Alcohol Consumption and Its Determinants among adults aged 18-69 years in Tanzania: Data from the 2023 National STEPS Survey

Background: Non-Communicable Diseases (NCDs) cause a substantial share of mortality worldwide and in Tanzania, with harmful alcohol consumption as a key modifiable risk factor. Updated national data on alcohol use and its determinants among Tanzanian adults are limited. This study utilises data from the 2023 Tanzania National STEPS Survey to estimate alcohol consumption prevalence and identify associated demographic and behavioural factors among adults aged 18–69 years. Prevalence estimates are reported with corresponding 95% confidence intervals to indicate precision. Methods: A cross-sectional household survey was conducted from September to November 2023 across all regions of mainland Tanzania and Zanzibar. 3,565 adults were enrolled using a three-stage stratified design. Data collection included structured interviews, physical measurements, and biochemical sampling. Descriptive statistics, bivariate analyses, and logistic regression were applied to determine prevalence and associated factors, with results presented alongside 95% confidence intervals. Results: Overall alcohol consumption prevalence was 19.4% (95% CI: 16.7–22.1), with males (26.9%, 95% CI: 21.9–31.9) nearly twice as likely to consume alcohol as females (12.5%, 95% CI: 9.0–16.1). Highest prevalence occurred among adults aged 31–45 years (28.7%, 95% CI: 22.3–35.0). Rural residents (23.9%, 95% CI: 20.0–28.2) reported higher consumption than urban residents (15.0%, 95% CI: 12.4–18.2). Regional differences were significant, with the Lake zone showing the highest prevalence (36.3%, 95% CI: 26.3–47.6) and Zanzibar the lowest (Unguja 1.0%, 95% CI: 0.4–2.7; Pemba 13.6%, 95% CI: 9.4–19.3). Current smokers had markedly higher alcohol use (57.7%, 95% CI: 39.4–74.1) compared to non-smokers (16.1%, 95% CI: 13.7–18.7). Multivariate analysis showed that male sex, middle to older age groups, rural residence, smoking status, and regional location were significant determinants. Conclusion: Alcohol consumption remains a significant public health issue in Tanzania, with pronounced demographic, geographic, and behavioural disparities. The gender gap and elevated risk among smokers and rural populations highlight the need for targeted strategies in these populations. Recommendations: Interventions, including taxation, marketing restrictions, health education, and screening programs, should be tailored to demographic and regional contexts to effectively reduce alcohol-related health risks and contribute to NCD prevention in Tanzania and Sub-Saharan Africa.