Alcohol situation, it’s impacts and control measures in Sri Lanka Pubudu Sumanasekara Executive Director Alcohol and Drug Information centre (ADIC) Sri Lanka 15.07.2009-Stop Drinking ADIC OUTREACH 23 OUT OF 25 DISTRICTS ARE COVERED USING VARIOUS MICHANISAMS. -WORKING DIRECTLY - WORKING THROUGH OTHER NGOO - VARIOUS PROJECTS International Awards Received • WHO AWARD • IFNGO AWARD • COMMONWEALTH AWARD DURING THE YEAR 2001 ADIC(SRI LANKA) WAS INVITED TO THE ALCOHOL POLICY STRATERGY ADVISORY COMMITTEE OF THE WORLD HEALTH ORGANIZATION TO REPREESENT THE SOUTH EAST ASIAN REGION. ADIC Programmes • Social mobilization(School, Community and Media) • Strategic intervention • Policy Advocacy and Litigation • Human Development and Innovative Intervention • Research and Information • Plantation • Prevention of transmission of HIV/AIDS among drug users • Finance and Accounts Problem Alcohol • Rural communities spend 1/3rd of their family expenditure on alcohol (Mirisankotuwa Research). • Estate sector spend half of their family expenditure spend on alcohol (ADIC Plantation Research). Health Indicators in Sri Lanka Number of cases of hospitalization on Alcoholic Psychosis , Alcohol Dependence and Alcohol withdrawal (Excludes data from private sector medical institutions) 14000 12000 NO OF CASES 10000 8000 NO. OF CASES 6000 4000 2000 0 1989 1999 YEAR Source – Statistics of Ministry of health , Government of Sri Lanka Health Indicators in Sri Lanka Hospitalization due to Chronic Liver Disease (Excludes data from private sector medical institutions) 18000 16000 14000 NUMBERS 12000 10000 NO OF CASES 8000 DEATHS 6000 4000 2000 0 1989 1999 YEAR Source – Statistics of Ministry of health , Government of Sri Lanka Other problems Violence Discipline Relationship Absenteeism Productivity Nutrition levels Alcohol Prevalence Alcohol ever use 36% yes no yes no 48% 52% 64% Age group 15-24 44.9 25-40 50.8 40< 48.6 41 42 43 44 45 46 47 Percentage 48 49 50 51 52 Source – Spot Survey 2008 December Alcohol Production Arrack Production 2007 50.3 44.93 2005 38.46 2004 34.59 2003 32.02 2002 28.42 0 10 20 30 40 50 60 Liters in Millions Beer Production By Alcohol Level 19.95 2007 29.58 Years Years 2006 Alcohol Level 5% below Alcohol Level 5% above 24.8 2006 22.03 0 5 10 15 20 25 30 35 Liters in Millions Source – Excise reports Attitudes on Alcohol Job Habit Sad Forget problems Avoid weary Addiction/Intoxicated Pressure of friends Nothing special Parties/Fun/Happy/Pleasure 0.8 Reasons 3.1 4.6 5.4 Reasons for alcohol use 7.9 8.2 16.4 16.4 37.3 0 10 20 30 40 Percentage Reasons Policy Smelly/Not… Have Knowledge Bad results Religious Family… Economical No reason Stupid thing Health hazard Not a habit 0 1.6 2.2 2.4 2.7 3.6 4.3 Reasons for not using alcohol 7.8 12.7 14.6 18.4 29.7 5 10 15 20 Percentage 25 30 35 Source – Spot Survey 2008 December Major Health Risk Factors 14000 1400 High blood pressure 800 Alcohol 600 400 Overweight 200 High cholesterol 0 WPR_A Australia, Brunei Darussalam, Japan, New Zealand, Singapore 16000 14000 12000 10000 8000 6000 4000 2000 0 10000 Tobacco Overweight High cholesterol WPR_B Tobacco 8000 High cholesterol 6000 4000 Alcohol 2000 0 Overweight SEA_D Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Maldives, Myanmar, Nepal Alcohol High blood pressure High blood pressure 12000 DALYs (000's) DALYs (000's) DALYs (000's) 1000 DALYs (000's) Tobacco 1200 4000 3500 3000 2500 2000 1500 1000 500 0 Tobacco High blood pressure Alcohol Overweight High cholesterol SEA_B Cambodia, China, Cook Islands, Fiji, Kiribati, Lao People's Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated States of), Mongolia, Nauru, Niue, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu, Viet Nam Indonesia, Sri Lanka, Thailand Source: World Health Organization 2004 Approach • Moralistic ? • Religious ? • Scientific ? – Do users really enjoy alcohol? – Why youth start consuming alcohol while knowing the harm and unpleasantness •The highest number of smoking incidents in the past 12 years has been recorded in movies featuring the Indian super star Sharuk Khan. •The second highest is noted in films featuring the South Indian superstar Ragini Kanth. The approach Opinion makers and professionals Media Policy Industry Field level (communities) Non - users users youth women children Approach cont. • Reduce the attractiveness of the image alcohol • Reducing unfair privileges attached to alcohol use • Improving recognition of the real harm form alcohol use • Counteracting the forces that promote increased consumption • Encouraging quitting or reduction of use • Formulation and implementation of effective policies local and beyond etc. Strategies to address alcohol problems • Do not alienate users • Mobilize every single structure in the community • Develop expertise within the community and transfer ownership of the programme to the community through empowering people • Include everyone in the community (sellers, users, non users, children, youth, women, political leaders) while using target group specific systems • Integrate prevention activities in to the community agenda and daily life of the people • Make prevention activities fun simple and attractive THANK YOU