Alcohol use and problem drinking in South Africa: findings from a national population-based survey

Objective: This study formed part of the South African National HIV, Incidence, Behaviour and Communication (SABSSM) 2008 survey, which included questions assessing the extent of alcohol use and problem drinking among South Africans. Method: A multistage random population sample of 15 828 persons aged 15 or older (56.3% women) was included in the survey. Alcohol use was assessed using the Alcohol Use Identification Test (AUDIT). Tabulation of data for different age groups, geolocality, educational level, income, and population group produced the estimates and associated confidence intervals. The odds ratios for these variables in relation to hazardous or harmful drinking were also computed. Results: Current alcohol use was reported by 41.5% of the men and 17.1% of women. White men (69.8%) were most likely and Indian/Asian women (15.2%) least likely to be current drinkers. Urban residents (33.4 %) were more likely than rural dwellers (18.3%) to report current drinking. Risky or hazardous or harmful drinking was reported by 9%: 17% among men and 2.9% among women. In men, risky drinking was associated with: the 20-54 year age group; the Coloured population group; lower economic status; and lower education. Among women, risky drinking was associated with: urban residence; the Coloured population group; lower education; and higher income. Conclusion: An increase in current, binge drinking and hazardous or harmful drinking prevalence rates was observed from 2005 to 2008 in South Africa. Multilevel interventions are required to target high-risk drinkers and to create awareness in the general population of the problems associated with harmful drinking. Future prospective studies are needed to assess the impact of problem drinking.