of the male and female university students were binge drinkers.[1] The Hindustan Times reported that 5% of Indians can be classified as alcoholics, which projects that at least 5 million people are addicted to alcohol. Studies conducted by the De-addiction Centre at the All India Institute of Medical Sciences showed that every 5th teenager between 15 and 19 age group takes alcohol. About 300,000 are addicted, and another one lakh need medical attention for alcohol-related disorders.[2]

Problems related to alcohol consumption have risen substantially in many Asian countries, including India, over the last several years. Alcohol-related disorders are increasingly being reported in India. A significant lowering of the age at initiation of drinking was found in Karnataka, which also showed a drop from a mean age of 28 years to 20 years between the birth cohorts of 1920–1930 and 1980–1990. He asserted that alcohol consumption had visibly increased in the nontraditional segments of urban women and young people, with a noticeable upward shift in rates of drinking among urban middle and upper socioeconomic sections.[3] The greater concern is the consumption of alcohol by adolescents and youth. Of the whole Brazilian population in the age group of 12–17 years, 48.3% claim to consume alcoholic beverages, and 5.2% are alcoholic. This age group entering the university acquires social mobility from specific rules where behaviors are built from the process of social comparison. Thus, the teenager tends to model his actions by searching for similarities with the reference group, in this case, university students, who overestimate alcohol consumption. Social remodeling intensifies when the individual is presented with little experience in a new place, which occurs on entry to the university.[4] People have excuses to start alcohol consumption. One-third of the user began drinking before 20 years of age with strained relations with their family members and neighbors both. Many people complain that reason behind alcohol consumption is stress. India is a developing country, and people have different types of stress, for example, family stress, occupational, and job-related stress. In this condition, when a person cannot deal with stress and want to suppress the stress, he starts alcohol consumption.[5]

Consumption of alcohol among college students is a worldwide problem. Alcoholism is gradually tearing down college students. Alcoholism has taken its toll on college student, and this is turning out to be a major social predicament in the state. The majority of the students start taking alcohol simply for enjoyment. However, their consumption may be started because of class differences. Unemployment, poverty, frustration, etc., are also some of the main reasons for taking drugs and alcohol during youth since they feel that it can ward off tensions and worries. The problem with college drinking is not necessarily the drinking itself but the negative consequences that result from excessive drinking, which leads to college dropouts, death, injury, health problems, suicide attempts, etc., Many students are trapped into the consumption of alcohol which spoil their life and affect their careers.[6]

Alcohol consumption in college life is identified due to some risk factors including age, gender, social environment, stress, emotional health, genetic predisposition, urbanization, westernization, curiosity, and peer pressure. It is a major life-threatening problem affecting the individual college student, his family, and society in numerous adverse ways. Alcohol consumption in college life results in poor academic consequences, alcohol-related health problems, unprotected sexual problems, violence, property damage, public drunkenness or driving, suicides, and motor vehicle crashes. It is a distressing thing when college students indulge in alcoholic behavior.[7]

“All the children and adolescents have the right to grow up in an environment protected from the negative consequences of alcohol consumption and, to the extent possible, from the promotion of alcoholic beverages.”

-World Health Organization's (WHO's) European Charter on Alcohol.[8] Article 47 of the Indian constitution directive principles of state policy states, “The state shall endeavor to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health.”[9]

Alcohol is the third-leading preventable risk factor for the global burden of disease and responsible for 3.3 million deaths (5.9% of all global deaths). In 2012, WHO reported that 7.6 and 4% of deaths were attributable to alcohol among males and females, respectively. Alcohol contributes to over 200 diseases and injury-related health conditions, mostly alcohol dependence, liver cirrhosis, cancers, and injuries. Alcohol consumption is the fifth-leading risk factor of premature death globally; among people between the ages of 15 and 49 years, it is the first-leading cause. Alcohol consumption was also reported as a strong predictor of students' mental health in which it was attributable to increased depressive symptoms accompanied with drinking to cope, attempted suicide and self-harm behaviors, and aggressive behaviors.[10] The literature suggests that alcohol consumption among college students is prevalent across the globe. To identify the prevalence among undergraduate students, this study was planned to assess the prevalence of alcohol consumption, factors associated with it, and its effects among undergraduate college students of the selected college in the Sikar district of Rajasthan, India.


  Materials and Methods Top


A descriptive cross-sectional survey was applied to 180 undergraduate students of one nongovernmental, nonprofessional, Shekhawati P. G. College, Kanwat, district Sikar of state Rajasthan, India, to assess the prevalence of alcohol consumption, factors associated with it, and its effects among undergraduate college students. Stratified random sampling was used to collect the data. A structured questionnaire was developed to assess the prevalence of alcohol consumption, factors associated with it, and its effects. The tool consisted of four sections. SECTION-I included sociodemographic data such as age, sex, stream of study, year of study, type of family, educational status of parents, occupation of parents, income of the family, living arrangement, domicile, and order of siblings in the family. SECTION-II consisted of 13 items which ascertain information regarding alcohol consumption and drinking pattern of undergraduate college students. SECTION-III consisted of four main questions with multiple responses to determine the factors associated with alcohol consumption among undergraduate college students. SECTION-IV was a three-point scale to determine the effect of alcohol consumption. It consisted of 20 statements. The three-point scale consisted of responses as never, rare, and often with scores 1, 2, and 3, respectively. The maximum score was 60. The effect of alcohol consumption has been categorized into three categories – mild (20–30), moderate (31–45), and severe (46–60). The tool was developed after reviewing related literature, discussions with the experts in the field and related field, collection of information from various sources, and informal talk with undergraduate students.

To ensure the content validity of the tool, a structured knowledge questionnaire was given to nine experts. To establish the reliability of the structured questionnaire, it was administered to 10 undergraduate students of Krishna College, Kanwat, Sikar district (Rajasthan). The tool was found reliable with computed Cronbach's alpha 0.84. The average time taken by each individual for complete of knowledge questionnaire was around 30 min.

Ethical consideration

Administrative approval was obtained from the principal of Shekhawati P. G. College, Kanwat, district Sikar of Rajasthan state. Written informed consent was obtained from the participants of the study. The purpose of the study was explained to the participants, and the confidentiality of their responses was assured. Anonymity was maintained throughout the study. The study was conducted from October 15, 2019, to October 27, 2019. Participants were administered a structured questionnaires on the prevention and control of alcohol consumption. It took them around 30 min to complete the questionnaire. The data obtained were organized, tabulated, and analyzed using IBM SPSS version 26 developed by NH Niel, DH Bent and CH Hull, 1975, Chicago (USA), now IBM is the manufacturer.


  Results Top


[Table 1] shows that the maximum number (47.8%) of students were 18–19 years. Male and female participated equally in number (n = 180). Majority of students (52.2%) belongs to nuclear family. Majority of the mothers (53.3%) were illiterate. Mothers (37.2%) had secondary level education, whereas only 1.7% were postgraduate. Maximum number of fathers (33.9%) were farmers. Majority (54.5%) of the mothers was homemakers and 34.4% were in agriculture activities. Families of 33.6% of the students had income above rupees 30,000/month. Majority of students (63.33%) were day scholars, whereas 36.66% were hostelers. Maximum of the day scholars (44.4%) were living with their parents. Majority (77.8%) of students were residing in rural areas.
Table 1: Frequency and percentage distribution of sample characteristics (n=180)

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[Table 2] shows that alcohol prevalence was found at 25.55% among undergraduate students; out of that, 63.04% were male, while 36.96% were female.
Table 2: Frequency percentage distribution according to consumption of alcohol (n=180)

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[Table 3] shows that majority of students (65.23%) were of 16–18 years when they started consumption of alcohol, whereas 10.87% were of 19–21. Majority (65.23%) had beer, while 21.7% had rum as the first drink with their friends (60.9%), 30.4% with family members, and 8.7% with relatives. Majority of students (69.56%) consumed occasionally, 19.56% once a week, and 1 0.86% once in a month. Majority of the students (52.17%) drink 1–2 pegs at a time. Majority of students (76.08%) never drank five or more times in a month, whereas 2.17% drank 5–6 times in a month. Majority of the students (71.73%) were always able to stop drinking when they wanted, while 28.26% were not. Majority of the students (65.21%) used to drink outside the home, 13.04% drink at home, and 21.73% drink at both places. Majority of the students (91.30%) drink at night time. Majority of the fathers (58.69%) used to drink, whereas 26.08% of brothers, 4.34% of mothers, and 2.17% of sisters used to drink. On 56.52% times of the occasions sometimes self and sometime others whereas 34.78% times of the occasions only others paid for the drink.
Table 3: Frequency and percentage distribution according to their drinking pattern of the students who use alcohol (n=46)

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[Table 4] shows that majority of students (69.56%) consume in social gathering or marriage party, 13.04% were influenced by peer pressure and curiosity about alcohol effects, whereas 6.52% of them were influenced by their parents. Among the students, 4.34% consume alcohol due to easy availability, 4.34% drink to become happy, whereas 2.17% were influenced by a famous person or their role model. Majority (86.95%) of the students had an urge for alcohol consumption on special occasions/party functions, 13.04% had an urge when they saw somebody drinking, 2.1% when feeling depressed, while no one drank on the weekend. Majority of students (93.47%) drink for pleasure, and 6.53% when they get depressed.
Table 4: Frequency percentage distribution of factors associated with alcohol consumption among students (n=46)

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[Table 5] describes that majority of the students (78.3%) had mild, while 21.7% had moderate effect of alcohol.
Table 5: Effect of alcohol on the students (n=46)

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  Discussion Top


In the discussion of the study, we found that alcohol prevalence was 25.55% among undergraduate students; out of that, 63.04% were male, while 36.96% were female. The findings of the study are consistence with the findings of Global status report on alcohol and health (2018) which revealed alcohol consumption in young people by comparing prevalence rates of abstainers and current drinkers among the population 15–19 years of age with those in the total population. It was noted that prevalence rates of current drinking was highest in the WHO European Region (43.8%), followed by the region of the Americas (38.2%) and the Western pacific region (37.9%). Accordingly, these rates are lowest (1.2%) in the Eastern Mediterranean Region. Worldwide, more than quarters (26.5%) of all 15–19 years olds are current drinkers, amounting to 155 million adolescents.[11] Similarly, Htet et al. (2020) found that in Southeast Asia, the prevalence of harmful alcohol consumption among university students was 24.4% in Laos, 10.8% in Thailand, 1.4% in Myanmar, and 0.7% in Indonesia. The WHO recently reported that the prevalence of heavy episodic drinking among those between the ages of 15 and 19 is higher among males (47.2%) than among females (16.1%) in Myanmar.[1]

Similarly, Goel et al., in a study on alcohol and tobacco use among undergraduate and postgraduate medical students in India, found that the prevalence of alcohol and tobacco consumption among U. G. students was 16.6% and 8.0%, respectively. For both substances, males had a higher prevalence of alcohol consumption compared to females in both groups.[12] Consumption of alcohol and other substance has become a global problem. Similar findings were found in a study by Tesfaye et al. (2014) with 15,183 undergraduate regular students in Haramaya University. The study indicates that substance use among Ethiopian adolescents was considerably rising; in a particular college and university, students were the most at risk of substance use. The aim of the study was to assess substance use and associated factors among university students. A cross-sectional survey was carried out using a self-administered structured questionnaire. About two-third (62.4%) of the participants used at least one substance. The most commonly used substance was alcohol (50.2%). Being male had a strong association with substance use. These findings are similar to the present study. The study revealed that the consumption of alcohol at smaller age (among 18–19 years) in both male and female is an alarming situation.[13]

The use of alcohol in the younger generation is an alarming situation. The present study found that maximum number (47.8%) of the students who started alcohol consumption at an early age were between 18 and 19 years. Similarly, Olayinka et al. reported that alcohol consumption began at <10 years (6.25%), 11–15 years (6.25%), 16–20 years (81.25%), and 21–30 years (6.25%). Thirteen females reported they began to consume alcohol at <10 years (10.71%), 11–15 years (7.14%), 16–20 years (60.71%), and 21–30 years (21.43%).[14] Similarly, the research showed that many adolescents start to drink at very young ages. In 2003, the average age of first use of alcohol was about 14, compared to about 17.5 in 1965. People who reported starting to drink before the age of 15 were four times more likely to also report meeting the criteria for alcohol dependence at some point in their lives.[15]

The use of alcohol at early age makes the students vulnerable to become addict. It was found in the present study that maximum (28.26%) of students were not able to stop alcohol consumption, which is a sign of alcohol addiction. These findings are consistent with Hingson et al., where they reported that those who began drinking before the age 14 years were more likely to experience alcohol dependence ever and within 10 years of first drinking. They also more often experienced past-year dependence and multiple dependence episodes.[16]

Many factors are found influencing the alcoholic behavior of the students in younger age groups. These factors include easy availability (4.34%) of alcohol around the institution, in the party and social occasions or in marriage ceremony. The students consume alcohol for pleasure. The present study showed that parents' drinking habits influenced the students (6.52%) to start alcohol consumption at early age. Majority of the students (69.56%) used alcohol on the occasion of social gathering or marriage party. Majority (86.95%) of the students had urged for alcohol on special occasion or party function. Almost all the students (93.47%) drink for pleasure. Similar findings were reported by Medavarapu, where they determined the common reasons and influencing factors to start alcohol consumption in younger age groups in Dominica. The study showed that the most common age to start consuming alcohol was between 16 and 20 years and common reasons to start included “social activities” and “peer pressure” for majority and for a few “curiosity” and “adult influence.”[17] Similarly, a study was conducted to investigate the factors affecting alcohol consumption among 1200 university students of Bangkok in Thailand. It was found that alcohol consumption was not only affected by the individual level factor, but also by multilevel environmental factors, including interpersonal level, institutional level, community level, and societal level factors.[18]

Alcohol, on consumption, induces several ill effects with variable severity in the body. The present study showed that maximum number of the students (78.3%) had mild effects of alcohol, whereas 21.7% of the students experience moderate effects of alcohol. Various systemic ill effects of alcohol are reported in the report: National Institute of Alcohol Abuse and Alcoholism (2015). It suggested that early alcohol consumption may have detrimental effects on the developing brain, perhaps leading to problems with cognition later in life.[19] Similarly, it was reported that as an individual becomes more dependent on alcohol, the functional reserve and regenerative capacity of the gastro intestinal tract (GIT) are overwhelmed and malnutrition increases.[20] Similarly, the study summarized the clinically relevant effects of acute and chronic alcohol consumption on motility, mucosal inflammation, and cancer of the esophagus and the stomach.[21] This is evident that consumption of alcohol leads to nowhere except harmful effects of the health, wasting of money, damage to career, and intellectual underdevelopment. It is incumbent on the family, society, government, health-care practitioners, and other stakeholders to promote responsible drinking and discourage premature drinking. Age is a predictor of alcohol consumption.

Consumption of alcohol should be stopped at special occasion/party function as students should be engaged in other extracurricular, constructive, and pleasurable activities they have interests as.


  Conclusions Top


The study showed that the most common age to start consuming alcohol was between 18 and 19 years, and common reasons to start included “social activities” and “peer pressure” for majority and for a few “curiosity” and “family influence.” It becomes incumbent on the government, health-care practitioners, and other stakeholders to promote responsible drinking and discourage premature drinking. In conclusion, applying regression analysis, age is a predictor of alcohol consumption. Provision for periodical screening, health guidance, and counseling in the educational institutions will help in identifying potential problems related to alcohol use and preventing its after effects.

Limitation

The present study had small sample size of 180 and single setting during a short span, thus posing restriction to make a broader generalization.

A similar study with larger sample and different settings is recommended. A similar study can be done in the area of drug abuse and in various other groups such as school students, office workers, teachers, and other professional group.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.











 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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