Prevalence, knowledge of long-term effects, and associated factors of alcohol consumption among adults in the Hohoe Municipality, Volta Region - Ghana

Alcohol consumption is a significant and growing public health concern in Ghana, where it contributes to rising rates of non-communicable diseases, social dysfunction, and economic burden. Despite its impact, municipality-level data on alcohol use among the general adult population remains scarce, creating an evidence gap that limits the development of targeted, context-specific interventions. Prior studies in Hohoe Municipality have been restricted to youth and tertiary student populations, leaving the broader adult population unexamined. This study aimed to determine the prevalence of current and lifetime alcohol consumption, assess knowledge of the long-term health effects of alcohol, and identify sociodemographic and behavioral factors associated with alcohol consumption among adults in Hohoe Municipality, Volta Region, Ghana. A quantitative cross-sectional design was used among 318 adults aged 18 years and above in Hohoe Municipality. Participants were recruited from residential households and alcohol-selling points in Hohoe Municipality using stratified random sampling and a balloting procedure. A structured questionnaire was administered face-to-face by trained interviewers. Current alcohol consumption was defined as consuming at least one standard drink in the 30 days preceding the survey. Knowledge of the long-term effects of alcohol was assessed, scored dichotomously and summed into a composite score, with the sample median used to classify participants into high and low knowledge groups Data were analyzed using Stata Version 17. Descriptive statistics summarized the sample, and chi-square tests examined bivariate associations. Binary and multivariable logistic regression were used for inferential analysis, with statistical significance set at p < 0.05 and 95% confidence intervals reported. Of the 318 participants, 122 (38.4%) were current alcohol consumers; those who had consumed alcohol in the past 30 days while an additional 48 (15.1%) were former consumers. Combined, 170 participants (53.5%, 95% CI: 48.0–59.0%) reported any lifetime alcohol exposure, representing the study’s overall lifetime prevalence. Among the 56.2% of male participants and 50.6% of female participants who were consumers, sex was not a statistically significant predictor of consumption ( p = 0.323). Local gin (akpeteshie) was the most consumed beverage (47.6%). Knowledge of the long-term effects of alcohol was low, as only 53.5% of respondents demonstrated high knowledge of chronic consequences, despite 85.6% acknowledging general health harm. Accessibility (55.3%) and peer influence (18.9%) were the primary self-reported drivers of consumption. Ewe ethnicity (aOR = 5.6; 95% CI: 1.97–15.95; p = 0.001), Guan ethnicity (aOR = 3.9; 95% CI: 1.06–14.55; p = 0.039), and Islamic religious affiliation (aOR = 0.22; 95% CI: 0.05–0.90; p = 0.036) were the significant independent predictors of alcohol consumption. Ethnicity likely reflects the influence of cultural norms, community-level alcohol availability, and social practices rather than any inherent characteristic. Alcohol consumption is prevalent among adults in Hohoe Municipality, with over half reporting lifetime exposure and more than a third identified as current consumers. Knowledge of specific long-term health risks remains limited, particularly awareness of recommended drinking limits. Ethnicity and religion are the strongest independent predictors of consumption, pointing to the central role of sociocultural context in shaping drinking behavior. These findings call for multi-level, culturally sensitive public health responses combining targeted health education, regulatory action on alcohol accessibility, and engagement with community and faith-based structures to reduce alcohol-related harm and support Ghana’s national NCD prevention agenda.