Sri Lanka’s drinking culture: correlates of alcohol consumption in adult males in the Colombo District

Introduction: Alcohol is a significant global public health issue. Despite a high prevalence of alcohol abstinence in Southeast Asia, the region has some of the highest drinking rates globally. In Sri Lanka, alcohol is linked to major health concerns and poverty. Identifying factors that influence alcohol use will inform effective prevention programmes.Objectives: To explore the factors linked to alcohol consumption among adult males in Colombo, Sri LankaMethods: A community-based cross-sectional study was conducted among 1106 adult males in Colombo District, selected using multi-stage cluster sampling to represent all 13 divisional secretariat divisions. Data were collected by pre-intern medical graduates using a pre-tested interviewer-administered questionnaire. The PRECEDE-PROCEED model was applied to identify factors associated with alcohol consumption between current drinkers and never drinkers. Logistic regression analysis with adjusted odds ratio (AOR) was performed for statistical evaluation.Results: The study achieved a 95.4% response rate, with participants averaging 45.7 years of age. Non-modifiable socio-demographic factors associated with current drinking were being younger than 45 years of age (AOR: 0.3; 95% CI: 0.2, 0.5), Sinhalese (AOR: 9.7; 95% CI: 2.9, 3.1), being currently married (AOR: 2.4; 95% CI: 1.4, 4.0) and being employed (AOR: 5.9; 95% CI: 3.4, 10.0). Modifiable factors associated with current drinking were being a current smoker (AOR: 4.5; 95% CI: 2.7, 7.4), having unfavourable attitudes (AOR: 5.4; 95% CI: 3.4, 8.6) having unsatisfactory knowledge (AOR: 2.3; 95% CI: 1.5, 3.6) and influence of the family members (AOR: 2.3; 95% CI: 1.3, 4.1).Conclusions & Recommendations: The findings emphasize the importance of targeted interventions addressing family and peer influence, and integrated strategies for smoking and alcohol prevention.