The Lancet Regional Health - Southeast Asia (Jul 2024)
Effects of a large-scale alcohol ban on population-level alcohol intake, weight, blood pressure, blood glucose, and domestic violence in India: a quasi-experimental population-based studyResearch in context
Abstract
Summary: Background: Globally, alcohol consumption is a leading risk factor for deaths and disability and a causal factor in over 200 diseases, injuries, and health conditions. In April 2016, the manufacture, transport, sale, and consumption of alcohol was banned in Bihar, a populous Indian state. We sought to estimate the impacts of this ban on health outcomes and domestic violence. Methods: Data from the Indian National Family Health Surveys (2005–06, 2015–16, 2019–21), Annual Health Survey (2013), and District Level Household Survey (2012), were used to conduct difference-in-differences (DID) analysis, comparing Bihar (n = 10,733 men, n = 88,188 women) and neighbouring states (n = 38,674 men, n = 284,820 women) before and after the ban. Outcomes included frequent (daily or weekly) alcohol consumption, underweight, obesity, hypertension, diabetes, and intimate partner violence. A triple difference model adding male–female interaction to the DID model was also estimated. Attributable averted cases were calculated to estimate the impact of the ban. Findings: Across all models, the ban led to reduced frequent alcohol consumption (DID: −7.1 percentage points (pp) (95% CI −9.6pp, −4.6pp), lower overweight/obesity (−5.6pp (−8.9, −2.2) among males, and reduced experiences of emotional (−4.8pp (−8.2pp, −1.4pp) and sexual (−5.5pp (−8.7pp, −2.3pp) violence among females. The ban prevented approximately 2.4 million cases of daily/weekly alcohol consumption and 1.8 million cases of overweight/obesity among males, and 2.1 million cases of intimate partner violence among females. Interpretation: Strict alcohol regulation policies may yield significant population level health benefits for frequent drinkers and many victims of intimate partner violence. Funding: No funding was received for this work.
