Unrecorded Alcohol ConsumptionFocus on the Americas

Norman Giesbrecht & Emma Haydon

Centre for Addiction & Mental Health

Toronto, Ontario, Canada

1a Conferência Pan-Americana

de Polícas Públicas sobre Álcool

Brasília, Brasil

November 28-30, 2005

Topics

• Implications• Dimensions • Sources of information• Estimates• Contributing factors• Policy implications• Interventions• Recommendations

Implications of Unrecorded Alcohol Consumption

• Accuracy of drinking volume estimates– studies of associations between consumption &

harm (or benefits) from alcohol– impact of interventions– cross-sectional and longitudinal research– drinking patterns

Implications of Unrecorded Alcohol Consumption (2)

• Heavy consumption & high risk drinking– Easy access to untaxed alcohol– High risk patterns– Addition versus substitution– Alcohol of questionable quality

Implications of Unrecorded Alcohol Consumption (3)

• Alcohol Policy– Reduce revenue for the state– Reduce profit for producers– Distributors with compromised role re illegal

alcohol– Rational to undermine control measures

Dimensions of Unrecorded Alcohol Consumption

• Legal– home production of legal amounts– consumption of non-beverage ethanol– importation of legal amounts

Dimensions of Unrecorded Alcohol Consumption (2)

• Illegal – home production of illegal quantities– sale of home produced alcohol– mass produced illegal alcohol– smuggling

• individuals • large-scale operations

Sources of Information

• Seizures by customs officials

• Police activities & seizures

• Liquor inspector activities

• Cross-border traveler activity & extrapolations

• Extrapolations using official statistics

• Self-reports

Sources of Information

• Caveats & challenges:– Useful method varies by country, region and time

period– Vested interests in the estimation process– No one method produces comprehensive estimates,

some only are based on a fraction – Challenge of comparing & combining divergent

estimates

Americas: Recorded plus estimated Unrecorded*

Bermuda 12.9

St. Lucia 10.5

Bahamas 9.2

Venezuela 8.8 + 2.0

Argentina 8.6 + 1.0

U.S. 8.5 + 1.0

Canada 8.3 + 2.0

St. Kitts 7.6

Grenada 7.4

Uruguay 7.0 + 2.0

Barbados 6.7 - 0.5

Paraguay 6.7 + 1.5

St. Vincent 6.7

Haiti 6.5 + 0

Dom. Republ 6.1 + 1.0

Panama 6.0 + 1.5

Chile 6.0 + 2.0* Litres of absolute alcohol per capita aged 15+: Recorded FAO 2003; Unrecorded estimates for after 1995 from Rehm & Gmel 2001

Recorded plus estimated Unrecorded (2)*

Columbia 5.9 + 2.0

Guyana 5.8 + 2.0

Suriname 5.8 + 0.0

Costa Rica 5.5 + 2.0

Brazil 5.3 + 3.0

Peru 4.7 + 1.0

Mexico 4.6 + 3.0

Belize 4.5 + 2.0

Guam 4.5

Cuba 3.7 + 2.0

El Salvador 3.5 + 2.0

Bolivia 3.4 + 3.0

Jamaica 3.4 + 1.0

Trinidad

& Tobago 3.2 + 0.0

Nicaragua 2.5 + 1.0

Honduras 2.3 + 2.0

Ecuador 2.0 + 1.0

* Litres of absolute alcohol per capita aged 15+: Recorded FAO 2003; Unrecorded estimates for after 1995 from Rehm & Gmel 2001

Americas: Recorded & Estimated Unrecorded Alcohol Consumption

• Recorded consumption– 1.99 to 12.92 litres per capita aged 15+

• Estimated unrecorded consumption– minus 0.5 to plus 3.0 litres per capita 15+

• Unrecorded as a % of total (recorded plus estimated unrecorded)– 11% to 55%

Traditional & local beverages*Selected countries in Latin & South America

Argentina - local beer 7%

Bolivia - Chicha 5-7%

Brazil - Cachaça 38-54%

Chile - Pisco 35%

Columbia - Rum 28%

Costa Rica - Guaro

Ecuador - Aguardiente 40-70%

Guatemala - Chicha

Guyana - Ti’ punch

Honduras - Aguardiente

Mexico - Pulque 7%

Paraguay - Abati

Peru - Pisco, Chicha

Suriname - Borgoe 38%

Trinidad &

Tobago - Babash

Uruguay - Cana 38%

Venezuela - corn liquor

* These are examples & not a comprehensive list of beverages.

Contributing Factors

• Restrictions on access to legal alcohol sales in host country– Price, outlet density, hours of sale

• Inter-country differences in access to alcohol– lower prices in adjacent jurisdictions– high volumes allowed for legal personal

importation

Contributing Factors (2)

• Traditional and local beverages– extensive tradition and quality

• Smuggling of other goods– Tobacco from US to Canada in early 1990s

• Tolerance for illegal behaviour– among general population– among legal distributors or producers

• Geography and population density

Policy Implications

• Legal & illegal trade (particularly smuggling) used to justify proposed erosion of control policies– questionable estimation procedures used

• Resource management & inter-sectorial collaboration

• Impact on traditional and local beverages

• Quality control issues & harm reduction

Interventions

• Process– Training– Coordination– International

symposia– Resource issues– Data collection

• Outcome oriented– Public education – Mass media– Warnings to

distributors– Inspections– Law enforcement– Enhance legal

outlets– Review of alcohol

policies

Recommendations

• Use multiple methods for data collection

• Subject estimates to peer review

• Consider cultural aspects and norms re traditional and local beverages

• Consider impact of unrecorded alcohol on high risk drinking & dependence

Recommendations (2)

• Coordinate control/interventions of unrecorded with harm reduction management of recorded sales of alcohol

• Build on evaluations of alcohol policies to develop interventions to manage unrecorded alcohol

• Conduct routine monitoring & evaluation of interventions

Acknowledgements

Sunny Ba, Guilherme Borges,

Mariana Cremonte, Laura Krech, Maristela Monteiro, Jürgen Rehm,

Robin Room & Maria Luiza Segatto