Prevalence of Unrecorded Alcohol Consumption and Associated Factors: Findings From a Nationally Representative Survey...

Evidence from the World Health Organization shows that measures exist to regulate both recorded and unrecorded alcohol. In Thailand, comprehensive evidence on the amount of unrecorded alcohol consumed is lacking. This study aims to quantify the prevalence of unrecorded alcohol consumption and determine associated factors.

A cross-sectional survey was conducted from July to August 2022. Thai residents aged 15 years or above were recruited from 15 provinces, including Bangkok, using stratified multi-stage sampling. Types of unrecorded alcohol included surrogate, home-brewed, smuggled or industrially produced illegal and duty-free outlet products. Annual alcohol consumption was calculated by multiplying the daily quantity by the estimated number of drinking days.

Among 3924 participants, unrecorded alcohol constituted 4.4% (95% CI 4.3-4.4) of the total alcohol consumption (10.9 million of 248.5 million litres/year). The annual unrecorded pure alcohol intake per current drinker was 2.2 L. Drinkers aged 45-59 years had the highest prevalence of unrecorded alcohol consumption (13.2%), while those aged 60 years and over had the largest share (10.0%). Consumption was higher in males (2.5 L/year) compared to females (0.5 L/year) and heavy episodic drinking individuals (3.2 L/year) compared to non-heavy episodic drinking individuals (0.9 L/year).

Although middle-aged adults had the highest consumption rates, the greatest intensity of intake and, therefore, potential for harm, was seen among older-aged and heavy episodic drinking individuals. Given the risks of unknown ethanol concentrations and contaminants in unrecorded products, policymakers should prioritise high-intensity users over overall prevalence to better mitigate risks within Thailand's alcohol consumption profile.