undoc method & results - nimhansnimhans.ac.in/cam/sites/default/files/publications/25.2.pdf ·...

42

Method

43

The study was carried out as a part of a World Health Organisation Multi-centre collaborative pilot

study on unrecorded alcohol consumption in four sites: Brazil, China, India and Nigeria. The method

of study adopted was a door-to-door survey.

It was decided that in order to overcome the resistance likely to be encountered in getting people to

answer questions on their alcohol use, which would most likely be perceived to be stigmatizing, the

inquiry would be embedded within a general health survey.

1. Sampling Strategy

1a. In order that the sample be

representative of the state, the sampling units

were selected from districts chosen based on the

Human Development Report for Karnataka

(Govt. of Karnataka, 1999). The districts were

chosen so as to span the human development

spectrum in the state. So there were two districts

representing the higher (Bangalore Urban,

ranked 2) and the lower (Bidar, ranked 18) ends

of the distribution and three districts in between

(Uttara Kannada, Bangalore Rural and

Dharwad; ranked 4, 8 and 11 respectively). The

districts were also geographically representative

of the state. Bangalore Urban and Rural Districts

are in the southern part of the state and form the

heartland of the old Mysore State. Dharwad is in

the north-west and Uttara Kannada is a coastal

district again in the north-west of Karnataka.

Both these districts represent the Colonial

Bombay Presidency. Bidar is in the northern tip

of Karnataka and was a part of Hyderabad-

Karnataka.

Bangalore Urban district: 6523110

(Urban:Rural = 5745417: 777673) This consists essentially of Bangalore City and the surrounding Town Municipal Councils forming

the larger Urban Agglomeration of Bangalore Urban District.

Bangalore has emerged as a major commercial and Industrial center in South and South East Asia. It

is also the base for various large units manufacturing alcohol beverages. There has been a recent

emergence of Bangalore being associated with Pub culture implying the exponential growth of

recorded consumption of alcohol in the city.

Bangalore Rural District: Population= 1877416 (Urban:Rural = 406874:1470542)

Bangalore rural district was carved out of a unitary Bangalore district at the time when the growth

rate of Bangalore City itself was spiraling upwards. The division is a large administrative and not a

socio- cultural division. People from the rural district have extensive connections to Bangalore City

and many of the residents of the rural district come regularly and frequently to Bangalore city for

commercial, social and other transactions.

HDI Ranking: Districts of Karnataka 1991

District Human Development

Index 1991 Rank

Kodagu

Bangalore Urban Dakshina Kannada

Uttara Kannada Chikmagalur Shimoga Hassan

Bangalore Rural Belgaum Chitradurga

Dharwad Tumkur Mandya Bijapur Kolar Mysore Bellary

Bidar Gulbarga Raichur

0.630

0.601 0.592

0.533 0.524 0.483 0.473 0.472 0.471 0.466 0.459 0.447 0.444 0.443 0.443 0.440 0.429 0.419 0.412 0.399

1

2 3

4 5 6 7

8 9

10

11 12 13 14 15 16 17

18 19 20

State 0.470

Human Development in Karnataka 1999

44

Bidar :Population: 1501374 (Urban:Rural = 344454: 1156920)

Bidar district is a dry place and one of the worst drought-prone districts in Karnataka. Bidar town is

735 kms from Bangalore.

Dharwad: Population: 1603794 (Urban : Rural= 881726: 722068).

Dharwad is situated in the northern and central parts of Karnataka. A recent administrative decision

trifurcated the district into three parts- Dharwad, Gadag and Haveri- the latter two being

predominantly rural, Dharwad district currently has a urban majority.

Uttara Kannada: 1353399 (Urban:Rural = 387954: 965345) Uttara Kannada is a coastal district bordered on the north by the state of Goa. Porous borders and

inequal taxation on alcoholic beverages in Karnataka

1b. In each district representative areas for sampling were identified, so that representative

samples could be drawn from: a] Urban areas, b] Rural areas, keeping in perspective the 1: 2 urban –

rural ratio in the state. Tribal settlements were also sampled keeping in mind that tribals account for

almost 5% of the state’s population (Census of India, 2001).

Having decided the proportion of urban, rural and tribal households required to be sampled, areas

were then chosen. The proper procedure would have been to randomly choose these areas, however

for logistical reasons, areas with resources (people and institutions who could help the field workers

approach the respondents), areas where travel was easier were preferentially chosen.

1c. Having decided on the sampling areas, in each of the above areas representative sampling

units were selected based on the National Census sampling Units - The Enumeration Block

(constructed by the Census of India and recently used for the 2001 Census; each enumeration unit is

so constructed as to give a representative sample in a particular area). Enumeration blocks were

45

randomly selected from a list of enumeration blocks covering the chosen areas, provided by the

Director of Census Operations, Bangalore.

The sampling estimate was roughly:

[3 individuals per household] x [100 houses per Enumeration Block] x [1 site per district] x [5

districts] x [6interviewers] = 15,000 individuals to be covered.

The sampling was carried out in the months of November, December, 2001 and January 2002. The

timing of the sampling was fixed to coincide with the end of the monsoon season [when travel to

interior areas is almost impossible] and was planned to coincide with the Diwali festival and other

festivals, when alcohol consumption in the community was expected to rise significantly and so be

especially visible.

2. Construction of the questionnaire

Using the Health questionnaire suggested by the WHO [formulated after a meeting at Geneva] as a

template, a local version of the Health Questionnaire to assess the health status and health related

behaviors in the family was formulated. The questionnaire comprised two sections [Annexure 1] :

Section 1 – a common Family Questionnaire, addressed to a key informant- usually the head of the

family or a senior member of the family. The questionnaire collected information on the a]

geographical location of the family, b] socio-demographic details of its constituent adult members, c]

significant illness in the past 12 months, d] significant life-time illness and use of e] tobacco and f]

alcohol as well as g] Household income and h] household expenditure.

Section 2 - Based on the information given by the key informant, individual members who used

alcohol and tobacco (had used within the last ONE YEAR) were administered the questionnaire for

individuals in a face-to-face interview. The questionnaire probed for social background of the

individual, overall and specific indicators of health status and for patterns of alcohol and tobacco use.

Detailed assessment of alcohol use with a view to detecting unrecorded consumption was made.

Subjects were also asked about their alcohol use expectancies.

The questionnaire was modified from inputs received from seven experts in the field of

epidemiology, substance abuse and social work, with special focus on applicability and relevance to

the local situation.

Modifications were made in the questionnaire to take into account local variants of alcoholic

beverages and tobacco products.

Care was taken to embed the alcohol questions within the background of a general health

questionnaire.

The questionnaire was translated into Kannada, the local language predominantly used in the areas to

be sampled and back-translated into English, using the WHO recommendations for translation. The

back-translated version was compared with the original and relevant modifications were made in the

Kannada version.

3. Ethical approval of the study protocol

The proposal was cleared by the Ethics Review Committee at the National Institute of Mental Health

and Neurosciences, Bangalore. Due to the fact that the local Ethics committee at the National

Institute of Mental Health and Neurosciences could not meet to review the project, we were not able

to secure a formal clearance from the Ethical review board till January, 2002. However, utilising an

alternative procedure allowing circulation of the proposal to the members of the review board to

secure a preliminary clearance, we were able to secure permission to start sampling pending the

formal review meeting on January 30, 2002. The formal clearance was intimated to the investigators

through a letter dated 18 February, 2002

46

4. Selection and training of field staff

The field staff were selected based on previous experience of having worked in epidemiological/

population studies in the past. Six field staff who had previously worked in the WHO Collaborative

project on Alcohol and Injuries in Emergency rooms of Large General Hospitals were selected.

The field staff were trained over two half day work-shops on the objectives of the study,

administering the questionnaires and collection of additional information. The field staff received

special training on house to house surveys and the sensitivities involved in entering homes and

asking questions regarding substance use. Assistance in training the field staff was taken from the

Census office and techniques used by census enumerators were imparted.

A free listing of licit and illicit alcoholic beverages was conducted during the workshop and the field

staff were encouraged to do such free listing with respondents in the communities they were to

survey.

5. Pilot survey

The six field staff interviewed five families each [n=60] in an urban location in Bangalore city.

Problems encountered during the pilot phase were discussed in a meeting between the project

supervisor and the field staff. No significant problems were encountered during the pilot phase,

however a few of the field staff felt that some respondents were minimizing their alcohol use and this

was resulting in under-reporting. The need to present the survey as a general health assessment rather

than one measuring alcohol use was stressed. However keeping in mind the proscriptive attitudes to

alcohol use prevailing in the Indian society, it was acknowledged that there would be some under-

reporting of use. However, since the aim of the project was to obtain estimates of unrecorded [illicit]

consumption it was felt that despite lower prevalence of reported use, the data would still present a

true picture of unrecorded consumption as a proportion of total use.

6. Implementation and Completion of field work

The field work was completed by 30 January,2002. The total number of households surveyed were:

Bangalore district 1800

Dharwad district 910

Bidar district 1500

Uttara Kannada district 1200

Total Households 5200

7. Data Entry and Analysis

The data was entered into a database on the SPSS 11.0 platform, cleaned and analysed.

47

Results

Queue at the hooch shop

48

A g e ra n g e

3 4 .9 3 1 .8

4 9 .8 5 1 .6

9 .9 9 .7

6 .5 6 .9

0 %

1 0 %

2 0 %

3 0 %

4 0 %

5 0 %

6 0 %

7 0 %

8 0 %

9 0 %

1 0 0 %

C en s u s S am p le

> 6 0 ye a rs

4 5 -5 9 ye a rs

1 5 -4 4 ye a rs

0 -1 4 ye a rs

1. Socio-demographic data

The population sampled consisted

of 21,276 individuals [938

females to 1000 males] from 5200

families. This comprised 14,364

adults [7445 men and 6919

women (1000:930)].

The sociodemographic profile of

the sample population is roughly

similar to that in the general

population of the Karnataka state

[Census of India, 1991 and 2001].

The age range of the sample

population is very close to that of

the general population in the state.

The sex ratio at 930 females per

1000 males is roughly similar

[Karnataka figures of 964 females

per 1000 males].

Age: The mean age of the men in the adult sample was 34.8 (15.4) years [median 30 years, mode 40

years; range 15-95 years] and the mean age of the women was 33.5 (15) [median and mode 30 years;

range 15-98 years].

Occupation

Table1a: Main work status in past 12 months

Frequency Valid Percent

Government employee 178 5.0

Non-government employee 1168 32.6

Self employed 1622 45.3

Non-paid(volunteer) 20 .6

Student 9 .3

Homemaker 243 6.8

Retired 50 1.4

Unemployed(able to work) 102 2.8

Unemployed(unable to work) 190 5.2

Total 3582 100.0

Missing 10782

Total 14364

Education: The educational level [in terms of number of years of formal education achieved] was 5.6

(5.1) years for the men [median of 5 years, mode 0; range 0-19 years] and 3.6 (4.6) years for the

women [median and mode =0; range 0-19 years].

Marital status: 74.8% of the sampled population were married and 25.2% single

The average family income was Rs. 30,596 (28,501) per family per year. The modal value for family

income was Rs. 24,000 which is almost double the per capita income [Rs. 13,621] in the state

49

[Source:Directorate of Economics & Statistics, Bangalore]. This is compatible with about two earning

members per family.

2. Prevalence of Alcohol Use

Among the adults, 15.3% [n=2198] reported consuming any alcohol in the past 12 months.

The prevalence of alcohol use in the last 12 months was 28.4% [2114/7445] in men and 1.2%

[83/6919] in women.

The mean age of the drinking population is 41.9 (13.9) years, whereas the age at initiation for this

population is 22.8 (4.3) years [Modal value of 20 years] and the age at which the average person was

drinking regularly i.e. at least once a month was 24.6 (5.6) years [Modal value of 20 years] .

The prevalence of users was significantly higher in the rural sample than in the urban sample [61.4%

vs. 38.6%; Pearson’s Chi square = 93.9, df 1, p< 0.0001]. The difference continued to be significant

even when the tribal sample was factored out [51.8% vs. 48.2%; Pearson’s Chi square = 37.6, df 1,

p< 0.0001].

The data related to 951 alcohol drinkers were used to find the presence of any trend in age at first

drink in different birth cohort. Quasi-independent loglinear model approach was employed to find

the shift towards earlier onset of first drink in successive birth cohort. The method proposed by

Stassen et.al(1997) was used to make adjustment for the observability of data (i.e. when the age at

assessment is less than the age at first drink at the time of recording). The results show that there is

a significant trend towards earlier onset of first drink as shown by the likelihood ratio chi square (L2

=74.84, P<0.001).

Table. 1b: Mean age at first drink (years) in different birth cohorts

1920-1930 1930-1940 1940-1950 1950-1960 1960-1970 1970-1980 1980-1990 Total

N 15 70 119 179 341 207 20 951

Mean 27.67± 6.38 24.31±4.59 23.35±4.17 23.36±4.17 22.87±3.50 21.12±2.61 19.45±2.44 22.75±3.87

Table. 1c:- Observed and expected frequencies under smoothed truncation method

1920-1930 1930-1940 1940-1950 1950-1960 1960-1970 1970-1980 1980-1990 Total

14-18 2(0.8) 4(3.8) 7(6.5) 11(9.7) 11(18.6) 16(13.4) 6(4.2) 57

18-22 1(8.0) 27(37.4) 65(63.6) 87(95.6) 189(182.4) 151(131.2) 12(13.8) 532

22-26 4(3.7) 19(16.5) 24(28.3) 45(42.6) 97(81.2) 32(46.7) 0 221

26-30 4(2.4) 18(11.1) 23(18.9) 34(28.5) 44(54.4) 8(15.6) 0 131

30-34 3(0.2) 2(0.8) 2(1.3) 1(2.0) 0(3.6) 0(0.1) 0 8

34-38 1(0.1) 0(0.2) 0(0.4) 1(0.6) 0(0.7) 0 0 2

Total 15 70 119 179 341 207 20 951

L2

=74.84, P<0.001; Chi2 = 116.08, p<0.001

50

3. Alcoholic Beverages consumed

Of the total alcohol users, 34.6% specified using illicit alcoholic beverages as their preferred drink.

Indian made foreign liquors accounted for 38%, country liquor (arrack) for 23%, beers for less than

4% and imported foreign liquors for less than 1% [Table2a].

149 out of the 836 (about 18%) consumers of IMFL reported buying their beverage at prices below

the minimum suggested retail price (Rs. 30.00 for 180 ml. Bottle of whisky, brandy, vodka or rum),

which is highly suggestive of the fact that they had been sold “seconds” liquor. This would increase

the quantity of undocumented alcohol consumed to 39.2% of the total consumption [Table 2b]. Only 24.3% of the users [534/2197] reported having a second preference. Here too, the second

preference beverage most indicated was in the undocumented/illicit category (54.5%). The other

beverages were IMFL (23.6%), Arrack (15.2%), Beers (5.8%) and FMFL (.9%) [Table2c]

Table 2c: Second preference beverage

Beverage type Frequency Percent As a proportion of people with 2

nd

preference

IMFL 126 5.7 23.6

Arrack 81 3.7 15.2

Beers 31 1.4 5.8

FMFL 5 .2 .9

Undocumented / Illicit 291 13.2 54.5

Total 534 24.3 100.0

None 1663 75.7

Total 2197 100.0

Table 2a: Beverage of first choice Frequency Percent Percent

Indian Made Foreign Liquors (IMFL)_Whisky 486 22.2

Indian Made Foreign Liquors (IMFL)_Brandy 236 10.8

Indian Made Foreign Liquors (IMFL)_Rum 94 4.3

Indian Made Foreign Liquors (IMFL)_Gin 6 .3

Indian Made Foreign Liquors (IMFL)_Vodka 4 .2

Indian Made Foreign Liquors (IMFL)_Others 7 .3

38.0

Government licensed country liquor (Arrack) 507 23.1 23.1

Light beer 69 3.1

Strong beer 10 .5

3.6

Foreign Made Foreign Liquors (Imported) _Scotch whisky 12 .5

Foreign Made Foreign Liquors (Imported) _Brandy 2 .1

.7

Foreign Made Foreign Liquors (Imported) _Rum 1 .0

Illicit distilled spirits 553 25.2

Illicit beers and brews 37 1.7

Illicit others- smuggled etc 170 7.7

34.6

Total 2194 100.0 100.0

Table 2b: Beverage of first choice (adjusted for seconds)

Beverage type Frequency Percent

Indian Made Foreign Liquors (IMFL) 687 31.3

Government licensed country liquor (Arrack) 507 23.1

Beers 80 3.6

Foreign Made Foreign Liquors (Imported) 15 .7 Undocumented/Illicit including “seconds” 909 41.3

Total 2198 100.0

51

None of the respondents reported a third preference.

There was little gender difference in the preference for undocumented / illicit beverage [Table2d]

In men and women who reported drinking a second beverage when the preferred beverage was not

available, women reported an overwhelming preference (71%) for illicit beverages, and so did the

men (54%) [Table2e].

Consumers who expressed having a second preference beverage had significantly lower family

incomes [Rs. 2028.66 (1417.79) per month vs. Rs. 2481 (2907.84) ; t=4.6, df 1699, p< 0.0001]

compared to consumers who did not express a preference for a second beverage. Similarly, they had

significantly less education [2.9 (4.2) years vs. 3.7 (4.7) years,; t=3.8, df1017, p<0.0001], drank

significantly more [20.9 (17.5) litres of absolute alcohol per year vs. 16.8 (16.8) litres of absolute

alcohol per year; t=4.9, df 2183, p<0.001], had higher AUDIT scores [12.8(5.5) vs. 11.8 (5.1); t= 3.8,

df 2192, p <0.0001] and spent a greater proportion of their income on alcohol [ 30 (32.8%) % vs.

26.2 (43.6) %; t=1.8, df 1969, p=.081].

4. Distributions in Urban – Rural – Tribal areas

While illicit / undocumented beverages constituted 15% of total consumption among urban

consumers, it accounted for 38% of consumption among rural consumers, rising to 65% in tribal

areas.

Table 2d: Beverage of choice among men and women

Sex Frequency Percent Female IMFL 28 33.7 Arrack 27 32.5 Beers 1 1.2 Undocumented/Illicit 27 32.5 Total 83 100.0

Male IMFL 807 38.2 Arrack 480 22.7 Beers 79 3.7 FMFL 15 .7 Undocumented/Illicit 733 34.7 Total 2114 100.0

Not adjusted for seconds

Table2e: Second preference beverage among men and women Sex Frequency Percent Female Arrack 3 21.4 Beers 1 7.1 Undocumented / Illicit 10 71.4 Total 14 100.0

Male IMFL 126 24.2 Arrack 78 15.0 Beers 30 5.8 FMFL 5 1.0 Undocumented / Illicit 282 54.1 Total 521 100.0

52

The prevalence of abstainers was the highest in the urban areas, 88% of the sampled population; 84%

in the rural population and the lowest (65%) among the tribal sample.[Tables 2f] .

Table2f: Beverage of choice in Urban, Rural and Tribal respondents Urban respondents Frequency Users and abstainers

(Percent) Beverage choice among users (Percent)

Indian Made Foreign Liquors 447 6.5 52.8 Arrack 239 3.5 28.3 Beers 28 .4 3.3 Foreign Made Foreign Liquors 6 .1 .7 Undocumented/Illicit 126 1.8 14.9 Total 846 12.3 100.0 Abstainers 6059 87.7 Total 6905 100.0 Rural respondents Frequency Users and abstainers


Indian Made Foreign Liquors 336 5.9 36.8 Arrack 198 3.5 21.7 Beers 25 .4 2.7 Foreign Made Foreign Liquors 5 .1 .5 Undocumented/Illicit 349 6.2 38.2 Total 913 16.1 100.0 Abstainers 4745 83.9 Total 5658 100.0 Tribal respondents Frequency Users and abstainers


Indian Made Foreign Liquors 53 2.9 12.1 Arrack 70 3.9 15.9 Beers 27 1.5 6.2 Foreign Made Foreign Liquors 4 .2 .9 Undocumented/Illicit 285 15.8 64.9 Total 439 24.4 100.0 Abstainers 1362 75.6 Total 1801 100.0

Abstainers were significantly more likely at least in urban and rural areas, to have a higher

education, and higher income. No such differences were noted among the tribal respondents. Table 2g: Differences in Education and Income between Users and Abstainers

Alcohol users and abstainers

Mean (S.D) T df p

Abstainers 5 (5) Education (years) Users 3.9(4.7)

6.627 1123.380 .000

Abstainers 2931.28 (2121.55)

Urban

Family income (Rupees) Users 2504.62 (1786.89)

4.525 1859 .000

Abstainers 5.2 (5) Education (years)

Users 3.4 (4.4)

10.911 1401.663 .000

Abstainers 2512.83 (2246.22)

Rural

Family income (Rupees) Users 2225.69 (3205.94)

2.044 1575 .041

Abstainers 3.1 (4.8) Education (years) Users 2.9 (4.7)

.974 765.781 .330

Abstainers 2211.48 (1657.65)

Tribal

Family income (Rupees)

Users 2409.90 (2613.36)

-.792 524 .429

53

5. Quantity and Frequency of use

More than 55% of female consumers and more than 68% of male consumers drank their beverage of

first preference, daily or almost daily [Table 3a].

Table 3a: Frequency of use of preferred beverage (Past 3 months) Sex Frequency Valid percent Female Daily 43 51.8 3-5 days a week 3 3.6

55.4

1-2 days a week 19 22.9 2-3 times a month 14 16.9 Once a month 3 3.6 Less than once a month 1 1.2 Total 83 100.0

Male Daily 1349 63.9 3-5 days a week 79 3.7

67.6

1-2 days a week 366 17.3 2-3 times a month 219 10.4 Once a month 93 4.4 Less than once a month 4 .2 Total 2110 100.0 Missing 4 2114

When it came to the use of the second preference

beverage, 4% drank daily or nearly daily; around

20% drank 2-3 times a month or less frequently

[Table 2b].

Frequency of use of preferred beverage

(Past 3 months)

In Men

less

1/month

2-3/month

1-2 days

3-5 days/week

Daily

Perc

ent

70

60

50

40

30

20

10

0

Frequency of use of preferred beverage

(Past 3 months)

In Women

less

1/month

2-3/month

1-2days/week

3-5 days/week

Daily

Perc

ent

60

50

40

30

20

10

0

Frequency of 2nd preference

(Past 3 months)

Men and Women

Frequency of 2nd preference

less often

once/month

2-3/month

1-2days/week

3-5days/week

Daily

Never

Pe

rce

nt

80

60

40

20

0

54

Quantity of preferred beverage drunk per drinking occasion (representative day)

Men drank 62.2 (43) ml. of absolute alcohol equivalent per typical drinking occasion [Median 43 ml

and mode 37 ml; range 12.9-580.5] and women drank 62.3 (53.4) ml. of absolute alcohol equivalent

per typical drinking occasion [Median and mode 38.7 ml; range 12.9-279.5].

In terms of standard drinks (10 g. ethanol) this amounted to 4.9 (3.4) drinks [Median and mode 3

drinks; range 1-46 drinks] per day in men and 4.9 (4.2) drinks [Median and mode 3 drinks; range 1-

22 drinks].

Quantity of second preference beverage drunk per drinking occasion (representative day)

Men drank 56.1 (28.7) ml. of absolute alcohol equivalent per typical drinking occasion [Median 43

ml and mode 77 ml; range 12.9-279.5] and women drank 60.9 (21.3) ml. of absolute alcohol

equivalent per typical drinking occasion [Median 60 ml, mode 43 ml; range 34-97.5].

In terms of standard drinks (10 g. ethanol) this amounted to 4.5 (2.3) drinks [Median 3.4 ml, mode

6.2 drinks; range 1-22 drinks] per day in men and 4.8 (1.7) drinks [Median 4.8, mode 3.4 drinks;

range 3-8 drinks].

Table 3b: Frequency of 2nd

preference beverage (Past 3 months) Frequency Percent Never 1655 75.6 Daily 60 2.7 3-5 days a week 26 1.2 1-2 days a week 24 1.1 2-3 times a month 157 7.2 Once a month 173 7.9 Less than once a month 95 4.3 Total 2190 100.0

No. of drinks - preferred beverage

45.0

40.0

35.0

30.0

25.0

20.0

15.0

10.0

5.0

0.0


In Men

Fre

quency

1400

1200

1000

800

600

400

200

0

Std. Dev = 3.41

Mean = 4.9

N = 2110.00


22.520.017.515.012.510.07.55.02.50.0


In Women

Fre

qu

en

cy

60

50

40

30

20

10

0

Std. Dev = 4.24

Mean = 4.9

N = 83.00

55

6. Per capita consumption estimates

To arrive at an estimate of the total annual consumption (of both the preferred and second

preference beverage), the quantity per typical drinking occasion was weighted by values of

frequency of drinking [the maximum possible number of days in a subcategory was taken as the valid

weight; e.g. respondents drinking daily were weighted by a factor of 30 days a month, those drinking

3-5 days a week received a weight of 20 days a month and so on]. The product was then extended

[multiplying by 12] to amount of beverage drunk per year.

The total annual consumption in the sampled population of 14364 persons (2194 drinkers) was thus

estimated at 38811.84 litres of absolute alcohol equivalent per year.

38811.84 litres of absolute alcohol equivalent per year drunk by 2194 drinkers amounts to 17.7 litres

of absolute alcohol equivalent per year per user. The median and modal value is 13.94 litres of

absolute alcohol (32.4 litres of spirits) per user per year

For drinkers in urban areas the per capita consumption (average consumption) is 16.9 (19) litres of

absolute alcohol equivalent per year per user. The median value is 13.2 litres and modal value is 13.9

litres of absolute alcohol per user per year. For drinkers in rural areas the per capita consumption

(average consumption) is 17.7 (14) litres of absolute alcohol equivalent per year per user. The

median and modal values are 13.9 litres of absolute alcohol per user per year.

For drinkers in tribal areas the per capita consumption (average consumption) is 19.6 (18.7) litres of

absolute alcohol equivalent per year per user. The median and modal values are 13.9 litres of

absolute alcohol per user per year.

38811.84 litres of absolute alcohol equivalent per year available to 14364 adults amounts to a per

capita availability of 2.7 litres of absolute alcohol equivalent per year per caput [6.3 litres of spirit

per person per year].

7. Patterns of drinking

Drinking situations

For most consumers (68%) the typical drinking situation comprised having a drink in the evening,

often while returning home from work. Fewer consumers reported that they drank on weekends and

going out with friends.

Drinking at home (4%) and at festive occasions (4%) were rarely reported [Table 4a].

Table 4a: Usual drinking situations

Total Female Male Frequency Percent Frequency Percent Frequency Percent

Evening (almost every day) 960 43.8 32 39.0 928 44.0 Returning home from work 501 22.9 16 19.5 485 23.0 Weekends 272 12.4 11 13.4 261 12.4 Going out with friends 270 12.3 3 3.7 267 12.7 Festivals, marriages, etc. 87 4.0 4 4.9 83 3.9 Relaxing at home 87 4.0 14 17.1 73 3.5 Other 15 .7 2 2.4 13 .6 Total 2192 100.0 82 100.0 2110 100.0 Missing 2 Total 2194

56

Place of drinking

Most of the drinking (60%) occurred in male –oriented drinking places like pubs, bars, counters of

off-premises liquor shops and in country-liquor bars. Another aspect of under-socialised drinking

was drinking alone in the street or in lonely places (20%). Drinking in socialized circumstances

whether at home (6%) or restaurants, clubs and parties or with friends (15%) was far less common.

Table 4b: Preferred place to have a drink Frequency Valid Percent In a pub, bar or arrack shop 775 35.3 At the counter of the liquor shop 424 19.3 In a country liquor serving place 128 5.8 On the street or lonely places 428 19.5 At home 138 6.3 At clubs, restaurants 131 6.0 At parties or at friends houses 68 3.1 Others 101 4.6 Total 2193 100.0 Missing 1 Total 2194

Table 4c: Gender differences in preferred places of drinking Sex Frequency Valid Percent

In a pub, bar or arrack shop 17 20.7 In a country liquor serving place 5 6.1 At the counter of the liquor shop 8 9.8 At parties or at friends houses 1 1.2 At home 28 34.1 At clubs, restaurants 2 2.4 On the street or lonely places 18 22.0 Others 3 3.7 Total 82 100.0 Missing 1

Female Total 83

In a pub, bar or arrack shop 756 35.9 In a country liquor serving place 123 5.8 At the counter of the liquor shop 416 19.7 At parties or at friends houses 67 3.1 At home 110 5.2 At clubs, restaurants 129 6.1 On the street or lonely places 410 19.4 Others 98 4.6

Male Total 2111 100.0

Social drinking

In the same vein, 81% of consumers preferred drinking in predominantly male company, 4% in

mixed company and 15% preferred solitary drinking.

However men and women expressed radically different preferences. 43% of women consumers

preferred to drink alone; 28% with male relatives or acquaintances and 20% in mixed company

[Table 4d].

57

Table 4d: Social drinking – preferred company while drinking Sex Frequency Valid Percent

In the company of male friends & acquaintances 23 28.0 In the company of male and female friends 17 20.7 Mostly on my own 35 42.7 Other situations 7 8.5

Female

Total 82 100.0

In the company of male friends & acquaintances 1750 82.9 In the company of male and female friends 63 2.9 Mostly on my own 285 13.5 Other situations 14 .7


A large proportion of both men and women reported that they drank their beverages rapidly and

without mixing or diluting (mostly spirits) with water, soda or other fillers [Tables 4e & 4f].

Table 4e: Style of drinking – gulping drinks Sex Frequency Valid Percent

Sip your drinks 38 46.3 Gulp your drinks 44 53.7 Total 82 100.0 Missing 1

Female Total 83

Sip your drinks 1152 54.6 Gulp your drinks 956 45.3 Total 2108 100.0 Missing 3

Male Total 2111

Table 4f: Style of drinking – diluting spirits Sex Frequency Valid percent

Neat, without mixing 51 62.2 Mixed with water, soda or other filters like cola etc.

31 37.8

Total 82 100.0 Missing 1

Female

Total 83 Neat, without mixing 1127 53.4 Mixed with water, soda or other filters like cola etc.

984 46.6 Male

Total 2111 100.0

Table 4g: Style of drinking – drinking along with food Sex Frequency Valid Percent

Light snacks, something to munch 18 22.0 Prefer to finish drinking before I eat 61 74.4 Drink along with my meals 3 3.7

Female Total 82 100.0

Light snacks, something to munch 850 40.3 Prefer to finish drinking before I eat 1230 58.3 Drink along with my meals 31 1.5


58

For men and women, drinking was not an activity which accompanied eating of meals. 58% of men

and 74% of women preferred to finish drinking before they ate anything; however 40% of the men

and 22% of women usually had light snacks or something to munch along with their drinks [Table

4g].

8. Family history and normalization of use

While 30% of male consumers reported alcohol use in their first and second degree relatives, 65% of

female consumers reported use in first and second degree relatives (mostly male) Table 5a].

Table 5a : Family history of alcohol use Sex Frequency Valid Percent

No one other than me 29 35.4 My spouse, brother(s), son(s) 32 39.0 Father/uncle(s)/grandfather(s) 10 12.2 Mother,sister,aunt(s), daughter(s) 11 13.4


No one other than me 1500 71.2 My brother(s), son(s) 327 15.5 Father/uncle(s)/grandfather(s) 269 12.8 Spouse, mother,sister,aunt(s), daughter(s) 12 .6


While 36% of male consumers reported knowing close acquaintances like co-workers and friends

who drank, in women this figure was comparably lower (23%) [Table 5b].

Table 5b: People you know closely, who also drink Sex Frequency Valid Percent

Neighbours, mostly people in the locality 63 76.8 Co-workers 9 11.0 Friends 10 12.2


Neighbours, mostly people in the locality 1343 63.7 Co-workers 463 22.0 Friends 301 14.2


39% of women consumers and 32% of male consumers acknowledged that they faced socio-cultural

/ religious restrictions applied to drinking.

Table 5c: Socio cultural restrictions against drinking in the immediate milieu (community/religion/caste) Sex Frequency Valid Percent

No 50 60.9 Yes 33 39.0

Female

Total 82 100.0

No 1428 67.7 Yes 683 32.4


45.6% of males and 31.3% females had initiated drinking before the age of 21 years. 23% of the

males and 23% of females had begun regular drinking before the age of 21.

59

67.4% of tribal respondents, 50.4% of urban respondents and 29.3% of the rural respondents had

had their first drink before 21 years. [10.6% of urban consumers, 3.5% of rural consumers and

11.6% of tribal consumers had initiated drinking by 18 years] Similarly 45% of tribal respondents,

29% of urban respondents and 15% of rural respondents had started regular drinking before 21 years.

9. Drink related expectancies and attitudes

A common expectancy among both male consumers (35%) and female consumers (20%) was that

people got drunk (or drank to intoxication) whenever they drank at all.

Table 6a: Drinking leads to intoxication Sex Frequency Valid Percent Female Get drunk when they are drinking at all 16 19.5 Get drunk some of the time when they are drinking 63 76.8 Never get drunk at all 3 3.7 Total 82 100.0 Missing 1 Total 83 Male Get drunk when they are drinking at all 729 34.6 Get drunk some of the time when they are drinking 1295 61.4 Never get drunk at all 84 4.0 Total 2108 100.0 Missing 3 Total 2111

Regarding women’s drinking, both men and women consumers expressed the view that they

believed some women drank but in small amounts and rarely (72% and 79% respectively).

Table 6b: Attitudes: what proportion of women drink?

Sex Frequency Valid Percent

Never drink 8 9.8

Some drink but in small amounts and rarely 65 79.3

Drink, but keep it hidden because of the shame attached

9 11.0

Total 82 100.0

Missing 1

Female

respondents

Total 83

Never drink 314 15.0

Some drink but in small amounts and rarely 1519 72.0

Drink, but keep it hidden because of the shame attached

273 12.9

Total 2109 100.0

Missing 2

Male

respondents

Total 2111

10. Problems arising from drinking (Subjective).

Regarding problems they had faced due to alcohol use, both men (27%) and women (26%) stated

problems with money as the major problem. Men reported more problems with spouse, parents or

children than the women consumers. On the whole most consumers (56% male and 68% female)

reported no problems arising from their drinking [Table 7a].

60

Table 7a: Faced any problems due to drinking

Sex Frequency Valid percent Female None 56 68.3

Physical health(accidents/mental problems) 2 2.4 Home life(trouble with spouse/trouble with parents/children) 3 3.7 Money problems 21 25.6 Total 82 100.0

Male None 1190 56.4

Physical health(accidents/mental problems) 127 6.0

Home life(trouble with spouse/trouble with parents/children) 158 7.5

At work 63 3.0

Money problems 572 27.1

Total 2110 100.0

11% female consumers and 17% male consumers reported suffering problems due to other people’s

drinking (Table 7b).

Table 7b: Faced problems with other people;s alcohol use

Sex Frequency Valid percent Female None 73 89.0

Insulted or disturbed by someone who had been drinking 6 7.3 Physically /sexually assaulted by someone who had been

drinking 3 3.7

Total 82 100.0 Male None 1759 83.4

Insulted or disturbed by someone who had been drinking 254 12.0

Physically /sexually assaulted by someone who had been drinking

84 4.0

Family problems because of someone else's drinking 11 .5

Accidents because of someone else's drinking 2 .1

Total 2110 100.0

11. AUDIT Scores

The AUDIT score among all alcohol consumers was 12(5.2) [Median 12, mode 13, Range 1-39).

80% of all consumers (65% of all female consumers and 80% of all male consumers) scored eight or

above, which is generally used as the cut-off for hazardous drinking.

The total AUDIT scores were significantly higher, among male consumers (12.1+ 5.2; mode 13,

range 1-39) than among female consumers (10.1 + 5.3; mode 5, range 2-32) [t=-3.4, df 88.4,

p=0.001]

The differences were contributed to by significantly increased scores in males compared to females,

on the following items:

AUDIT item 1- tapping frequency of use [Mann-Whitney U=76680. 0; Z=2.3, p=.024]; AUDIT

item 3- tapping frequency of bingeing i.e 5 drinks or more [Mann-Whitney U=70158.5; Z=3.2,

p=.001]; AUDIT item 4- tapping loss of control [Mann-Whitney U=68137; Z=3.8, p=.0001];

AUDIT item 5- tapping salience of drinking [Mann-Whitney U=76761; Z=2.3, p=.022]; AUDIT

item 9- drinking causing injury to self or others [Mann-Whitney U=75687.5; Z=3.1, p=.002];

AUDIT item 10 – having received advise to stop or cut down [Mann-Whitney U=77621.5; Z=2,

p=.001];

However there was no significant difference in the typical quantity drunk (AUDIT item 2).

61

Thee total AUDIT scores were significantly higher, among rural consumers (12.4+ 5) than among

urban consumers (11.4 + 5.4) [t=-4.3, df 2192, p<0.0005]

12. Burden on Health

Illness in last one year – Differences between alcohol users and abstainers

A significantly higher number of alcohol users (15%) compared to abstainers (7%) reported that they

had suffered at least one significant illness in the past year [Table 8a].

Table 8a : Prevalence of Illness in last year

Significant illness in last one year

Absent Present Total

Abstainers 11195 (92.7%) 877 (7.3%) 12072 Alcohol users 1855 (84.7%) 335 (15.3%) 2190

Pearson Chi-Square = 153.8, df 1, p<0.0005

While there was no significant difference in the overall prevalence of illness in the last year, between

those who drank more or less than 5 drinks per typical session [Table 8b], heavy drinkers i.e. those

who drank more or less than 5 drinks per typical session were significantly more likely to suffer

emotional problems like depression and anxiety, stomach pain presumably indicative of alcohol

related erosive gastritis, and other somatic problems like headache and generalized aches and pains.

While not statistically significant this population also reported more frequent heart ailments, diabetes

and increased blood pressure [Table 8c].

Table 8b: Significant illness in last one year

Absent Present Total Abstainers 11195 (92.7%) 877(7.3%) 12072

1-5 drinks 1036 (84.8%) 185(15.2%) 1221

More than 5 drinks 819(84.5%) 150(15.5%) 969

Table 8c: Health consequences in Heavy drinkers

Drinking < 5 drinks / occasion

Drinking >5 drinks / occasion

Chi square

df p

Yes 20 (1.8%) 24 (2.3%) High Blood pressure No 1090 (98.2%) 1040 (97.7%)

.56 1 0.45

Yes 2 (0.2%) 6 (0.6%) Diabetes

No 1107 (99.8%) 1058 (99.4%)

2.2 1 0.14

Yes 9 (0.8%) 18 (1.7%) Heart problems No 1101 (99.2%) 1064 (98.3%)

3.4 1 0.06

Yes 35 (3.2%) 53 (5%) Back pain Aches & pains

No 1075 (96.8%) 1010 (95%)

4.7 1 0.03*

Yes 15 (1.4%) 29 (2.7%) Headache No 1095 (98.6%) 1034 (97.3%)

5.2 1 0.02*

Yes 33 (3%) 55 (5.2%) Stomach pain/ burning No 1076 (97%) 1007 (94.8%)

6.8 1 0.009**

Yes 1 (0.1%) 3 (0.3%) Stroke No 1109 (99.9%) 1060 (99.7%)

1.1 1 0.3

62

Yes 0 14 (1.3%) Depression / Anxiety No 1110 (100%) 1049 (98.7%)

Fisher’s Exact Test

<0.0005

Yes 44 (4%) 47 (4.4%) Sleep problems No 1066 (96%) 1015 (95.6%)

0.29 1 0.59

Yes 10 (0.9%) 4 (0.4%) Hearing problems No 1100 (99.1%) 1058 (99.6%)

2.3 1 0.13

Yes 39 (3.5%) 14 (1.3%) Vision problems No 1071 (96.5%) 1048 (98.7%)

11 1 0.001

Yes 81 (7.3%) 100 (9.4%) Others No 1029 (92.7%) 962 (90.6%)

3.2 1 0.07

Quality of beverage and health consequences

Surprisingly, the prevalence of significant illness in the last year, did not significantly differ between

the users of licit beverages and illicit beverages (although people who drank illicit alcohol had a

greater percentage of health consequences) [Table 8d] nor between those who drank beverages

generally believed to be of poor quality (illicit and country liquor) and those who consumed the so-

called better quality beverages [Table 8e ]

Table 8d: Illicit alcohol and health problems

Significant illness in last one year


Licit 1199 (83.8%) 231 (16.2%) 1430 Licit or illicit

Illicit 656 (86.3%) 104 (13.7%) 760

Total 1855 335 2190

Pearson Chi-Square=2.3, df1, p=.126

Table 8e: “Poor quality” alcohol and health problems

Significant Illness In Last One Year


"High Quality" 787 (85.3%) 136 (14.7%) 923 "High" Or "Poor" Quality "Low Quality 1068 (84.3%) 199 (15.7%) 1267

Total 1855 335 2190

Pearson Chi-Square = .39, df1, p = .53

Alcohol and Tobacco use

Alcohol users, both male (78%) and female (75%) had significantly higher prevalence of tobacco use

in the last year [Table 9].

Table 9 : Tobacco use among Alcohol users

Any tobacco use in last one year Total

Sex No Yes

Abstainers 6201(91.6%) 570(8.4%) 6771 Female Alcohol users 20 (25.0%) 60 (75.0%) 80 6221 630 6851

Abstainers 4121 (77.7%) 1181(22.3%) 5302 Male Alcohol users 475 (22.5%) 1635 (77.5%) 2110

Total 4596 2816 7412

Female: Chi-Square=419.8, df1, p<0.0001; Male: Chi-Square=1953, df1, p<0.0001;

63

Gender, alcohol use and illness

Women consumers had their first drink – age at initiation to alcohol use, significantly later than the

men (17.8+13.4 years vs. 15.6+10.6 years, t = -4.3, df 85.02, p < 0.0001), started regular drinking –

age of starting to drink at least once a month- significantly later (27.9 + 8.4 years vs. 24.5 + 5.4; t = -

3.7, df 84.7, p < 0.0001).

Age of starting to use tobacco in alcohol consumers was also later than in men, however the

difference was not statistically significant (17.8 + 13.4 years compared to 15.6 + 10.6 years in men, t

= 1.8, df 2167, p = 0.066).

However, there were no significant gender differences in the amount of preferred beverage (or

second preference beverage, where applicable) consumed during a typical drinking occasion

(Women : 4.95 + 4.2 drinks vs. Men :4.94 + 3.4 drinks and for the 2nd

preference Women : 0.8 + 1.9

drinks vs. Men : 1.1 + 2.2 drinks).

But the frequency of drinking was significantly different between women and men. Women drank on

significantly fewer days in a month (18.7 + 12.3 days in a month compared to 21.7 + 11.5 days in

men; t = -2.2, df 87.8, p = 0.03).

Women consumers spent significantly less money on buying drinks (Rs. 251.20 + 245.60 compared

to Rs. 431.30 + 564, t = -6.1, df 119.4, p< 0.001

Women consumers had a slightly higher prevalence of illness in the past year than the men but it was

not statistically significant [Table 10 ].

Table 10: Gender differences: Significant illness in last one year across users and abstainers

Alcohol users and abstainers Absent Present Total

No-users /abstainers

Female 6276 (92.7%) 495 (7.3%) 6771

Male 4919 (92.8%) 382 (7.2%) 5301

Total 11195 877 12072

Alcohol users Female 66 (82.5%) 14 (17.5%) 80

Male 1789 (84.8%) 321 (15.2%) 2110

Total 1855 335 2190

Economics of alcohol use

Users spent an average of Rs. 413.60 on alcohol per month. This amounted to over 25% of their

monthly family income [Table 11a].

Table 11a: Spending on alcohol per month

Amount spent on preferred beverage

per month (Rupees)

Amount spent on 2

nd preference

beverage per month (Rupees)

Total spending on alcohol per month

(Rupees)

Alcohol spend as a percentage of family

income

Mean (SD) 392.30 (376.13) 21.2591 (74.99) 413.58 (384.86) 26.18 (30.37)

Median 300.0000 .0000 300.0000 20.00

Mode 300.00 .00 300.00 30.00

Range 1.00 - 3300.00 .00 - 1350.00 1.00 - 3300.00 .07 - 330.00

64

Table 11b: Budget share of alcohol in rural and urban consumers

Money spent on alcohol per month Alcohol spending as percentage of income

Mean (sd) 434.42 (422.95) 23.9729 (26.02) Urban Mode 300.00 20.00

Mean (sd) 457.21 (368.29) 32.3214 (53.46) Rural Mode 300.00 30.00

Mean (sd) 337.43 (955.48) 22.55 (33.58) Tribal Mode 300.00 30.00

Rural consumers (rural tribal and non-tribal combined) spent a significantly greater proportion of

their family income on alcohol than urban consumers (t=2.7, df 1969, p = 0.007) [Table 11b].

65

Key informant data

Bangalore Urban district

Illicit brewing is lower than

in the other districts.

Centres of illicit brewing

and distillation are confined

to lower socio-economic

areas and in the urban

slums. The wide availability

of IMFLs at very affordable

prices and an extensive

network of outlets selling

Government Arrack has led

to a relatively unimportant

market for illicitly made

alcohol. However, as

mentioned above a large

proportion of the

consumption is by way of

excise evaded (therefore

undocumented) “seconds”

liquor. In the suburbs of

Bangalore city there are

several small units that

make alcoholic beverages

using several local

commodities as ingredients

and rectified spirit (diverted

from distilleries and other

non-beverage sources) as

the common solvent. Many

of these units do not distill

the beverage and is the brewed product is merely filtered, fortified with rectified spirit and consumed

directly.

Bangalore Rural district

Despite the easy availability of licit alcoholic beverages there are plenty of manufactures of illicit

alcohol. Their clients seem to be a section of the local population who prefer only this type of

beverage. There is however a reluctance to talk about illicit alcohol among the local population as

well as among the identified manufacturers. There is the fear of the ‘Police raid’. These are raids by

the Excise department in response to tip-offs (usually by rival manufacturers) which many of the

informants alleged were more for the financial benefit of the raiding officer in terms of bribes to

overlook the manufacture, than an attempt to trace and eradicate illicit alcohol manufacture.

Illicit brewing and distillation is widespread and illicitly brewed liquor is easily available. In

Sakalwara village and in Anekal taluka on the outskirts of Bangalore city, the field staff were easily

able to buy bottles of illicitly produced alcohol [locally called kalla bhatti or bhatti sarai]. The

66

consumers bought and consumed the illicit liquor directly from the people who manufactured it and

often at the place of manufacture (bhatti). A variety of kalla bhatti that the team was able to procure,

came in a 180 ml. quarter bottle.

The place of manufacture was a shed in the village itself.

The raw materials used were jaggery, wood apple, waste fruit and Nau-sadar (sal ammoniac). Other

additives consisted of shells of batteries. Unconfirmed reports by consumers described other

additives such as rubber slippers, lizards and other decomposing matter being added.

Informants recalled that while many years back, the manufacture was restricted to families belonging

to a traditional caste of brewers, in recent times the business had been taken over by non-specific

networks with considerable muscle power and alleged contacts with the police and politicians.

The process of manufacture is as follows:

To 20 litres of water, in a large earthen pot, 10 kg. of jaggery, 5 kg. of wood apple and other fruits,

as well as pieces of a certain thorn tree are added. Also added are 3 old battery shells and two pieces

of nausadar ground into powder. The ingredients are thoroughly mixed and allowed to ferment for 5-

6 days after which it is boiled for three hours. The mixture is then distilled by passing through a

water cooled pipe, to allow the distillate to collect through a funnel into another pot. The process of

distillation takes around 6-7 hours. The distilled liquid is then put in bottles, capped and kept for at

least three days. After which it is generally sold. The liquor is light coffee brown in colour and of

watery consistency.

The manufacturers say that the liquor can be stored for upto three months. Two to three batches of 20

litres each are made in a day. The approximate cost of manufacture is Rs. 150 per 20 litres and the

manufactures say they make a profit of around Rs. 850 for every 20 litres.

The liquor is sold on the spot but is also transported for sale to other areas in the village or town. In

which case it is sold to middle-men for Rs. 10 per 180 ml. bottle. The consumer pays about Rs. 12

per quarter bottle (180 ml.).

Consumers reported that the kalla bhatti was more potent and fiery than the licit country liquor and

made them more inebriated and violent.

Another alcoholic beverage which has hit the local rural market is “Neera”. Tapping neera, the sweet

sap that is produced by the coconut tree's spathe, is an age-old practice. To get neera, the spathe has

to be sliced away. An earthen pot which is hung up, collects the sweet sap. The white-coloured sweet

drink fetches Rs 25 a litre. As each coconut tree produces two litres of neera every day, farmers who

tapped neera earned Rs 50 from each tree every day. The production and marketing of this product is

entirely local- by the roadside, and sold not only to the local population but also to tourists on the

Bangalore- Mysore- Kanakapura highways. The fermentation product of neera is toddy and is priced

at about Rs 20 per bottle of 250-300 ml. The recent upsurge in the production of Neera is a

consequence of a mite disease that almost wiped out the coconut crop of the region. The farmers’

lobby argued that since the mite thrives on the sap inside the spathe, by removing it, the risk is

eliminated and agitated for the rights to tap neera and sell it. However, Neera tapping, has been

banned by the state government since 1965. While other major coconut-producing states such as

Kerala, Maharashtra and Gujarat did not ban it, the Karnataka administration saw neera as a direct

threat to the huge revenue it earned from the sale of liquor. In the previous financial year, the

revenue from liquor sales was Rs 2,000 crore; the government has set a target of Rs 2,500 crore this

year. The administration auctions the rights for the manufacture and sale of arrack for huge sums.

The bidders are powerful arrack contractors, whose interests have been directly affected by neera.

Arrack sales have gone down by 50 per cent as a result, according to the deputy excise commissioner

of the state. Obviously, the arrack contractors could not swallow this, nor could the government go

against this influential lobby. Consequently, this has resulted in often violent confrontations between

the police and the farmers. Finally, the government relented and permitted sales of neera but not

toddy. However, neera and toddy sales have continued to mount. There are no estimates of this

consumption.

67

Bidar district

Bidar district is a dry place

and is one of the worst

draught-prone districts' in

Karnataka. The district

headquarter, Bidar, is a

small town, with a majority

Muslim population.

Historically, Bidar was a

part of the Bahamani

Kingdom which comprised

of Bijapur, Gulbarga, Bidar,

Golconda, and Birar. The

ruler of Bidar was Barid

Shah. Bidar was later ruled

by the Nizams of

Hyderabad. After the

formation of Karnataka,

Bidar was brought under

Karnataka State. Bidar was

not industrialized for a very

long time and only recently,

Bidar has seen the arrival of

several induatrial centers.

There is an Engineering

college run by the Sikh trust

in the town. Additionaly,

there are several other

educational institutions (managed by Christian Missionaries and other communities). There is an

Indian Air Force station in Bidar, which was the Elementary Flying School (This has now been

transferred to Secunderabad). The main occupation of the people here is agriculture. Sugarcane,

Jowar and wheat are the main crops.

It has large tribal population who live in settlements called Tandas. 'Tanda' means 'settlement' in the

Lambani tongue. This is a local dialect that is spoken in the area, it is a curious mixture of Gujarati,

Hindi, Marwari etc. The occupations of the people are chiefly agriculture labour and stone breaking.

People also brew arrack here. Most of the men and women migrate to the nearby cities in search of

work.

Historically it was at the center of the Veera Shaiva Movement (a reform movement in Hinduism,

which proscribed alcohol use) and a large part of the urban population are followers of this sect and

the under reporting of alcohol consumption is significant in the urban population, unlike in the tribal

population. In the tribal areas, alcoholic beverages are brewed for the whole thanda and is made out

of what seem to be locally available ingredients, which are largely the Mahua inflorescence and

Navasagar (sal ammoniac). The brewed item is used by everyone in the thanda, including children.

In all Thandas it is restricted to the population of that thanda or for guests. Occasionally ‘packet

sarai’ (Government arrack) is added to the brew to make it stronger. However for important

68

occasions the brew is consumed unadulterated. Interestingly the thandas had started a commercial

exercise of their brew by selling in Andhra Pradesh when prohibition was in force in that state.

However it died out after prohibition was lifted and also the initiative by the tribals died out.

The alcoholic beverage made in the tribal areas is known by various names which represent variants

of liquor. Called Desi daru (translated as country liquor, not to be mistaken for the government

licensed country liquor), sharaab (which is a generic Hindi /Urdu word for alcohol), haat bhatti,

mohwa daru (made from the mohwa flower), goud daru (predominant ingredient being jaggery),

bhilawa phool ka daru (made from the bilwa flower).

Similar to the above process, jaggery, grapes and certain flowers (the mowha flower and the bilwa

flower are favourites) are soaked for eight to ten days, after adding minute quantities of nawa sagar

(nausadar; see above). This is the fermentation process. The mixture is then distilled and bottled in

750 ml. bottles (usually discarded beer bottles). In some places, the liquor is stored in plastic jerry-

cans or buckets and sold by the glass. The colour of the liquor is usually milky white and usually no

other additives are added.

While the cost of manufacture per 750 ml. bottle is around Rs. 16, it is sold to the consumer at Rs.

25 per bottle or Rs. 5 per 180 ml. bottle.

Each production center produces about 4-5 buckets of liquor at a time two to three times a weekThe

alcohol is made by the women of the household using traditional recipes. The excise laws of the

country are silent on the status of home-brew for personal consumption and most of the tribal

manufacturers have rarely faced problems with the law.

According to consumers, it is not only far cheaper than the ‘government country liquor’ (baby) and

IMFL but healthier.

Uttara Kannada district

This is a coastal district, which

is on the north-western edge of

Karnataka. It borders the state

of Goa, which was a former

Portuguese colony. Both Uttara

Kannada and Goa are part of the

Kadamba region and the

indigenous alcoholic beverages

have been well described in

ancient Kannada literature by

Pampa.

Goa is home to the famed Feni

or fenny, which is distilled

primarily from cashew apples.

There are however less

expensive varieties of Feni

made from Palm trees or

Coconut sap. There is however

declining sales because fewer

people are taking to the age-old

profession of "toddy- tapping".

Both Uttara Kannada and Goa

are coastal regions and share a

porous border along the Konkan

(West Indian) coastline and are

69

vulnerable to contraband smuggling of alcoholic beverages. The strict policies, which the Goan

Government has adopted recently seems to have increased this smuggling activities from Goa to

Uttara Kannada.

Most of the unrecorded alcohol is either smuggled Feni from Goa, Coconut Feni mixed with Cashew

Feni and sold as Goan Feni to tourists or Feni brewed from cashew, Palm or Coconut at homes and

for a limited circulation.

Illicit manufacture is common. People usually prepare it in their own homes and in many places the

team observed that illicit liquor as also IMFL and arrack was given to agricultural labour by the

landlords in lieu of wages.

A large proportion of the undocumented consumption in this district is due to the trans border

smuggling of fenny from the neighboring state of Goa. In fact, informants added that very often,

liquor illicitly manufactured locally by distilling toddy was labeled and sold as Goan fenny.

Dharwad district

The twin cities of Hubli-

Dharwad are located at a

distance of around 430 kms

from Bangalore the capital of

Karnataka state. The climate

is hot and wet during the

summer and rainy seasons

and pleasant during winter.

The twin cities have a history

behind them dating back to

the Hoysala period. Dharwad

is the administrative capital of

the Dharwad district and

Hubli serves as the commerce

center. Dharwad is a quiet,

pleasant, and fast growing

city in the northern part of

Karnataka. Together with

Hubli , which is a city twenty-

two kilometers away,

Dharwad forms a twin city.

Dharwad is known for its

prestigious educational

institutions. It houses the

Karnataka University, which

caters to graduate and

research students. Karnataka

College offers educational

services to students just out of

high school who aspire to make a career either in the arts or the sciences. S.D.M. Engineering

college a more recent addition to the list of educational institutions offers education in Engineering.

Hubli has an Engineering college( B.V.B College of Engineering and Technology), the Karnataka

Medical College and other institutions.

No clear forms or patterns of unrecorded consumption were available because of the reluctance of

the local population to speak about this issue. There was a significant element of underreporting of

70

unrecorded Consumption of Alcohol. This seems to be related to the local Lingayat mutts, which are

influential socio-cultural and religious bodies. These mutts as well as the local population are

strongly influenced by the Veerashaiva philosophy, which considers alcohol consumption as a mortal

sin. There were no proclaimed sanctions as such, but the Mutts were known to look upon alcohol

users with disfavor. Consequently, in Dharwad district, especially in urban areas, there was a lot of

under-reporting. A highly charged anti-liquor campaign being carried out by the elders and religious

leaders of the Veerashaiva community had resulted in the closure of many outlets and the social

stigmatization of alcohol use, made people reluctant to openly discuss their alcohol use. There were

also rumors to the effect that the State Excise machinery and the Mutts were providing financial

incentives to the local (illicit) alcohol beverage manufacturers to close down their commercial

establishments. This however was not verifiable and was denied by the manufacturers. Interestingly

one of the rural centers where data was collected- Jogellapura, respondents spoke about unrecorded

alcohol brewing in their village- but said it was prepared in the fields and was served only to women.

The team found evidence of illicit manufacture in several villages. The distilleries are usually

situated outside the village limits. The procedure is similar to the ones recorded above. Usually sold

at Rs. 5 per 180 ml. bottle.

undoc method & results - nimhansnimhans.ac.in/cam/sites/default/files/publications/25.2.pdf ·...

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