Incidence rate, risk factors and behaviour changes for alcohol drinking: findings from a community-based cohort study in Southwest China

OBJECTIVE: To describe changes in alcohol drinking behaviour, estimate the incidence rate of alcohol drinking and explore its risk factors in the Chinese community population. DESIGN: A community population prospective cohort study. SETTING: A total of 48 townships of 12 counties or districts in Guizhou province, China. PARTICIPANTS: With the multistage proportional stratified cluster sampling method, a total of 7343 adult residents were enrolled into this study and eligible to be analysed. PRIMARY AND SECONDARY OUTCOME MEASURES: The incidence rate and its risk factor (adjusted HR (aHR) and 95% CIs) as well as the prevalence of alcohol drinking. RESULTS: There was a little increase trend in the overall prevalence of alcohol drinking among 7343 subjects over an average of 7.22-year follow-up, and the prevalence in women increased by 2.5% statistically (p=0.001). Among 5005 non-drinkers in 7343 subjects at baseline, 1107 incident drinkers were identified, and the incidence rate of alcohol drinking was estimated at 30.63/1000 person-years with significant sex difference (57.46 vs 17.99 per 1000 person-years for men and women, respectively, p<0.001). The incidence rate decreased gradually with age, peaking in men aged 18–29 years old and women aged 30–39 years old at baseline. After the adjustment for covariates, being male (aHR=3.46, 95% CI: 3.02 to 3.96), being non-Han Chinese (aHR=1.65, 95% CI: 1.44 to 1.88), living in urban areas (aHR=3.50, 95% CI: 3.01 to 4.08), being employed (aHR=1.33, 95% CI: 1.16 to 1.52), smoking (aHR=1.17, 95% CI: 1.00 to 1.38) and having no history of chronic diseases (aHR=1.19, 95% CI: 1.04 to 1.35) were independent risk factors for incident drinkers. CONCLUSION: The number of women increased in the prevalence of alcohol drinking significantly although there was no significant overall change for the cohort population in Southwest China. Also, there was a high risk of developing alcohol drinking among the study population, especially for those non-drinkers who were younger men, non-Han Chinese, living in urban areas, employed, current smokers or without any chronic diseases. Interventions to prevent and manage alcohol consumption should be designed and implemented in Chinese communities as soon as possible.