PREVALENCE OF ALCOHOL CONSUMPTION AND AWARENESS OF ITS HEALTH EFFECTS AMONG YOUNG ADULTS IN ZONKWA, ZANGON KATAF LOCAL GOVERNMENT AREA, KADUNA STATE

Author: Akau B.Z.

Abstract
Background: Alcohol is the most common psychoactive substance abused in Nigeria and globally. Studies have shown a sharp increase in alcohol consumption among adolescents and young adults in Nigeria and around the globe. This increase is likely to continue due to increased local production and the availability of alcohol in the country. Alcohol use among adolescents and young adults remains a significant public health problem worldwide. Knowledge of the prevalence and awareness of the health effects of alcohol use is necessary, considering the public health effects of alcohol use.

Aim: To determine the prevalence of alcohol consumption and awareness of its health effects among young adults in Zonkwa, Zango Kataf LGA, Kaduna State.

Methods: An interviewer-delivered structured questionnaire was used to complete a descriptive, cross-sectional study. To choose a sample, a multi-stage sampling technique was applied. The data were gathered using the Kobo Toolbox and then examined using the Statistical Package for Social Science (SPSS version 26). Frequency tables were employed to show the results of the analysis. The chi-square (x2) and Fisher's exact tests were used to determine the relationship between the variables. The level of statistical significance was established at a 0.05 p-value. For continuous variables, means and standard deviations were calculated. In percentage form, the rates were stated. One mark was given for each correctly answered question about the effects of alcohol on health. Zero points were awarded for incorrect or "I don't know" answers. Scores were totaled, and those who achieved less than half (< 50%) were deemed to have poor awareness, while those who scored half or more (≥ 50%) were considered to have a good understanding.

Results: The study enrolled a total of 406 young adults. The respondents were 18.48 years old on average, with a 2.91 SD. Alcohol consumption prevalence rates for a lifetime and current use are 37.7% and 81.7%, respectively. The primary justifications for drinking alcohol were the desire to interact with friends and drink with them (42.5%), enjoyment of drinking (22.9%), curiosity (12.4%), etc. More than one-third (36.5%) of the respondents had a good understanding of the impacts of alcohol drinking, compared to about two-thirds (63.5%) who had poor knowledge. The respondents' age, sex, religion, attendance at school, degree of education, and work status all strongly predicted their lifetime drinking (p < 0.05). A significant correlation between respondents' current drinking patterns, marital status, and alcohol consumption was also found (p < 0.05).

Conclusion: In Zonkwa, Zangon Kataf LGA, Kaduna State, the prevalence rates of lifetime and present alcohol intake among young adults were found to be relatively high, and the majority of respondents had little knowledge of the negative health implications of alcohol use. The organization of initiatives to lower these drinking rates and raise understanding of the negative consequences of alcohol intake on health is necessary.

Keywords: Young adults, Awareness, Prevalence, Alcohol consumption, and Health effects

1. Introduction

Achieving high health standards is a fundamental human right, irrespective of race, religion, culture, or social condition. It is necessary for stability and security, and it is also essential for advancement to have sound medical knowledge.¹ The natural fermentation of sugars and starches yields alcohol, a psychoactive drug with addictive qualities. It is a colorless, flammable, volatile liquid used in many products, including explosives, household cleaners, medicines, solvents, and intoxicants. Alcohols are water-derived substances that are used in sweeteners and fragrances.^2-5 Numerous cultures have consumed alcohol for thousands of years; it first appeared in northern China around 7000 B.C. It was consumed during festivals, celebrations, and religious settings as a source of calories and because it was so nutritious. Alcohol was thought to boost immune systems, treat and prevent illnesses, and promote general health. The first modern temperance movement began in England in the 16th and 17th centuries because of excessive alcohol use. Alcohol was eventually decriminalized in 1933, but despite the level of awareness of its harmful effects, excessive drinking is still a significant issue today.^6-8

Alcohol consumption increases morbidity and mortality globally, endangering public health. Drinking alcohol increases your risk of many diseases, injuries, and social problems. Chronic illnesses and other catastrophic effects of heavy use can result in early death or disability. Global research in 2016 found that alcohol use contributed to over 200 diseases and disorders, including liver cirrhosis, diabetes mellitus, some cancers, cardiovascular disease, stroke, mental health issues, sleep issues, malnutrition, infectious diseases (like HIV/AIDS, pneumonia, and tuberculosis), traffic accidents, falls, poisoning, violence, suicide, drowning, and assault, as well as social issues (such as decreased productivity at work and loss of employment).^4,9-11,13-16It is the leading risk factor in developing countries with low mortality rates and the third-largest risk factor for disease and disability.^11–14Harmful alcohol consumption is attributed to 3 million (5.3%) deaths per year, 5.1% of the global burden of diseases and injuries, and 13.5% of death and disability in early life (20–39 years).^4,15-16 In Nigeria, high alcohol consumption is associated with physical, emotional, social, and morbid burdens like liver cell damage, depressive psychosis, personality deterioration, and suicidal ideation.¹⁷ Nigeria is one of the countries with the highest alcohol consumption in African countries, even though it is less compared to the Western European regions and the regions of America.^11,17-18

The WHO categorized young people into adolescents (10–19 years) and youths, also known as young adults (15–24 years). Young adulthood is a unique stage of development with high health needs and disparities in access to care. Globally, over 155 million (26.5%) adolescents aged 15–19 are current drinkers.^10–15 Young adults believe drinking is necessary for social acceptance, enjoyment, and relaxation, according to a 2001 WHO report. People drink to relieve discomfort, pain, anxiety, and fatigue in the African region.^11-17 Studies from Nigeria show a lack of knowledge about the harmful effects of alcohol, as well as complacency and disregard for how it affects society as a whole.^12,15 Over 50% of alcoholics in a study at the Jos University Teaching Hospital in Nigeria believed their drinking was not harmful.¹⁹

This study was designed to assess the prevalence of alcohol consumption and the extent of awareness of its health effects among young adults in Zonkwa, Zango Kataf LGA, Kaduna State. In addition, this study also seeks to explore the risk factors and causes of alcohol consumption among these young people that might have contributed to the severity of morbidity and mortality experienced today.

2. Methods

2.1. Study Area

This study was conducted in Zonkwa, the headquarters of Zangon Kataf LGA, Kaduna State. Zonkwa is the Bajju Chiefdom's administrative center and also one of its districts. Zonkwa town has an estimated population of 35,749 as of the 2006 census. The projected population in Zonkwa stood at 40,282 in 2020. The indigenous and predominant ethnic group in the town is the Bajju people. Other ethnic groups found in Zonkwa include the Atyap, Anghan, Ikulu, Igbo, Hausa, Yoruba, and other Nigerian peoples.²⁰ Zonkwa as a district is divided into six (6) areas: Zonkwa Central (Zonkwa town), Kurmin Bi, Fadiya, Zuturung, Zagom, and Fadan Kaje. Each area is divided into several sub-areas, also known as ungwas. Zonkwa Central has thirty (30) ungwas, Kurmin Bi has fifteen (15) ungwas, Zuturung has eleven (11) sub-areas, Fadiya has sixteen (16) sub-areas, Zagom has nine (9) sub-areas, and Fadan Kaje has seven (7) sub-areas, thereby making a total of eighty-eight (88) ungwas in the entire district.²¹

Some of the significant enterprises engaged in by the people of Zonkwa include trading, pottery, crafts making (winnower-bzibzi, basket-making-kanshyang), and farming (of ginger, yam, corn, sorghum, millet, soya beans, local beans (jok-kadak), potatoes, and cocoyam). Another important economic activity in Zonkwa is the brewing of local alcoholic beverages known as "dikan" by the Bajju people and "akan" by the Atyap people. It is also commonly known as burukutu. The use of burukutu is culturally accepted and has been used to settle disputes during celebrations such as the Bajju festival, Christmas, the New Year, naming ceremonies, or the deaths of the elderly. There is usually no age or gender discrimination in the consumption of burukutu. It is also given to children to serve as food, make them sleep, or for medication. It has been the source of income for most women who are not gainfully employed (especially married women and widows). Other forms of alcoholic beverages consumed by the inhabitants of Zonkwa include pito, palm wine, and commercially brewed alcoholic drinks.

There are several drinking bars and joints for commercially and locally brewed alcoholic beverages in Zonkwa. Those for local drinks are commonly called kantyi. The most popular bars for commercially brewed drinks include Elvado, Gwaben, Shooting, Sakut, Umaru, Kazah Bachet, Only Place, Bass, Nmma, Ziyachat, Biggard, Benjis, One Corner, State 19, Kantyikon, and Kumyim bars. Every sub-area ("Ungwa") has at least 3–5 kantyi for selling local alcoholic beverages and one bar for commercially brewed alcohol. Almost every household has at least one or two drinkers.

2.2 Study Design

The study is a descriptive, cross-sectional study.

2.3 Study Population

The study was conducted among young adults in Zonkwa, Zangon Kataf LGA, Kaduna State.

2.4 Inclusion Criteria

1. Young adults between the ages of 15 and 24

2. Young adults who have been residents of Zonkwa for a minimum of 2 years

3. Young adults who are willing to participate in the study

4. Young adults who were present at the time of data collection

2.5 Exclusion Criteria

1. People who are not young adults

2. Young adults who have not been residents of Zonkwa for at least 2 years

3. Young adults who were not willing to participate in the study

4. Young adults who were not present at the time of data collection

2.6 Sample Size Determination

The sample size for this study was determined using the formula:
n = Z²pq/d²

Where,

n = minimum sample size required.z = standard normal deviation at 95% confidence level =1.96

p = minimum prevalence in a previous study, which was 40%²² (0.4).

q = complementary probability of positive prevalence, which is 1-p = 1-0.4 = 0.6.
d = degree of accuracy desired at a 95% confidence interval of 5% = 0.05

n = 1.96²x 0.4 x 0.6/ 0.05²

= 0.922/0.0025

= 368.8

n ≈ 369

Adjusting for non-response, 10% is added as a non-response rate (attrition rate).

Attrition rate = 10% of the calculated sample size

= 10% x 369

= 0.10 x 369

= 36.9

Therefore,

n = 369 + 36.9

= 405.9

n ≈ 406

2.7 Sampling Technique

A multi-stage sampling technique was used to select the study sample.

Stage 1: Selection of a District Four (4) districts were identified in the Bajju Chiefdom: Zonkwa District, Madakiya District, Ungwan Rimi District, and Farman District. Zonkwa District was selected from among these districts using purposeful sampling, a non-probability sampling technique.

Stage 2: Selection of Areas According to the background data for the study area, six (6) areas were found in the Zonkwa District. By simple random sampling, only one (1) area (Zonkwa Central) was selected (by balloting without replacement).

Stage 3: Selection of ungwas A total of thirty (30) ungwas were identified in the chosen area (Zonkwa Central), and ten (10) ungwas were selected using a simple random sampling method.

Stage 4: Selection of streets The lists of all avenues in each of the selected ungwas were obtained from the heads of the ungwas, and a total of eighty-four (84) streets were identified (as presented in Table 3.1 below). Based on their share of the total number of avenues (per Ungwa), two-fifths (or 40%) of the identified streets were chosen using the stratified random sampling technique.

No. of streets in a selected Ungwa x 40%/total number of streets in all the selected ungwas (84)

A total of 34 streets were selected.

Stage 5: Selection of houses: House lists in each of the selected streets were obtained from the heads of the ungwas, and 2,193 homes were identified and line-listed. At an interval of 5, four hundred and six (406) homes were chosen at a standard sampling interval of 5, using systematic random sampling methods. The formula below was used to calculate the sampling interval:

Sampling interval = total number of houses (2,193)/sample size (406)

= 5.40

≈ 5

Stage 6: Selection of households A total of 3,049 families were identified from the 406 houses selected. The number of households per house ranged from 1 to 12. Out of these 3,049 identified households, 2,232 were identified as having eligible young adults. Using systematic sampling at five (5) regular sampling intervals, four hundred six (406) households with young adults who met the inclusion criteria were chosen. The sampling interval was determined using the formula below:

Sampling interval = total number of identified households (2,232)/sample size (406)

= 5.49

≈ 5

Stage 7: Selection of Participants One eligible young adult was selected by a simple random sampling technique from each selected household to participate in the study.

2.8 Instruments for Data Collection

The information was gathered using an interviewer-administered, pre-tested, standardized questionnaire. Before data collection, a pre-test questionnaire was conducted with 37 young adults (10% of the total sample size) in Ungwan Boro, Kaduna, Kaduna State. Responses from the pre-test were utilized to modify the questionnaire. The questionnaire was developed using an analysis of the literature on studies that were comparable to this one.^12,23-28 Questions were conceived and prepared to meet the goals of this study. The questionnaire was split into four parts. Section (A) contains information on the socio-demographics of the respondents; Section (B) discusses the level and pattern of alcohol consumption among respondents; Section (C) assesses public awareness of the harmful effects of alcohol consumption on health; and Section D discusses the elements that influence alcohol consumption.

2.9 Data Collection

Data collection was done using the Kobo Toolbox. Three (3) research assistants were trained to use the app and administer the questionnaires to the participants. The researcher and the assistants met with the respondents at their various houses. The questionnaires were administered verbally to the respondents after receiving their informed consent, and the researcher and assistants filled them out using the Kobo Toolbox.

2.10 Data Analysis

The data were analyzed using the Statistical Package for Social Science (SPSS version 26). Frequency tables were employed to show the results of the analysis. The chi-square (x2) and Fisher's exact tests were used to determine the relationship between the variables. The level of statistical significance was established at a 0.05 p-value. For continuous variables, means and standard deviations were calculated. In percentage form, the rates were stated. One mark was given for each correctly answered question about the effects of alcohol on health. Zero points were awarded for incorrect or "I don't know" answers. Scores were totaled, and those who achieved less than half (< 50%) were deemed to have poor awareness, while those who scored half or more (≥ 50%) were considered to have a good understanding.

2.11 Ethical Consideration

The study received approval from the Barau Dikko Teaching Hospital (BDTH) Health Research Ethical Committee and the Chief of Zonkwa District (Mr. Musa Gaiya), heads of ungwas, and household heads. The confidentiality and anonymity of the responses provided by the respondents were assured, and participation was entirely voluntary.

3. Results

A total of 406 questionnaires were administered.

Socio-demographic Characteristics of the Respondents

Table 3.1: Socio-demographic characteristics of the respondents (n = 406)

Variables	Frequency	Percentage (%)
Age (years)
15-17	189	46.6
18-19	91	22.4
20-21	47	11.6
22-24	79	19.5
Sex
Male	232	57.1
Female	174	42.9
Tribe
Bajju	148	36.5
Kataf	46	11.3
Jaba	33	8.1
Ikulu	14	3.4
Kamantan	13	3.2
Kagoro	13	3.2
Koro	11	2.7
Chawai	11	2.7
Tribes non-indigenous to Kaduna State (Igbo, Yoruba, Ngas, Esan, Igala, Tiv, and Idoma)	65	16.0
Others (Attakar, Adara, Kurama, Kahugu, Hausa, Ninzon, Kagoma and Gbagi)	52	12.8
Religion
Christianity	384	94.6
Islam	22	5.4
Marital status
Single	385	94.8
Married	21	5.2
Currently schooling
Yes	315	77.6
No	91	22.4
Highest level of education
Junior Secondary	52	12.8
Senior Secondary	252	62.1
Tertiary (BSc, NCE, Polytechnic, etc.)	102	25.1
Engaged in any kind of occupation/work
Yes	136	33.5
No	270	66.5
Total	406	100.0
Types of occupation n= 136 (Multiple responses were allowed)
Civil servant	10	7.4
Farming	25	18.4
Trading	49	36.0
Artisans (hairdressing, tailoring, painting, carpentry, make-up artist, etc.)	71	52.2
Monthly income - N (n = 136)
N0- N9,999	33	24.3
N10,000- N19,999	27	19.9
N20,000-N29,999	16	11.8
N30,000-N39,999	12	8.8
N40,000-N49,999	10	7.4
N50,00-N59,999	4	2.9
N60,000-N69,99	5	3.7
≥ N70,000	29	21.3
Total	136	100.0

Almost half (46.6%) of the respondents are under 18. The mean age of the respondents is 18.48 years, ± 2.91 SD. The peak age of the respondents is 15 years. More than half (57.1%) of the respondents are male, while 42.9% are female. Almost all the respondents (94.8%) are single, while a few (5.2%) are married. Over one-third (36.5%) of the respondents are Bajju, followed by a combination of tribes non-indigenous to Kaduna State and Kataf (16.0% and 11.3%, respectively). Almost all the respondents (94.6%) are Christians, with only a few (5.4%) being Muslims. About three-quarters (77.6%) of the respondents are currently schooled, with about two-thirds (62.5%) having senior secondary education as their highest level of education; 25.1% have tertiary education; and 12.8% have junior secondary education. One-third (33.5%) of the respondents are working in some capacity, with artisans making up the majority of this group (52.2%), followed by traders (36.0%) and farmers (18.4%). Only a few (7.4%) of them are civil servants. The average monthly income found in this study is N38,102.94 ± N40,363.034 SD. Their monthly income ranges between N3,000 and N150,000.

Prevalence, Types, and Patterns of Alcohol Consumption Among Respondents

Table 3.2: Prevalence of alcohol consumption among respondents (406)

Variables	Frequency	Percentage (%)
Lifetime drinkers (ever drank alcohol)
Yes	153	37.7
No	253	62.3
Current drinkers (consumed alcohol within the last 12 months) n = 153
Yes	125	81.7
No	28	18.3
Time of last alcohol consumption (n = 153)
Within the last seven (7) days	67	43.8
Within the last eight (8) to thirty (30) days	34	20.9
Within the last > one (1) to twelve (12) months	24	15.7
Above one year	28	18.3
Total	153	100.0

More than one-third (37.7%) of the respondents have ever consumed alcohol in their lifetime, while 62.3% affirmed not having ever used alcohol before. The majority (81.7%) of the lifetime (ever) drinkers declared themselves to be current drinkers (i.e., they have consumed alcohol within the past 12 months). About 43.8% of the current drinkers affirmed drinking within the last seven (7) days, 20.9% reported drinking within the previous thirty (30) days, and 15.7% within the last 12 months. About 18.3% drank alcohol over one year ago.

Table 3.3: Types of alcoholic beverages consumed by respondents (n = 153)

Variables	Frequency	Percentage (%)
Categories of alcohol consumed by respondents (Multiple responses were allowed)
Only bottled alcohol	94	61.4
Only local brew	15	9.8
Both	44	28.8
Types of alcoholic beverages consumed by respondents (Multiple responses were allowed)
Beer	115	75.2
Spirit	47	30.7
Wine	78	51.0
Local alcoholic beverages	59	38.6
Types of local alcoholic beverages consumed (n = 59) (Multiple responses were allowed)
Burukutu	8	13.6
Pito	20	33.9
Palm wine	57	96.6
Ogogoro	2	3.4
Types of alcoholic beverages consumed the most
Beer	80	52.3
Spirit	23	15.0
Wine	15	9.8
Burukutu	1	0.7
Pito	3	2.0
Palm wine	31	20.2
Total	153	100.0

About two-thirds (61.4%) of alcohol drinkers consume bottled alcoholic beverages only, while 9.8% consume only locally brewed alcohol. Over one-quarter (28.8%) drink both local brew and bottled alcohol. Over two-thirds (75.2%) of alcohol drinkers affirmed they consume beer, followed by wine and local alcoholic beverages (51.0%) and 38.6%, respectively. Wine is the least commonly consumed alcoholic beverage (30.7%) among the respondents. Almost all the respondents (96.6%) who consume local alcoholic beverages affirmed they drink palm wine, followed by pito and burukutu (33.9% and 13.6%, respectively). Ogogoro is the least commonly consumed local alcoholic beverage (3.4%). More than half (52.3%) of the respondents who drink reported that their most preferred drink is beer, followed by palm wine and spirits (20.2% and 15.0%, respectively).

Table 3.4: Patterns of alcohol consumption among respondents (n = 153)

Variables	Frequency	Percentage (%)
Age at initiation of alcohol consumption in years
7-12	30	19.6
13-19	106	69.3
20-23	17	11.1
Duration of alcohol consumption (years)
0-2	71	46.4
>2-4	43	28.1
> 4	39	25.5
Frequency of alcohol consumption
Daily	16	10.5
2-3 times per week	19	12.4
4-6 times per week	4	2.6
Weekly	32	20.9
Monthly	23	15.0
Occasionally (once in more than a month interval)	59	38.6
Total	153	100.0
No. of bottles consumed at a sitting (n = 138)
1-2	45	32.6
3-4	45	32.6
5 and above	48	34.8
Total	138	100.0
No. of calabashes (of local alcohol) consumed at a sitting (n = 59)*
1-2	20	33.9
3-4	30	50.8
5 and above	9	15.3

The average age at initiation of alcohol consumption among the respondents who drink is 15.27 years, ± 3.097 SD, with extremes of 7 and 23 years. Almost half of the drinkers (46.4%) said they had used alcohol for 0-2 years, followed by those who had used it for 2-4 years (28.1%). Over one-third (38.6%) of them affirmed that they drink occasionally. Only 10.5% of drinkers consume alcohol daily. Over one-third (34.8%) of the respondents who consume commercially brewed alcoholic beverages affirmed that they drink five (5) or more bottles at a sitting. Half (50.8%) of the respondents who consume local alcoholic beverages declared they drink 3–4 calabashes on average.

Table 3.5: Reasons for abstaining from alcohol consumption (n = 253)

Variables	Frequency	Percentage (%)
Reasons for abstaining from alcohol consumption (multiple responses were allowed)
It is against my religion	69	27.4
None of my family members drinks	58	22.9
Alcohol makes one misbehave	118	46.6
It is against my moral standards	99	39.1
It labels one as bad a person	48	19.0
Any intentions to drink alcohol in the future
Yes	3	1.2
No	250	98.8
Reasons for having intentions to consume alcohol in the future (n = 3)
To avoid being lonely	1	33.3
I want to stop thinking of some personal problems	1	33.3
Those who drink are always happy	1	33.3
*Reasons for not intending to consume alcohol in the future (n = 250)
For health reasons and general well-being	76	30.4
I want to maintain good moral standards	37	14.8
It causes social disrepute	61	24.4
Spiritual/religious convictions	27	10.8
To preserve the future (and ensure longevity)	21	8.4
It ruins/harms life	17	6.8
I want to contribute positively to the society	9	3.6
Others (I have not seen the benefit of drinking; I am too young to consume alcohol, I want to live a pleasant life)	4	1.6

(*multiple responses were allowed).

Nearly half (46.6%) of the respondents who do not consume alcohol affirmed that drinking alcohol makes drinkers misbehave, while 27.4% declared that consuming alcohol is against their moral standards. About 22.9% of the respondents also said they do not drink because none of their family members do, and it also labels drinkers as bad. Almost all (98.8%) of the respondents who do not drink alcohol affirmed that they have no intention of drinking anytime in the future, with about one-third of them (30.4%) reporting that they have no plans to drink for health reasons and general well-being. Only three (1.2%) respondents who do not consume alcohol plan to drink in the future because they do not want to be lonely, want to stop thinking about their problems, and want to live happily.

Awareness of the Health Effects of Alcohol Consumption by the Respondents

Table 3.6: Awareness of what alcohol is (n = 406)

Variables	Frequency	Percentage (%)
A psychoactive substance (a substance that can affect the brain)	240	59.1
A substance that makes one more active	106	26.1
A pain killer or reliever	85	20.9
Others (a drink that can be harmful to the body and make one sin against God)	53	13.1

(*Multiple answers were allowed).

Most of the respondents (59.1%) described alcohol as a psychoactive substance (a substance that can affect the brain). About a quarter (26.1%) of them described it as a stimulant, while 20.9% described it as a painkiller.

Table 3.7: Awareness of the health effects of alcohol consumption (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on health
Yes	389	95.8
No	11	2.7
I don’t know	6	1.5
Total	406	100.0

Almost all the respondents (95.8%) are aware of the health effects of alcohol. Only 2.7% of them reported that alcohol has no health effects, while 1.5% said they do not know about the health effects of alcohol.

Table 3.8: Awareness of positive (beneficial) effects of alcohol consumption (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has beneficial effects
Yes	88	21.7
No	262	64.5
I don’t know	56	13.8
*Beneficial effects of alcohol consumption mentioned by respondents (n = 88)
It eases stress and provides peace of mind	29	33.0
It provides happiness, pleasure, and fun	36	40.9
It is used for medicine	14	15.9
It provides energy and keeps one active	18	20.5
It is used to maintain good health (such as digestion, the heart, etc., and vision- related to palm wine)	5	5.7
It relieves pain (including afterbirth pains in women)	4	4.5
Others (it reduces sugar intake; it provides courage and confidence, and it keeps the body warm)	4	4.5

(*Multiple responses were allowed).

Almost two-thirds (64.5%) of the respondents affirmed that alcohol has no beneficial effects on health. About 21.7% of respondents reported that alcohol consumption has beneficial effects, while 13.8% did not know. The most frequently cited benefits of alcohol, according to respondents, are happiness, pleasure, and fun (40.9%), followed by stress relief and mental clarity (33.0%). About 20.5%, 15.9%, 5.7%, and 4.5% said it gives energy and keeps one active, is used for medicine, has health effects (such as digestion, vision, and the heart), and relieves pain (including afterbirth pains in women), respectively.

Table 3.9: Awareness of the negative (harmful) effects of alcohol consumption (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has any harmful effect
Yes	342	84.2
No	25	6.2
I don’t know	39	9.6
The harmful effects of alcohol consumption reported by respondents (n = 342)
It can harm body organs (the liver, brain, kidneys and lungs)	161	47.0
It can cause misbehavior and a lack of responsibility	46	13.5
It can cause mental conditions (madness, loss of memory, etc..)	41	12.0
It causes sickness (vomiting, body weakness, diabetes, stomach ulcer, skin rashes, etc.)	45	12.6
It can cause violence (crimes, murder, etc.)	23	6.7
It can cause early death (including suicide)	18	5.3
It can cause poverty	13	3.8
It can cause family conflicts	15	4.4
It can cause mouth odor and toothache	9	2.6
It can cause intoxication and road traffic accidents	9	2.6
It can cause promiscuity (womanizing, prostitution)	5	1.5
It causes social disrepute (loss of trust, loss of dignity, increased risk of unhealthy lifestyles)	5	1.5
Others (it can cause low self-esteem, produce arrogant people in society, etc.)	17	5.0

(*Multiple responses were allowed).

Over two-thirds (84.2%) of the respondents affirmed that alcohol consumption has harmful health effects. About 6.2% reported that alcohol consumption has no harmful effects, while 9.6% did not know. The most frequently mentioned negative effect was that it could affect body organs such as the liver, brain, kidneys, and lungs (47.0%), followed by the harmful effects of misbehavior and illness (13.5% and 12.6%, respectively).

Alcohol and the Body

Table 3.10: Awareness of the effects of alcohol consumption on the liver (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol has effects on the liver
Yes	376	92.6
No	13	3.2
I don’t know	17	4.2
Specific effects of alcohol consumption on the liver (n = 376)*
Liver cirrhosis	267	71.0
Alcoholic fatty liver disease	106	28.2
Liver cancer	161	42.8

(*Multiple responses were allowed).

The majority (92.6%) of the respondents are aware that alcohol consumption has harmful effects on the liver. Only a few (3.2%) respondents reported that alcohol consumption does not affect the liver, while 4.2% did not know. The majority (71.0%) of the respondents who are aware of the effects of alcohol on the liver affirmed that it affects the liver by causing liver cirrhosis. About 42.8% knew it could cause liver cancer, while a quarter (28.2%) knew it could cause alcoholic fatty liver diseases.

Table 3.11: Awareness of the effects of alcohol consumption on the brain (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on the brain (or mind)
Yes	383	94.3
No	7	1.7
I don’t know	16	3.9
Specific effects of alcohol consumption on the brain or mind (n = 383)*
Mental disorders	330	86.2
Impaired memory (problems with remembering things)	183	47.8
Difficulty in walking (due to intoxication or drunkenness)	212	55.4
Slurred speech	192	50.1

(*Multiple responses were allowed)

Almost all the respondents (94.3%) knew alcohol consumption could affect the brain (or mind). Only a few (1.7%) respondents reported that it does not affect the brain, while 3.9% did not know. Most respondents (86.2%) who knew that alcohol consumption can affect the brain reported that it causes mental disorders. About 55.4% and 52.1% of them affirmed that it causes difficulty walking (due to intoxication) and slurred speech, respectively. Less than half (47.8%) of them said it caused impaired memory.

Table 3.12: Awareness of the effects of alcohol consumption on the kidneys (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on the kidneys
Yes	280	69.0
No	33	8.1
I don’t know	93	22.9
Specific effects of alcohol consumption on the kidneys (n = 280)*
It causes kidney failure	239	85.4
Increases the risk of urinary tract infections	101	36.1

(*Multiple responses were allowed).

Over two-thirds (69.0%) of the respondents are aware that alcohol consumption has effects on the kidneys. About 22.9% said they did not know, while only a few (8.1%) reported that alcohol consumption does not affect the kidneys. The majority (85.4%) of the respondents who were aware that alcohol consumption could affect the kidneys affirmed that it causes kidney failure, and about one-third of them (36.1%) said it increases the risk of urinary tract infections.

Table 3.13: Awareness of the effects of alcohol consumption on the heart (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on the heart
Yes	278	68.5
No	46	11.3
I don’t know	82	20.2
*Specific effects of alcohol consumption on the heart (n = 278)
Heart attack	174	62.6
Hypertension	128	46.0
Stroke	87	31.3
Arrhythmias (abnormal heartbeats)	94	33.8

(*Multiple responses were allowed).

Over two-thirds (68.9%) of the respondents knew drinking could affect the heart. About 19.9% did not know, while a minority (11.9%) said alcohol consumption does not affect the heart. Almost two-thirds (62.6%) of those who affirmed that alcohol consumption affects the heart said it can cause a heart attack. Less than half of them reported that it can cause hypertension (46.0%), while about one-third said that it can cause arrhythmias (33.8%) and stroke (31.3%), respectively.

Table 3.14: Awareness of the health effects of alcohol consumption on other body parts (n =406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on the heart
Yes	278	68.5
No	46	11.3
I don’t know	82	20.2
Specific effects of alcohol consumption on the heart (n = 278)*
Heart attack	174	62.6
Hypertension	128	46.0
Stroke	87	31.3
Arrhythmias (abnormal heartbeats)	94	33.8

(*Multiple responses were allowed).

Less than half (46.8%) of the respondents are aware that alcohol consumption can affect other body parts aside from the liver, brain, kidneys, and heart. About one-third (30.5%) did not know, while 22.7% reported that alcohol consumption does not affect other body parts. Over two-thirds (67.4%) of those aware that alcohol consumption affects different body parts (aside from those mentioned above) affirmed that it can also affect the lungs. About 36.3%, 23.7%, 14.7%, 13.2%, 12.1%, and 4.2% declared that it can also affect the stomach, reproductive system, eyes, pancreas, bones, and skin, respectively.

Alcohol and some Disease Conditions/Poor Health Outcomes

Table 3.15: Awareness of the effects of alcohol consumption on diabetes mellitus (n = 405)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on diabetes mellitus
Yes	229	56.4
No	76	18.7
I don’t know	101	24.9
Specific effects of alcohol consumption on diabetes mellitus (n = 229)*
Poor control of blood sugar levels	198	86.5
It increases the risk of eye disease	49	21.4
It increases the risk of abnormal body sensation	64	27.9
It increases the risk of poor wound healing	59	25.8

(*Multiple responses were allowed).

More than half (56.4%) of the respondents are aware that alcohol consumption has effects on diabetes mellitus. About a quarter (24.9%) did not know, while 18.7% reported that alcohol consumption does not affect diabetes mellitus. Most (86.5%) of those aware of its effects on diabetes affirm that it could result in poor control of blood sugar levels. About one-fifth to a quarter (21.4%, 27.9%, and 25.8%) of the respondents reported increased risks of eye disease, abnormal body sensation, and poor wound healing, respectively.

Table 3.16: Awareness of the effects of alcohol consumption on cancers (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on (or increases the risk of) cancers
Yes	240	59.1
No	56	13.8
I don’t know	110	27.1
Specific effects of alcohol consumption on (or increased risk of) particular types of cancers (n = 240)*
Breast cancer	74	30.8
Esophageal (throat) cancer	32	13.3
Oral (mouth) cancer	41	17.1
Stomach cancer	81	33.8
Liver cancer	200	83.3
Cancer of the pancreas	31	12.9

(*Multiple responses were allowed).

More than half (59.1%) of the respondents are aware that alcohol consumption has effects on (or increases the risk of) cancer. About a quarter (27.1%) did not know, while 13.8% reported that alcohol consumption does not affect cancer. Most (83.3%) of those aware that alcohol consumption affects cancer affirm that it results in liver cancer. Other responses (33.8%, 30.8%, 17.1%, 13.3%, and 12.9%) connected alcohol consumption with stomach, breast, oral, esophageal, and pancreatic cancers, respectively.

Table 3.17: Awareness of effects of alcohol consumption on sexually transmitted diseases (STIs) (n= 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on sexually transmitted diseases
Yes	205	50.5
No	156	38.4
I don’t know	45	11.1

*Specific effects of alcohol consumption on

sexually transmitted diseases (n = 205)

It increases the risk of contracting HIV/AIDS

174

84.9

It increases the risk of contracting gonorrhea

124

60.5

It increases the risk of contracting syphilis

38.0

(*Multiple responses were allowed).

A little more than half of those surveyed (50.5%) are aware that drinking alcohol can increase the risk of STIs. Over one-third (38.4%) of them reported that alcohol consumption does not affect STIs, while 11.1% of them did not know. Most respondents (84.9%) aware of how alcohol consumption affects STIs agree that it raises the risk of contracting HIV/AIDS. About 60.5% knew that alcohol consumption increases the risk of contracting gonorrhea, while over one-third of them (38.0%) knew it increases the risk of contracting syphilis.

Table 3.18: Awareness of the effects of alcohol consumption on pregnancy and fertility (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on pregnancy and fertility
Yes	324	79.8
No	31	7.6
I don’t know	51	12.6
Specific effects of alcohol consumption on pregnancy (n = 324)*
It increases the risk of miscarriages	251	77.5
It increases the risk of death of unborn children (in the womb)	167	51.5
It increases the risk of abnormalities in the bodies of newborn babies	106	32.7
It increases the risk of barrenness/infertility in women	55	17.0
It increases the risk of impotence/infertility in men	60	18.5

(*Multiple responses were allowed).

Most participants (79.8%) knew alcohol could affect fertility and pregnancy in alcohol drinkers. About 7.6% claimed it does not, while 12.6% said it does not. Most respondents (77.5%) who knew drinking alcohol could affect fertility and pregnancy agree that it raises the risk of miscarriages. A little over half of them (51.5%) asserted that it increases the risk of fetuses dying in the womb, and 32.7%, 18.5%, and 17.0% affirm that it also increases the risk of abnormalities in the bodies of newborns, impotence, or infertility in men, and barrenness or infertility in women.

Alcohol and the Personal Welfare of Alcohol Drinkers

Table 3.19: Awareness of the effects of alcohol consumption on self-harm (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on self-harm
Yes	369	90.9
No	21	5.2
I don’t know	16	3.9
*Specific effects of alcohol consumption about self-harm (n = 369)
It increases the risk of self-inflicted physical injuries	247	66.9
It increases the risk of domestic accidents	230	62.3
It increases the risk of road traffic accidents	231	62.6
It increases the risk of premature death	232	62.9
It increases the risk of suicide	135	36.6

(*Multiple responses were allowed).

Nearly all of the respondents (90.9%) are aware that alcohol consumption has effects on self-harm among drinkers. About two-thirds of the respondents who knew that alcohol consumption has effects on self-harm said that it increases the risk of self-inflicted physical injuries (66.9%), domestic accidents (62.3%), road traffic accidents (62.6%), and premature deaths (62.9%). Over one-third (36.6%) reported that it increases the risk of suicide among drinkers.

Alcohol and the Social Life of Alcohol Drinkers

Table 3.20: Awareness of the effects of alcohol consumption on violence (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on violence
Yes	371	91.4
No	22	5.4
I don’t know	13	3.2
Total	406	100.0
*Specific effects of alcohol consumption on violence (n-371)
It increases aggression against others	294	79.2
It impairs good decision-making about others by alcohol drinkers	173	46.6
It makes alcohol drinkers have a poor ability to correctly interpret (or process) information they receive from others	172	46.4
It increases the risk of inflicting physical injuries on others by alcohol drinkers	183	49.3
It increases the burden of care (given to alcohol drinkers when they fall sick) on others	114	30.7
It may lead to murder (killing of other people) by alcohol drinkers	184	49.6

(*Multiple responses were allowed).

Most respondents (91.4%) knew that alcohol use fuels violence. Only a few (5.4%) claimed that drinking alcohol does not affect violence, whereas 3.2% of the respondents said they had no idea. Over two-thirds of the respondents (79.2%) who knew alcohol usage can contribute to violence mentioned that it does so by encouraging aggressive behavior toward others. Less than half of them were aware that drinking alcohol makes people more likely to commit murder (49.6%), injure others physically (49.3%), interfere with making wise judgments about others (46.6%), and make it difficult for drinkers to interpret (or process) information received from others (46.4%).

Table 3.21: Awareness of the effects of alcohol consumption on domestic instability (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on domestic instability (broken/dysfunctional homes)
Yes	367	90.4
No	17	4.2
I don’t know	22	5.4
*Specific effects of alcohol consumption on broken/dysfunctional homes (n = 367)
It destroys general family relationships and harmony	296	80.7
It increases the risk of child abuse and neglect	193	52.6
It causes domestic violence	234	63.8
It causes separation (or divorce) between husbands and wives	224	61.0

(*Multiple responses were allowed).

The majority of respondents (90.4%) are aware that drinking has an impact on unstable families. Only a few (4.2%) claimed it does not affect broken homes, and 5.4% were unsure. Most respondents (80.7%) who know that drinking affects unstable families concur that it ruins harmony and ties within the family. 61% and 63.8% affirm that alcohol use causes domestic violence and marriage separation, respectively, and 52.6% agree that it increases the likelihood of child abuse and neglect.

Table 3.22: Awareness of the effects of alcohol consumption on committing a crime (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol has effects on committing crime
Yes	370	91.1
No	23	5.7
I don’t know	13	3.2
*Specific effects of alcohol consumption on committing a crime (n = 370)
It increases the risk of theft (stealing)	271	73.2
It increases the risk of murder (killing of other people)	230	62.2
It increases the risk of fighting	289	78.1
It increases the risk of rape	233	63.0
It increases the risk of financial crimes (like “419”, etc..)	152	41.1

(*Multiple responses were allowed)

Nearly all the respondents (91.1%) are aware that alcohol consumption contributes to committing crimes. Only a few (5.7%) reported that it does not affect crimes, and 3.2% of them did not know. The majority of those who are aware that alcohol consumption has effects on committing crimes affirm that it increases the risk of fighting (78.5%) and theft (73.2%) among drinkers. Almost two-thirds of them said it increases the risk of murder (62.2%) and rape (63.0%), while less than half (41.1%) of them said that it increases the risk of financial crimes like "419" (financial fraud).

Table 3.23: Awareness of the effects of alcohol consumption on the school performance of drinkers (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol has effects on school performance of drinkers
Yes	371	91.4
No	21	5.2
I don’t know	14	3.4
*Specific effects of alcohol consumption on school performance of drinkers (n = 371)
Poor school performance	312	84.1
Absenteeism/truancy	244	65.8
Withdrawal (or dropping out) from school	244	65.8
Others (distraction of other students in class, lack of concentration, misbehaving in school, and even fighting teachers)	5	1.3

(*Multiple responses were allowed).

The majority (91.4%) of the respondents knew that alcohol consumption influences the school performance of alcohol drinkers. Only a few (5.2%) reported that it does not affect school performance, and 3.4% of them did not know. Most of those who are aware that alcohol consumption influences the school performance of drinkers affirm that it causes poor school performance. 65.8% of respondents said it contributes to truancy, withdrawal from school, and absenteeism. Other effects mentioned by the respondents include distraction from other students in class, lack of concentration, misbehavior in school, and even fighting teachers.

Table 3.24: Awareness of the effects of alcohol consumption on the work performance of drinkers (n = 406)

Variables	Frequency	Percentage (%)
Awareness that alcohol has effects on work performance of drinkers
Yes	355	87.4
No	33	8.1
I don’t know	18	4.4
*Specific effects of alcohol consumption on work performance of drinkers (n = 355)
Reduced work productivity	259	73.0
Absenteeism from work	231	65.1
Loss of job	270	76.1
Others (going to work late, tiredness, making mistakes at work, etc.)	6	1.7

(*Multiple responses were allowed).

The majority (87.4%) of the respondents knew that alcohol consumption affects work performance among drinkers. Only a few (8.1%) of them reported that alcohol consumption does not affect work performance, while 4.4% of them did not know. Most respondents who knew that alcohol consumption affects work performance affirmed that it causes job loss (76.1%) and reduced work performance (73.0%). About two-thirds (65.1%) said that it causes absenteeism, while a few (1.7%) of them affirmed that it can also cause tiredness, mistakes or errors at work, and being late.

Table 3.25: Awareness of the effects of alcohol consumption on unplanned sex (n=406)

Variables	Frequency	Percentage (%)
Awareness that alcohol consumption has effects on unplanned sex among drinkers
Yes	345	85.0
No	35	8.6
I don’t know	26	6.4
Specific effects of alcohol consumption on unplanned sex among drinkers (n = 345)*
Unprotected sex	224	64.9
Unwanted pregnancy	275	79.7
Induced abortion	130	37.7
Sexually transmitted diseases	158	45.8
HIV/AIDS	124	35.9

(*Multiple responses were allowed).

Most of the respondents (85.0%) are aware that alcohol consumption has effects on unplanned sex among drinkers. Only a few (8.6%) reported that it does not influence random sex, while 6.4% did not know. The majority (79.7%) of those who knew that alcohol consumption affects unplanned sex affirmed that it increases the likelihood of unwanted pregnancy among drinkers. About two-thirds (64.9%) said that it increases the risk of unprotected sex, while others said that it increases the risk of HIV/AIDS (35.9%), an induced abortion (37.7%), and STIs (45.8%).

Table 3.26: Awareness of the effects of alcohol consumption on the loss of properties by drinkers (n = 406)

Variables	Frequency	Percentages (%)
Awareness that alcohol has effects on loss of properties by drinkers
Yes	340	83.7
No	39	9.6
I don’t know	27	6.7
Specific effects of alcohol consumption on the loss of properties by drinkers (n = 340)*
Gambling away money and other belongings/properties	247	72.6
Carelessness regarding belongings/properties	243	71.5
Forgetfulness regarding belongings/properties	176	51.8
Poverty	180	52.9
Lack of food	156	45.9
Lack of shelter	145	42.6
Others (selling off their properties to buy alcohol, etc..)	10	2.9

(*Multiple responses were allowed).

Over two-thirds (83.7%) of the respondents knew that alcohol consumption influences property loss. Only a few (9.6%) claimed that it does not affect the loss of properties, and 6.7% were unsure. Most respondents who are aware that alcohol consumption has consequences for property loss affirm that it results in gambling away money and other possessions or properties (72.6%). 71.5% said it causes carelessness on properties. Over half of the respondents reported poverty (52.9%) and forgetfulness about properties (51.8%). A few (2.9%) stated that it also raises the risk of alcohol drinkers selling their properties to buy alcohol. Less than half said it could cause a lack of food and shelter (45.9% and 42.6%, respectively).

Table 3.27: Source of information about alcohol and its health effects among respondents (n=406)

Sources of information	Frequency	Percentage (%)
Family members	148	36.5
Books/magazines	155	38.2
Radio/television	198	48.8
Friends	216	53.2
School	190	46.8
Healthcare workers	106	26.1
Church/mosque	95	23.4
Others (social media, personal experience, and the experience of other drinkers, etc.	46	11.3

(*Multiple responses were allowed).

Friends (53.2%), radio or television (48.8%), and schools (46.8%) are the most frequent sources of information about alcohol and its effects on health. The least common sources of information are other sources such as social media, personal experience, and the experiences of other drinkers (11.3%).

Table 3.28: Grading of awareness of alcohol and its health effects among respondents (n=406)

Grades	Score (%)	Frequency (n)	Percentage (%)
Good awareness	≥ 50	148	36.5
Poor awareness	< 50	258	63.5
Total	100	406	100.0

About two-thirds (63.5%) of the respondents have poor awareness of the health effects of alcohol consumption, while over one-third (36.5%) have good awareness of the health effects of alcohol consumption.

Social Factors Influencing Alcohol Use Among Young Adults

Table 3.29: Respondents’ perception of factors influencing alcohol consumption among young adults in their community (n=406)

Perceived reasons for alcohol consumption among young adults	Frequency	Percentage (%)
For pleasure or fun	259	63.8
Depression	180	44.3
Idleness	151	37.2
Peer pressure	252	62.1
Curiosity	127	31.3
Poverty	122	30.0
Home/personal problems	145	35.7
Drinking is accepted and encouraged by my culture	94	23.2
My family members allow and encourage drinking	47	11.6
Unemployment	130	32.0
Stress	137	33.7
Boredom	107	26.4

(*Multiple responses were allowed).

About two-thirds (63.8%) of the respondents affirmed that the perceived reasons for alcohol consumption among young adults in their community are for pleasure or fun, followed by peer pressure and depression (62.1% and 44.3%, respectively). A minority (11.6%) said they perceived it as due to family acceptance of alcohol consumption.

Table 3.30: Drinking among family members and social circles of the respondents (n=406)

Variables	Frequency	Percentage (%)
Respondents who have family members who consume alcohol
Yes	215	53.0
No	191	47.0
Family members of respondents who consume alcohol (multiple responses)- n=215
Father	79	36.7
Mother	25	11.6
Brothers	66	30.7
Sisters	16	7.5
Uncles	82	38.1
Aunties	6	2.8
Grandfather	3	1.4
Grandmother	3	1.4
Cousin	13	6.0
Husband	4	1.9
Respondents who have friends who consume alcoholic beverages
Yes	289	71.2
No	117	28.8
Respondents who have classmates who consume *alcoholic beverages (n = 315)**
Yes	157	49.8
No	158	50.2
Respondents who have colleagues (at work) who consume alcoholic beverages (#n = 136)
Yes	75	55.1
No	61	44.9
Total	136	100.0

*Respondents who are currently schooling only #Respondents who are working only

More than half (53.0%) of the respondents affirmed that they have family members who consume alcoholic beverages, with most of them mentioning their uncles (38.1%), fathers (36.7%), and brothers (30.7%) as drinkers. Almost three-quarters (71.2%) of the respondents have friends who consume alcoholic beverages. Nearly half (49.8%) of the respondents in school have classmates who drink alcoholic beverages. More than half (55.5%) of the respondents engaged in any occupation also have colleagues who consume alcoholic beverages.

Table 3.31: Introduction to alcohol consumption among respondents who drink alcohol (n=153)

Persons who introduced respondents to alcohol consumption	Frequency	Percentage (%)
Classmates	8	5.2
Colleagues at work	2	1.3
Family members	39	25.5
Friends	97	63.4
Neighbors	5	3.3
Others (myself)	2	1.3
Circumstances of first alcoholic drink
At a party or social ceremony	33	21.6
At home (or in the family environment)	35	22.9
In a hotel/bar	39	25.5
With friends	43	28.1
Others (on the school premises)	3	1.9
Motivation to drink alcohol the first time
I wanted to socialize and mingle with my friends	65	42.5
The pleasure and fun of drinking	35	22.9
I wanted to taste it (curiosity)	19	12.4
Stress	11	7.2
My friends told me it would give me courage and confidence (peer pressure)	7	4.6
I was bored and lonely	6	3.9
I was in a bad mood	6	3.9
Others (my uncle/father gave me to drink, I never knew it was alcohol)	4	2.6
Total	153	100.0

Most drinkers (63.3%) said friends introduced them to alcohol, followed by family members (25.5%). Only 2 (1.3%) respondents said they had started drinking out of self-interest. Nearly half (42.5%) of alcohol drinkers said they started because they wanted to interact and socialize with friends. About a quarter (28.1%) of those who drink admit to having their first drink with friends. 12.4% began drinking out of curiosity, while 22.9% began drinking for pleasure and fun.

Table 3.32: Sources of procurement of alcoholic beverages among respondents (n=153)

Sources of procurement of alcoholic beverages (n = 153)	Frequency	Percentage (%)
Night clubs	41	26.8
Night parties	84	54.9
Social ceremonies	49	32.0
Roadside joints	57	37.3
Drinking bars/hotels	103	67.3

(*Multiple responses were allowed).

Most of the respondents who drink affirmed that they usually get their alcoholic beverages from drinking bars or hotels (67.3%), followed by night parties and roadside joints (54.9% and 37.3%, respectively).

Table 3.33: Intention to quit (stop) alcohol consumption among respondents (n=153)

Intention to quit alcohol consumption	Frequency	Percentage (%)
Yes	110	71.9
No	43	21.1
Reasons for intention to quit alcohol consumption (n = 110)
Because of its harmful effects (including health reasons)	42	38.2
It is time and money-consuming	18	16.4
It makes me not plan for the future	9	8.2
It causes social disrepute (associated with misbehavior)	11	10.0
Advice from people	7	6.4
I want to live a better life	8	7.3
To avoid addiction	6	5.5
Others (because I drank out of ignorance/unknowingly, because of my previous experience, there is nothing good in drinking, etc.)	10	9.1
Reasons for not intending to quit alcohol consumption (n = 43)
It provides pleasure, a good time, and relaxation	14	32.6
It keeps me happy, and I enjoy drinking	8	18.6
It eases stress, gives me peace of mind, and helps me forget my problems	10	23.3
I cannot do without it	4	9.3
I am not a chronic drinker	2	4.7
Others (my parents do not have any problem with me drinking, alcohol is good for me, it is a food, it helps me to work well)	5	11.6
Total	43	100.0

The majority (71.9%) of alcohol drinkers affirmed that they intend to stop drinking in the future, with most (38.2%) saying they want to stop alcohol consumption because of its harmful effects on health. About 16.4% and 8.2% said they want to stop drinking because it consumes their resources (time, money, etc.) and makes them not plan for the future, respectively. About 21.1% of the respondents who drink alcohol affirmed that they have no intention of quitting alcohol consumption, with about one-third (32.6%) saying that it provides a good time, pleasure, and relaxation. About 23.3% of them have no intention of quitting because they perceive that it eases their stress, gives them peace of mind, and helps them forget their problems, while 18.6% said it keeps them happy and they enjoy drinking it.

Tests of Association (Bivariate Analysis)

(*Although analyzed, respondents’ tribes consistently were not significantly associated with any indicators and were not captured in the tables to allow for proper type-setting).

Table 3.34: Association between lifetime drinking and socio-demographic characteristics of the respondents (n = 406)

Variables	Drinking Indicators		Total	X²	Fisher’s test	df	P-value
Variables	Lifetime drinkers (%)	Lifetime abstainers (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	58 (30.7)	131 (69.3)	189	16.695		3	0.001
18-19	32 (35.2)	59 (64.8)	91
20-21	18 (38.3)	29 (61.7)	47
22-24	45 (57.0)	34 (43.0)	79
Sex
Male	109 (47.7)	123 (53.0)	232	19.929		1	0.000
Female	44 (25.3)	130 (74.7)	174	19.929		1	0.000
Religion
Christianity	150 (39.1)	234 (60.9)	384	5.728		1	0.017
Islam	3 (13.6)	19 (86.4)	22	5.728		1	0.017
Marital status
Single	142 (36.9)	243 (63.1)	385	2.037		1	0.154
Married	11 (52.4)	10 (47.6)	21	2.037		1	0.154
Currently schooling
Yes	106 (33.7)	209 (66.3)	315	9.739		1	0.002
No	47 (51.6)	44 (48.4)	91	9.739		1	0.002
Level of education
Junior Secondary	18 (34.6%)	34 (65.4%)	52	7.469		2	0.024
Senior Secondary	85 (33.7%)	167 (66.3%	252
Tertiary	50 (49.0%)	52 (51.0%)	102
Employment status
Employed	66 (48.5%)	70 (51.5%)	136	10.242		1	0.001
Not employed	87 (32.2%)	183 (67.8%)	270	10.242		1	0.001
Total	153	253	406
Monthly income (N)
N0-N9,999	11 (33.3)	22 (66.7)	33		9.940		0.193
N10,000- N19,999	17 (63.0)	10 (37.0)	27
N20,000-N29,999	10 (62.5)	6 (37.5)	16
N30,000-N39,999	5 (41.7)	7 (58.3)	12
N40,000-N49,999	6 (60.0)	4 (40.0)	10
N50,00-N59,999	1 (25.0)	3 (75.0)	4
N60,000-N69,99	1 (20.0)	4 (80.0)	5
≥ N70,000	15 (51.7)	14 (48.3)	29
Total	66	70	136

Lifetime drinking is significantly associated with age, sex, religion, being in school, level of education, and employment status of the respondents (p<0.05).

Table 3.35: Association between current drinking and socio-demographic characteristics of the respondents (n = 153)

Variables	Drinking Indicators		Total	X²	Fisher’s test	df	P-value
Variables	Current drinkers (%)	Former drinkers (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	46 (79.3)	12 (20.7)	58	0.485		3	0.922
18-19	26 (81.3)	6 (18.8)	32
20-21	15 (83.3)	3 (16.7)	18
22-24	38 (84.4)	7 (15.6)	45
Sex
Male	93 (85.3)	16 (14.7)	109	3.325		1	0.068
Female	32 (72.7)	12 (27.3)	44	3.325		1	0.068
Religion
Christianity	123 (82.0)	27 (18.0)	150		0.462		0.457
Islam	2 (66.7)	1 (33.3)	3		0.462		0.457
Marital status
Single	119 (83.8)	23 (16.2)	142		5.845		0.016
Married	6 (54.5)	5 (45.5)	11		5.845		0.016
Currently schooling
Yes	88 (83.0)	18 (17.0)	106	0.402		1	0.526
No	37 (78.7)	10 (21.3)	47	0.402		1	0.526
Level of education
Junior Secondary	15 (83.3)	3 (16.7)	18	1.121		2	0.571
Senior Secondary	67 (78.8)	18 (21.2)	85
Tertiary	43 (86.0)	7 (14.0)	50
Total	125	28	153
Employment status
Employed	59 (89.4)	7 (10.6)	66	4.596		1	0.032
Not employed	66 (75.9)	21 (24.1)	87	4.596		1	0.032
Total	125	28	153
Monthly income (N)
N0-N9,999	8 (72.7)	3 (27.3)	11		6.082		0.554
N10,000- N19,999	15 (88.2)	2 (11.8)	17
N20,000-N29,999	10 (100.0)	0 (0.0)	10
N30,000-N39,999	5 (100.0)	0 (0.00	5
N40,000-N49,999	5 (83.3)	1 (16.7)	6
N50,00-N59,999	1 (100.0)	0 (0.0)	1
N60,000-N69,99	1 (100.0)	0 (0.0)	1
≥ N70,000	14 (93.3)	1 (6.7)	15
Total	59	7	66

Current drinking is significantly associated with the marital and employment statuses of the respondents (p<0.05).

Tests of Association Between Sociodemographic Characteristics of the
Respondents and Other Aspects of Alcohol Consumption

(*Tribe was also not captured in the following tables for reasons earlier stated

Table 3.36: Association between socio-demographic characteristics of the respondents and period of last alcohol consumption (N=153)

Variables	Period of last alcohol consumption				Total	X²	Fisher’s test	df	P-value
Variables	Last 7 days (%)	Last 8-30 days (%)	Last > 1-12 months (%)	Above 1 year (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	26 (44.8)	9 (15.5)	11 (19.0)	12 (20.7)	58	6.193		9	0.720
18-19	17 (53.1)	7 (21.9)	2 (6.3)	5 (18.8)	32
20-21	7 (38.9)	5 (27.8)	3 (16.7)	3 (16.7)	18
22-24	17 (37.8)	13 (28.9)	8 (17.8)	7 (15.6)	45
Sex
Male	53 (48.6)	25 (22.9)	15 (13.8)	16 (14.7)	109	5.720		3	0.126
Female	14 (31.8)	9 (20.5)	9 (20.5)	12 (27.3)	44	5.720		3	0.126
Religion
Christianity	65 (43.7)	34 (33.3)	24 (23.5)	27 (18.0)	150		1.623		0.763
Islam	2 (66.7)	0 (0.0)	0 (0.0)	1 (33.3)	3		1.623		0.763
Marital status
Single	63 (44.4)	33 (23.2)	23 (16.2)	23 (16.2)	142		4.827		0.152
Married	4 (36.4)	1 (9.1)	1 (9.1)	5 (45.5)	11		4.827		0.152
Currently schooling
Yes	47 (44.3)	25 (23.6)	16 (15.1)	18 (17.0)	106	0.717		3	0.869
No	20 (42.6)	9 (19.1)	8 (17.0)	10 (21.3)	47	0.717		3	0.869
Level of education
Jnr. Secondary	12 (66.7)	1 (5.6)	2 (11.1)	3 (16.7)	18		7.159		0.299
Snr secondary	36 (42.4)	19 (22.4)	12 (14.1)	18 (21.2)	85
Tertiary	19 (38.0)	14 (28.0)	10 (20.0)	7 (14.0)	50
Employment status
Employed	37 (56.1)	14 (21.2)	8 (12.1)	7 (10.6)	66	8.739		3	0.033
Not employed	30 (34.5)	20 (23.0)	16 (18.4)	21 (24.1)	87	8.739		3	0.033
Total	67	34	24	28	153
Monthly income (N)
N0-N9,999	6 (54.5)	1 (9.1)	1 9.1)	3 (27.3)	11		23.737		0.193
N10,000- N19,999	13 (76.5)	2 (11.8)	0 (0.0)	2 (11.8)	17
N20,000-N29,999	5 (50.0)	2 (20.0)	3 (30.0)	0 (0.0)	10
N30,000-N39,999	2 (40.0)	1 (20.0)	2 (40.0)	0 (0.0)	5
N40,000N49,999	4 (66.7)	1 (16.7)	0 (0.0)	1 (16.7)	6
N50,00-N59,999	1 (100.0)	0 (0.0)	0 (0.0)	0 (0.0)	1
N60,000-N69,99	1 (100.0)	0 (0.0)	0 (0.0)	0 (0.0)	1
≥ N70,000	5 (33.3)	7 (46.7)	2 (13.3)	1 (6.7)	15
Total	37	14	8	7	66

There is a statistically significant relationship between the period of last alcohol consumption and the employment status of respondents (p<0.05).

Table 3.37: Association between socio-demographic characteristics and the number of bottles of commercially brewed alcoholic beverages consumed per sitting (n = 138)

Variables	No. of bottles consumed per sitting			Total	X²	Fisher’s test	df	P-value
Variables	1-2 (%)	3-4 (%)	5+ (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	16 (34.0)	15 (31.9)	16 (34.0)	47	5.587		6	0.487
18-19	6 (20.0)	13 (43.3)	11 (36.7)	30
20-21	5 (29.4)	7 (41.2)	5 (29.4)	17
22-24	18 (40.9)	10 (22.7)	16 (36.4)	44
Sex
Male	31 (30.7)	34 (33.7)	36 (35.6)	101	0.633		2	0.729
Female	14 (37.8)	11 (29.7)	12 (32.4)	37	0.633		2	0.729
Religion
Christianity	43 (31.6)	45 (33.1)	48 (35.3)	136		2.777		0.209
Islam	2 (100.0)	0 (0.0)	0 (0.0)	2		2.777		0.209
Marital status
Single	39 (30.5)	43 (33.6)	46 (35.9)	128		3.158		0.231
Married	6 (60.0)	2 (20.0)	2 (20.0)	10		3.158		0.231
Currently schooling
Yes	32 (34.0)	28 (29.8)	34 (36.2)	94	1.069		2	0.614
No	13 (29.5)	17 (38.6)	14 (31.8)	44	1.069		2	0.614
Level of education
Jnr Secondary	8 (50.0)	6 (37.5)	2 (12.5)	16	7.711		4	0.103
Snr Secondary	19 (25.7)	28 (37.8)	27 (36.5)	74
Tertiary	18 (37.5)	11 (22.9)	19 (39.6)	48
Employment status
Employed	20 (31.3)	21 (32.8)	23 (35.9)	64	0.115		2	0.976
Not employed	25 (33.8)	24 (32.4)	25 (33.8)	74	0.115		2	0.976
Total	45	45	48	138
Monthly income (N)
N0-N9,999	3 (30.0)	3 (30.0)	4 (40.0)	10		15.542		0.891
N10,000-N19,999	7 (41.2)	6 (35.3)	4 (23.5)	17
N20,000-N29,999	1 (11.1)	3 (33.3)	5 (55.6)	9
N30,000-N39,999	2 (40.0)	2 (40.0)	1 (20.0)	5
N40,000-N49,999	3 (50.0)	1 (16.7)	2 (33.3)	6
N50,000-N59,999	0 (0.0)	0 (0.0)	1 (100.0)	1
N60,000-N69,999	0 (0.0)	1 (100.0)	0 (0.0)	1
≥ N70,000	4 (26.7)	5 (33.3)	5 (40.0)	15
Total	20	21	23	64

There is no statistically significant association between the number of bottles consumed per sitting and any of the socio-demographic characteristics of the respondents (p<0.05).

Table 3.38: Association between the socio-demographic characteristics of respondents and the number of calabashes of locally brewed alcoholic beverages consumed per sitting (n = 59)

Variables	No. of calabashes consumed per sitting			Total	X²	Fisher’s test	df	P-value
Variables	1-2 (%)	3-4 (%)	5+ (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	11 (47.8)	10 (43.5)	2 (8.7)	23		9.027		0.145
18-19	2 (15.4)	6 (46.2)	5 (38.5)	13
20-21	1 (14.3)	5 (71.4)	1 (14.3)	7
22-24	6 (37.5)	9 (56.3)	1 (6.3)	16
Sex
Male	16 (36.4)	21 (47.7)	7 (15.9)	44	0.690		2	0.708
Female	4 (26.7)	9 (60.0)	2 (13.3)	15	0.690		2	0.708
Religion
Christianity	20 (34.5)	29 (50.0)	9 (15.5)	58		1.350		1.000
Islam	0 (0.0)	1 (100.0)	0 (0.0)	1		1.350		1.000
Marital status
Single	19 (34.5)	28 (50.9)	8 (14.5)	55		0.851		0.640
Married	1 (25.0)	2 (50.0)	1 (25.0)	4		0.851		0.640
Currently schooling
Yes	12 (34.3)	19 (54.3)	4 (11.4)	35	1.029		2	0.598
No	8 (33.3)	11 (45.8)	5 (20.8)	24	1.029		2	0.598
Level of education
Jnr Secondary	1 (9.1)	7 (63.6)	3 (27.3)	11		5.400		0.224
Snr Secondary	16 (42.1)	18 (47.4)	4 (10.5)	38
Tertiary	3 (30.0)	5 (50.0)	2 (20.0)	10
Employment status
Employed	10 (33.3)	17 956.7)	3 (10.0)	30		1.501		0.466
Not employed	10 (34.5)	13 (44.8)	6 (20.7)	29		1.501		0.466
Total	20	30	9	59
Monthly income (N)
N0-N9,999	2 (66.7)	1 (33.3)	0 (0.0)	3		7.716		0.694
N10,000-N19,999	3 (27.3)	7 (63.6)	1 (9.1)	11
N20,000-N29,999	1 (20.0)	2 (40.0)	2 (40.0)	5
N30,000-N39,999	1 (25.0)	3 (75.0)	0 (0.0)	4
N40,000-N49,999	2 (66.7)	1 (33.3)	0 (0.0)	3
≥ N70,000	1 (25.0)	3 (75.0)	0 (0.0)	4
Total	10	17	3	30

There is no statistically significant association between the number of calabashes consumed by respondents at a sitting and their socio-demographic characteristics (p<0.05).

Table 3.39: Association between the age at initiation of alcohol consumption and socio-demographic characteristics of the respondents (n=153)

Variables	Age at initiation of drinking			Total	X²	Fisher’s test	df	P-value
Variables	7-12 years (%)	13-19 years (%)	20-23 years (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	17 (29.3)	41 (70.7)	0 (0.0)	58		31.812		0.000
18-19	6 (18.8)	26 (81.3)	0 (0.0)	32
20-21	1 (5.6)	13 (72.2)	4 (22.2)	18
22-24	6 (13.6)	26 (57.8)	13 (28.9)	45
Sex
Male	23 (21.1)	72 (66.1)	14 (12.8)	109	2.025		2	0.363
Female	7 (15.9)	34 (77.3)	3 (6.8)	44	2.025		2	0.363
Religion
Christianity	29 (19.3)	104 (69.3)	17 (11.3)	153		0.869		0.670
Islam	1 (33.3)	2 (66.7)	0 (0.0)	3		0.869		0.670
Marital status
Single	28 (19.7)	99 (69.7)	15 (10.6)	142		0.991		0.700
Married	2 (18.2)	7 (63.6)	2 (18.2)	11		0.991		0.700
Currently schooling
Yes	22 (20.8)	78 (73.6)	6 (5.7)	106	10.381		2	0.006
No	8 (17.0)	28 (59.6)	11(23.4)	47	10.381		2	0.006
Level of education
Jnr Secondary	7 (38.9)	10 (55.6)	1 (5.6)	18		10.774		0.022
Snr Secondary	18 (21.2)	61 (71.8)	6 (7.1)	85
Tertiary	5 (10.0)	35 (70.0)	10 (20.0)	50
Employment status
Employed	9 (13.6)	45 (68.2)	12 (18.2)	66	7.345		2	0.025
Not employed	21 (24.1)	61 (70.1)	5 (5.7)	87	7.345		2	0.025
Total	30	106	17	153
Monthly income (N)
N0-N9,999	1 (9.1)	10 (90.9)	0 (0.0)	11		15.542		0.268
N10,000-N19,999	1 (5.9)	13 (76.5)	3 (17.6)	17
N20,000-N29,999	1 (10.0)	5 (50.0)	4 (40.0)	10
N30,000-N39,999	1 (20.0)	4 (80.0)	0 (0.0)	5
N40,000-N49,999	2 (33.3)	4 (66.7)	0 (0.0)	6
N50,00-N59,999	0 (0.0)	1 (100.0)	0 (0.0)	1
N60,000-N69,999	0 (0.0)	1 (100.0)	0 (0.0)	1
≥ N70,000	3 (20.0)	7 (46.7)	5 (33.3)	15
Total	9	45	12	66

There is a statistically significant association between respondents’ age at initiation of alcohol consumption and their ages, current enrollment in school, level of education, and employment status (p<0.05).

Table 3.40: Association between respondents’ socio-demographic characteristics and duration of alcohol consumption (n=153)

Variables	Duration of Alcohol Consumption			Total	X²	Fisher’s test	df	P-value
Variables	1-2 years (%)	> 2-4 years (%)	> 4 years (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	40 (69.0)	11 (19.0)	7 (12.1)	58	37.492		6	0.000
18-19	14 (43.8)	10 (31.3)	8 (25.0)	32
20-21	7 (38.9)	10 (55.6)	1 (5.6)	18
22-24	10 (22.2)	12 (26.7)	23 (51.1)	45
Sex
Male	44 (40.4)	34 (31.2)	31 (28.4)	109	5.558		2	0.062
Female	27 (61.4)	9 (20.5)	8 (18.2)	44	5.558		2	0.062
Religion
Christianity	70 (46.7)	42 (28.2)	38 (25.3)	150		0.755		1.000
Islam	1 (33.3)	1 (33.3)	1 (33.3)	3		0.755		1.000
Marital status
Single	66 (46.5)	43 (30.3)	33 (23.2)	142		7.251		0.022
Married	5 (45.5)	0 (0.0)	6 (54.5)	11		7.251		0.022
Currently schooling
Yes	56 (52.8)	32 (30.2)	18 (17.0)	106	13.404		2	0.001
No	15 (31.9)	11 (23.4)	21 (44.7)	47	13.404		2	0.001
Level of education
Jnr Secondary	11 (61.1)	1 (5.6)	6 (33.3)	18	22.634		4	0.000
Snr secondary	49 (57.6)	23 (27.1)	13 (15.3)	85
Tertiary	11 (22.0)	19 (38.0)	20 (40.0)	50
Employment status
Employed	23 (34.8)	19 (28.8)	24 (36.4)	66	8.744		2	0.013
Not employed	48 (55.2)	24 (27.6)	15 (17.2)	87	8.744		2	0.013
Total	71	43	39	153
Monthly income (N)
N0-N9,999	6 (54.5)	4 (36.4)	1 (9.1)	11		27.893		0.002
N10,000-N19,999	8 (47.1)	6 (35.3)	3 (17.6)	17
N20,000-N29,999	60 (60.0)	1 (10.0)	3 (30.0)	10
N30,000-N39,999	0 (0.0)	3 60.0)	2 (40.0)	5
N40,000-N49,999	0 (0.0)	0 (0.0)	6 (100.0)	6
N50,00-N59,999	1 (100.0)	0 (0.0)	0 (0.0)	1
N60,000-N69,999	0 (0.0)	0 (0.0)	1 (100.0)	1
≥ N70,000	2 (13.3)	5 (33.3)	8 (53.3)	15
Total	23	19	24	66

There is a statistically significant association between respondents' duration of alcohol consumption and their ages, marital status, being currently in school, level of education, employment status, and monthly income (p<0.05).

Table 3.41: Association between respondents’ socio-demographic characteristics and their awareness of the health effects of alcohol consumption (n=406)

Variables	Level of awareness		Total	X²	Fisher’s test	df	P-value
Variables	Good (%)	Poor (%)	Total	X²	Fisher’s test	df	P-value
Age (years)
15-17	61 (32.3)	128 (67.7)	189	8.949		3	0.030
18-19	31 (34.1)	60 (65.9)	91
20-21	26 (55.3)	21 (44.7)	47
22-24	30 ((38.0)	49 (62.0)	79
Sex
Male	79 (34.1)	153 (65.9)	232	1.348		1	0.246
Female	69 (39.7)	105 (60.3)	174	1.348		1	0.246
Religion
Christianity	147 (38.3)	237 (61.7)	384	10.223		1	0.000
Islam	1 (4.5)	21 (95.5)	22	10.223		1	0.000
Marital status
Single	139 (36.1)	246 (63.9)	385	0.391		1	0.531
Married	9 (42.9)	12 (57.1)	21	0.391		1	0.531
Currently schooling
Yes	115 (36.5)	200 (63.5)	315	0.002		1	0.966
No	33 (36.3)	58 (63.7)	91	0.002		1	0.966
Level of education
Junior Secondary	9 (17.3)	43 (82.7)	52	14.198		2	0.001
Senior Secondary	90 (35.7)	162 (64.3)	252
Tertiary	49 (48.0)	53 (52.0)	102
Employment status
Employed	49 (36.0)	87 (64.0)	136	0.016		1	0.900
Not employed	99 (36.7)	171 (63.3)	270	0.016		1	0.900
Total	148	258	406
Monthly income (N)
N0-N999	6 (18.2)	27 (81.8)	33		15.163		0.025
N10,000- N19,999	12 (44.4)	15 (55.6)	27
N20,000-N29,999	8 (50.0)	8 (50.0)	16
N30,000-N39,999	4 (33.3)	8 (66.7)	12
N40,000-N49,999	3 (30.0)	7 (70.0)	10
N50,00-N59,999	4 (100.0)	0 (0.0)	4
N60,000-N69,999	3 (60.0)	2 (40.0)	5
≥ N70,000	9 (31.0)	20 (69.0)	29
Total	49	87	136

There is a statistically significant association between respondents’ awareness of the health effects of alcohol consumption and their ages, religion, level of education, and monthly income (p<0.05).

Table 3.42: Association between alcohol consumption and level of awareness of the health effects of alcohol consumption (n=406)

Variables	Level of awareness		Total	X²	Fisher’s test	df	P-value
	Good (%)	Poor (%)
Lifetime drinkers
Yes	56 (36.6)	97 (43.4)	153	0.002		1	0.962
No	92 (36.4)	161 (63.6)	253
Current drinkers (n=153)
Yes	48 (38.4)	77 (61.6)	125	0.952		1	0.322
No	8 (28.6)	20 (71.4)	28
No. of bottles consumed per sitting (n=138)
1-2	17 (37.8)	28 (62.2)	45	2.419		2	0.298
3-4	15 (33.3)	30 (66.7)	45
5+	21 (43.8)	27 (56.3)	48
No. of calabashes consumed per sitting (n=59)
1-2	5 (25.0)	15 (75.0)	20	0.391		1	0.531
3-4	11 (36.7)	19 (63.3)	30
5+	1 (11.1)	8 (88.9)	9
Total	17	42	59

There is no statistically significant relationship between lifetime drinkers, current drinkers, number of bottles or calabashes consumed per sitting, or level of awareness of the health effects of alcohol consumption among respondents (p<0.05).

4. Discussion

The respondents for this study were within the age range of 15–24 years, with almost half (46.6%) being within 15–17 years (Table 4.1). It can be inferred that most of the respondents are young adults who are under 18 years old. This is the age in life where cognitive development attains its peak and teenagers begin to assume adult duties and responsibilities. It is also the legally acceptable age for alcohol consumption in most parts of the world. However, this age distribution is in contrast to the findings of Ogundeko T. and Agofure O. et al. in Kagoro, Kaduna State, and Delta State, southern Nigeria, respectively, where the respondents were between the ages of 10–24 and 11–25 years, with the majority between the ages of 15–19 (84.75%) and 13–15 (46.88%), respectively. ^23-24 This study is also in contrast to the findings of Chikere and Mayowa and Odeyemi et al. in Owerri, southeast Nigeria, and Lagos, south-west Nigeria, respectively, whose respondents were 16 years and older, with the majority within 26+ years and 16-20 years (at 42.5% and 44.4%) age groups, respectively. ^25-26

More than half (57.1%) of the respondents in this study were males compared to females (Table 4.1). This is similar to the findings of Agofure O et al., where males (68.75%) were more likely than female (31.25%) respondents.²⁴ However, this study is in contrast with the findings of Ogundeko T. and Odeyemi et al., where the female (50.25% and 55.4%, respectively) respondents were more than the male (49.75% and 44.6%, respectively) respondents.^23,26 This finding is also different from the findings of Eze et al. in Ebonyi and Enugu States, which had an equal number of male and female respondents.²⁷ This study presents different findings from the Chikere and Mayowa study, which polled only males in Owerri, southeast Nigeria.²⁵ This observed difference in the age and gender distributions may be due to the differences in the study designs and areas. It could also be due to the availability of respondents who were physically present and willing to participate in the study. In addition, their studies were school surveys among primary and secondary school students, while this study was a community-based study among young adults.

The predominant tribe (36.5%) among the respondents is Bajju (table 4.1). The results differ from those of Chikere and Mayowa in Owerri, Imo State, Nigeria, as most of their respondents were Igbo.²⁵ The differences may be due to geographical location (Zonkwa is indigenous to the Bajju people, while Owerri is an Igbo-dominated area). Almost all (94.6%) of the respondents in this study were Christians and singles (Table 4.1). This finding is similar to that of Chikere and Mayowa, who reported that almost all the respondents (95.4%) were Christians, and over three-quarters (79.0%) were unmarried.²⁵This study is also similar to that of Odeyemi et al. and Ajayi et al., whose majority of respondents were Christians (73.3% and 73.4%, respectively).^26,28 These similarities may be because the study areas are Christian-dominated regions.

Also, most respondents were teenagers who were still within school age and were currently in school (Table 4.1). Over three-quarters (77.6%) of the respondents in this study were currently in school, with 100.0% having a formal education. About two-thirds (62.1%) of them had senior secondary educational status as their highest level of education. This finding is similar to that of Onodugo OD et al. in Enugu, Southeast Nigeria, where more than two-thirds (69.2%) of the respondents had a senior secondary level of education.²⁹ The finding is in contrast with that of Chikere and Mayowa and Odeyemi et al., whose respondents had a higher educational status (all were undergraduates).^25-26

The prevalence of lifetime and current alcohol use in this study is 37.7% and 81.7%, respectively (Table 4.2). By contrast, the prevalence of current alcohol users in this study is higher than the findings of Ogundeko T. and Agofure O. et al., who reported that the prevalence of current alcohol users was 52.6% and 25.0%, respectively.^23-24 It is also higher than the findings in a survey of 1,041 senior secondary school students by Onodugo OD et al., Odeyemi et al., and Ajayi et al. in Delta State, south-south Nigeria, Lagos, south-west Nigeria, and Ilorin, north-central Nigeria, who reported 66.7%, 33.3%, and 31.1% prevalence rates of current drinkers, respectively.^23-24,28 The finding in this study is also higher than the WHO global report of 2016, where 43% of the general population was found to be current alcohol users.¹⁵ The high prevalence of alcohol use in this study, according to the respondents (Table 4.29), may be attributed to some relative support and cultural acceptance. Additionally, the absence of policies governing alcohol consumption in the nation and the lack of awareness regarding the health effects of alcohol consumption (Table 4.28.) could also be factored in this trend.

The lifetime prevalence of alcohol use in this study is lower than the findings of Adelekan et al. and Eke in their survey of 636 undergraduate and 640 secondary school students in Ilorin, Kwara State, and Anambra States, respectively, who reported that 77% and 57% were lifetime drinkers, respectively.^25,30 The finding is also lower than that of Chikere and Mayowa in Owerri, Southeast Nigeria, and Ajayi et al. in north-central Nigeria, who reported that 43.5% and 78.4% of the respondents were lifetime drinkers, respectively.^25,28 However, the finding in this study is similar to the findings of Kendagor et al. in Kenya, where the prevalence of current alcohol use among young adults is higher than the lifetime prevalence (63.0% and 38.6%, respectively).³¹ Similarly, a study by Bondah et al. found that 38.2% of Ghanaian senior secondary school students had ever consumed alcohol.³² The differences in the prevalence rates of alcohol consumption may be due to differences in the socio-demographic characteristics of the respondents.

In this study, the prevalence of lifetime alcohol users and the prevalence of current alcohol users are higher in those aged 22–24 years (57.0% and 84.4%, respectively) and 20–21 years (38.3% and 83.3%, respectively) (Table 4.2). This implies that those between 20-24 years old consume alcohol the most. According to Ogundeko T research, substance abuse (including alcohol) is more prevalent among those between the ages of 15 and 19 (84.53%) than it is among people between 20 and 24 (11.9%), which is in opposition to the findings of this study.²³ Additionally, this study deviates from Chikere and Mayowa's findings, which show that respondents aged 26 and older consumed alcohol the most (92.2%).²⁵ This study also offers a divergent perspective from studies conducted in the UK, where adolescents between 13 and 16 years old are the most regular drinkers.³⁰ However, the finding in this study is similar to the WHO African Region and Global Report of 2016, where current alcohol consumption is higher among young adults aged (20-24 years) than among adolescents (15-19 years) at 34.7% and 21.4% in the African region, and 43.0% and 26.5% in the general population, respectively.¹⁵

In this study, lifetime and current alcohol use were higher among males than females (Tables 4.34 and 4.35). This is consistent with research from other regions of Nigeria, where male alcohol consumption was shown to be higher than female consumption in Kagoro, Kaduna State (75.0%), Enugu, Southeast Nigeria (75.7%), and Delta State, Southern Nigeria (21.6%), respectively.^23-24,29This is also consistent with the study conducted in African nations, where current drinking is prevalent among males (43.6%) compared to females (21.0%).¹⁵ The results of this study are similarly consistent with those of Masibo et al., who found that female students were less likely to drink (6.4%) than male students (10.6%). ³³ However, the results of Bondah et al. in Ghana, where alcohol intake is somewhat greater among female drinkers (40.49%) than male drinkers (40.0%), are in direct opposition to the findings of this study.³² This may be because their respondents were predominantly female (59.42%). This study is consistent with the global data from the WHO, which indicated that females aged 15 or older consumed alcohol at a lower rate (32.3%) than males.¹⁵

Alcohol consumption in this study was highest among Christians for both lifetime and current alcohol users (Tables 4.34 and 4.35). This is similar to the findings of Chikere and Mayowa and Ajayi et al., who reported a higher prevalence of alcohol consumption among Christians (79.8% and 45.9%, respectively) than Muslims (50.0% and 37.1%, respectively).^25,28However, in the study by Ajayi et al. in north-central Nigeria, there was little to no difference in the prevalence rates of current drinking among Christians and Muslims (at 31.9% and 30.8%, respectively).²⁸The study area's predominance of Christians and their beliefs that alcohol abuse (or drunkenness) is forbidden may be the reason for pattern similarities, even though these beliefs may not necessarily condemn or forbid the simple consumption of alcohol.

Alcohol consumption in the index study was higher among the married respondents for lifetime alcohol users, while for current alcohol users, it was higher among the unmarried (Table 4.34). The finding is consistent with that of Chikere and Mayowa, who reported a higher prevalence of alcohol consumption among married (91.1%) respondents compared to the single (75.1%) respondents for lifetime drinkers.²⁵ The similarities between these studies may be because the married respondents who were available and willing to participate in this study were mostly those who drank alcohol. This study also showed that alcohol consumption was more common among non-students than students among lifetime drinkers but higher among students for current drinkers, with the majority having a tertiary level of education among lifetime and current drinkers (49.0% and 86.0%), respectively.

This study also found alcohol consumption to be higher among those employed for a lifetime and current drinkers (Table 4.34 and 4.35), with the majority (63.0%) earning between N10,000 and N19,999 among lifetime drinkers. Among current drinkers, the prevalence increases with the increasing monthly income of the respondents (Table 4.35). However, all of the respondents in this study are from semi-rural areas with low socioeconomic status, as seen by the range of their monthly income. This finding is in contrast with the report of Ajayi et al., who reported that alcohol use is higher among the rich compared to the poor/middle-income earners for both lifetimes (at 54.5% versus 41.9%) and current drinkers (at 45.0% versus 29.8%), respectively.²⁸ However, the index study has high prevalence rates of alcohol consumption, which is in line with the Nigerian national study, where alcohol consumption was reported to be highest among individuals with low socioeconomic status and rural dwellers at 40.1% (24.2% to 56.1%) compared with urban dwellers at 31.2% (22.9% to 39.6%).²⁵ By contrast, the WHO Global Report 2016 showed that the prevalence of alcohol consumption is less (26.8%) among low-income groups compared to high-income (67.3%) groups.¹²

The average age at initiation of alcohol consumption in this study is 15.27 years ± 3.097 SD, with extremes (i.e., a range) of 7 and 23 years. The most vulnerable age group for initiation is 13-19 years- "teenage" (table 4.39). The implication is that most of the respondents in this study began drinking alcohol before 18 years old, the legally acceptable age for alcohol consumption in most parts of the world. This finding is similar to the findings of Ogundeko T., who reported that the average age at initiation of substance use was 14 years, with extremes of 6 and 20 years.²³The finding in this study is in line with that of the national study, which showed that the mean age at initiation of alcohol consumption in Nigeria is between 13.5 and 20 years. 39 In comparison to other countries, this study is also in line with the findings of Bondah et al. in Ghana, who reported that the average age at initiation of alcohol consumption was 14.97 years ± 2.84 SD, with an extreme of 6 years.³² This study is also similar to the findings in African country school surveys and the WHO 2016 global report, which showed that drinking begins in early life before the age of 15 years.^11,15The early onset of alcohol consumption may be due to unrestricted access to alcoholic drinks in Nigeria and most parts of the world. The increasing levels of alcohol marketing on radio, television, and social media may also contribute to this explanation. The earlier the age at the onset of alcohol consumption, the greater the likelihood of becoming alcohol-dependent subsequently, and the more the likelihood of becoming a victim of unintentional injuries (from motor vehicles, falls, drowning, etc.).²⁵

About two-thirds (63.4%) and one-quarter (25.5%) of alcohol users in this study affirmed that they were introduced to alcohol consumption by friends and family members, respectively (Table 4.31), with the majority of them stating that their main reasons for initiation of alcohol consumption were to socialize and mingle with friends (42.5%), followed by pleasure and fun, and then curiosity (at 22.9% and 12.4%, respectively). This finding is consistent with the findings of Chikere and Mayowa, who reported that most of their respondents were introduced to drinking by friends (46.8%), followed by family members (26.7%). However, their main reasons for drinking were to make them feel high (24.3%), and all their friends were alcoholics (16.4%).²⁵ This is in line with the findings of Agofure O et al., who found that peer pressure (37.50%), the influence of an adult (32.5%), and curiosity (18.75%) were the main reasons for the initiation of alcohol consumption.²⁴It is also in line with the findings of Odeyemi et al., who reported that the main reasons for the onset of alcohol consumption were to have fun with friends (73.8%), followed by gaining boldness and feel better whenever they are depressed (26.3% and 22.5%, respectively).²⁶This finding is, however, in contrast with the findings of Ogundeko T et al., who reported that the main reason for the initiation of alcohol consumption was curiosity (38.10%), followed by peer pressure and festivities (19.05% and 11.90%, respectively).²³

About three-quarters (71.2%) and more than half (53.0%) of the respondents in this study had friends and family members who consume alcoholic beverages (Table 4.30), and this could influence their drinking habits. This is in line with the findings of Odeyemi et al., who reported that the majority (74.6%) of their respondents had friends who consumed alcoholic beverages.²⁶Children having friends and family members who consume alcohol are likely to drink when they grow up.²⁶ Among those who do not consume alcoholic beverages in this study, their main reasons for abstaining from alcohol were that it makes them misbehave (46.6%), followed by it is against their moral standards (39.1%) and their religion (27.4%)(Table 4.5). This is slightly in contrast with the findings of Odeyemi et al., who showed that the main reasons for abstention were that it was against their religious beliefs (66.3%), against their moral standard, and their family members do not consume alcohol (41.9% and 33.1%, respectively).²⁶

According to this study (Table 4.40), alcohol usage lasted longer (for years) as people aged. Also, more males than females reported drinking alcohol for extended periods. The index survey shows that most drinkers who drank within the previous seven days of the study were between the ages of 15 and 17 and 18 and 19, with respective percentages of 53.1% and 44.8% (Table 4.36). Males, Christians, singletons, students currently enrolled in junior secondary school, working people, and people with monthly incomes were likely to have consumed alcohol in the seven days before the survey (Table 4.36).

Over one-third, (38.6%) of drinkers in this study reported that they drink on an occasional basis, with about 34.8% of them stating that they consume 5+ bottles (for those who consume commercially brewed alcoholic beverages) and 3-4 calabashes (50.8%) for those who consume locally brewed alcoholic drinks (Table 4.4). The implication here is that the respondents in this study do not consume alcoholic beverages often, but when they do, they drink heavily. The consumption of five (5) or more drinks in males and four (4) or more drinks in females per sitting is considered heavy episodic drinking (HED) or binge drinking for commercially brewed alcoholic drinks.^34-36 Binge drinking for locally brewed beverages in Nigeria is defined as the consumption of more than four calabashes per sitting for low-concentration drinks and one-half to two calabashes for high-concentration drinks by men. For women, it is the consumption of more than three calabashes for low-concentration alcoholic beverages and more than one calabash for high-concentration drinks.³⁷

The finding in this study shows that drinkers consume alcohol on an occasional basis but drink in heavy episodes (Table 4.4), which is similar to the national pooled crude prevalence of harmful alcohol consumption in Nigeria, which was 34.3% (28.6%-40.1%), with the highest prevalence observed in south-south Nigeria at 50.2% (38.9%-61.4%), followed by southeast at 36.0% (23%-48.9%) and north-central: 31.0% (17.3%-44.7%). However, the finding in this study is higher than the findings in the southwest and northwest, where HED is estimated at 25.4% (16.7%-34.1%) and 15.6% (13.8%-65.0%), respectively.³⁹ This study is in contrast to the findings of Agofure O et al., who reported that most (68.75%) of the respondents in their study do not engage in binge drinking, with the majority (47.5%) taking 3–4 bottles each time they socialize.²⁴ It is also in contrast to the findings of Chikere and Mayowa, who reported that the majority (73.3%) of their respondents consume 1-3 bottles daily.²⁵ Compared to other African studies, this study supports previous studies that showed that HED in Nigeria is relatively high.³⁸ Heavy episodic drinking in this study was higher compared to the findings in Ghana and South Africa (16% and 14%, respectively).³⁸

Table 4.37 shows that heavy episodic drinking is more common among drinkers aged 18 to 19 (36.7%) than among drinkers aged 22 to 24 (36.4%) and 15 to 17 (34.0%). This implies that heavy episodic drinking is prevalent among drinkers between 15 and 19 years old and peaks at 18 and 19. Similar findings were discovered in a Nigerian national survey conducted in 2015, where it was found that heavy alcohol consumption was more common among teenagers (15–19 years old) than young adults (20–24 years old), at 33.2% and 33.0%, respectively.³⁸ The study is also comparable to one conducted in north-central Nigeria, which revealed that heavy episodic drinking peaks among teenagers (19 years of age or less) at 70.4%.²² The high prevalence of heavy episodic drinking among this age group (15–19 years) may be due to their lack of awareness of its harmful effects, as found in this study, which showed that knowledge of the health effects of alcohol consumption increases with age (Table 4.41). According to this study and one by Ogundeko T et al. in Kagoro, Kaduna State, Nigeria, it could also be because they want to experience alcohol's effects.²³ According to research by Chikere and Mayowa in Owerri, southeast Nigeria, it can be due to their desire to get high.²⁵ In contrast to the findings of the WHO global report, heavy episodic drinking is more prevalent among young adults between the ages of 15 and 24 and peaks between the ages of 20 and 24 (at 48.5% and 20.8%, respectively), as opposed to between the ages of 15 and 19 (at 45.7% and 12.7%, respectively).¹⁵

HED was found to be slightly higher among males than females for both commercially (35.6% and 32.4%, respectively) and locally (15.9% and 13.3%, respectively) brewed alcoholic beverages in this study (Tables 4.37 and 4.38). This is in contrast with the findings of the WHO in Nigeria, which showed that heavy drinking is almost four times higher among males (45.0%) than females (12.0%) in the total population and two times higher among males (67.7%) than females (31.8%) among drinkers.¹⁵ This research contrasts with findings from the African continent, where the prevalence of HED was three times higher in men (50.2%) compared to women (19.9%).¹⁵ The study is also in contrast to the WHO global report of 2016, which also revealed that HED is four times higher in men (29.2%) compared to women (7.2%) in the total population.¹⁵ Despite the low socioeconomic status of the respondents in this study, high prevalence rates of HED were observed among drinkers. This finding supports the WHO global report and in the African region, where it was found that low-income groups are less likely to be current drinkers but have higher prevalence rates of HED compared to high-income groups (at 45.4% and 38.7% in the global report and 51.2% and 43.7% in the African region, respectively).¹⁵

The most consumed alcoholic beverage in this study was beer (75.2%), with more than half (52.3%) reporting that their most preferred drink is beer (Table 4.3). The least consumed alcoholic beverage is spirit. This result is comparable to the study of Onodugo OD et al., who discovered that beer (37.1%) is the most widely consumed and preferred alcoholic beverage. However, gin was the least consumed alcoholic beverage in their study.²⁹ The results of this study are also in line with research done in Lagos, southwest Nigeria, which found that beer was the most popular alcoholic beverage consumed by respondents, at 57.3%.³⁹

This study shows that about two-thirds (63.5%) of the respondents had poor awareness of the health effects of alcohol consumption (Table 4.28). More than one-third (36.5%) of them had a good understanding of the health effects of alcohol consumption. However, the level of their awareness depends on the type of effect. For instance, while the majority (71.0%) of the respondents were aware that the effect of alcohol consumption on the liver is that it causes liver cirrhosis, less than half (42.8%) and one-quarter (28.2%) of them knew that it causes liver cancer and alcohol-induced fatty liver disease, respectively (table 4.10). This finding is similar to that of Eze et al., who reported that the level of awareness among secondary school students in Ebonyi and Enugu States, south-eastern Nigeria, differed with the type of effect. Thus, their overall knowledge of the harmful health effects of alcohol consumption was inadequate.²⁷By contrast, studies by Odeyemi et al. in Lagos, south-west Nigeria; Chikere and Mayowa in Owerri, south-east Nigeria; and Dada et al. in Lagos State reported that the majority of their respondents had adequate knowledge of the harmful effects of alcohol (at 83.3%, 68.5%, and 92.6%, respectively). However, their knowledge also varied depending on the type of effect.^25-26,39The finding of this study is comparable to the one in the US and Australia conducted by Wiseman and Klein and Cotter et al., who reported inadequate awareness of the effects of alcohol on cancer among their respondents (62% and 52%, respectively).^39-40

The observed differences in the level of awareness of the health effects of alcohol consumption may be due to differences in the study areas. The index study was conducted in a semi-rural area where there may be some level of ignorance regarding the health effects of alcohol consumption. Additionally, some family members approve of and promote drinking, and alcohol is socially and culturally acceptable in the community. It could also be due to differences in their sources of information about alcohol and its health effects. According to this study, friends (53.2%) and radio or television (48.8%) were the most popular sources of information about alcohol and its effects (Table 4.27). The implication is that these informational resources have the power to sway young people. As seen in this study (Table 4.27), where some drinkers reported that they started drinking because their friends told them it would give them courage and confidence to face life, peer pressure affects young people who believe that psychoactive substances have positive effects. Television commercials vividly portray the daily lives of socially significant and frequently inspirational characters, including what they do, eat, and drink. This could become a problem if the facts offered, the lifestyles shown, or the actions displayed inadequately reflect the actual state of affairs.

The level of awareness of the health effects of alcohol consumption was found to be relatively high among lifetime and current drinkers (36.5% and 38.4%, respectively) compared to lifetime abstainers and former drinkers (36.4% and 28.6%, respectively) (Table 4.42), with the highest level of awareness observed among current drinkers (at 38.4%). This implies that the level of awareness among drinkers in this study does not necessarily prevent them from consuming alcohol. This finding supports the findings of Eze et al. and Uzoeghe, who reported that students were aware of the dangers of alcohol use, yet this did not stop them from drinking it.^27,42The study also supports the findings of Mesibo et al. in Tanzania, who reported that knowledge of psychoactive substance use and its effects does not necessarily prevent students from abusing or wanting to abuse it.³³

This study shows a significant relationship between the respondent's age and alcohol consumption among lifetime drinkers (Table 4.34; p<0.05). The prevalence of alcohol consumption increases with age. This is consistent with the findings of Onodugo OD et al. and Agofure O et al. in Enugu, south-east Nigeria, and Delta, southern Nigeria, respectively.^24,29 The WHO conducted a global survey in 2016 that also showed that alcohol use rises with age and that young people between 15 and 19 years old are less likely (26.5%) to be current drinkers. However, they become current drinkers (40.7%) at 20–24 years of age and drink at the same rate as the general population.¹⁵ The association observed between the respondent's age and alcohol consumption among lifetime drinkers could be because, as adolescents go into adulthood, they focus on gaining independence, self-decision-making, and exploration of their identity, which may influence their drinking behavior as they may feel they are no longer under the control of their parents or others. This study also found a significant relationship between the respondent's sex and alcohol consumption among lifetime and current alcohol users (Tables 4.34 and 4.35; p<0.05). This is similar to the findings of Ogundeko et al., Odeyemi et al., Eze et al., Onodugo OD et al., and Agofure O et al. in Kagoro, Kaduna State, Lagos State, Ebonyi, Enugu, and Delta States, respectively, who reported that there is an association between gender and alcohol consumption, with a higher prevalence.^23-24,27,29 This association may be due to a cultural taboo against women drinking alcohol. In addition, women might be afraid of being stigmatized if they are known as drinkers.

This study showed a significant relationship between religion, employment, and alcohol consumption among lifetime and current alcohol users (Tables 4.34 and 4.35; p <0.05). This significant association between alcohol consumption and religion may be because alcohol consumption is forbidden in Islam, as they view alcohol as an intoxicant, and its consumption is considered “haram” (a taboo) and an abomination. On the other hand, Christianity is believed to forbid alcohol abuse (drunkenness) but may not necessarily condemn alcohol use. Similarly, Onodugo OD et al. in Enugu, south-east Nigeria, reported a significant association between marital status, employment, and current alcohol use.²⁹ This significant association between being single and alcohol consumption may be because unmarried individuals have fewer responsibilities than married individuals. Also, the association between being employed and alcohol consumption may be because employed people have financial resources that enable them to purchase alcoholic drinks. In contrast to this study, Chikere and Mayowa showed a significant association between lifetime drinking (only) and marital status.²⁵

The index study showed a significant relationship between alcohol consumption and being in school, level of education, and lifetime alcohol drinkers (Table 4.34; p 0.05). However, among current drinkers, there was no discernible connection between these factors (Table 4.35). This association may be because students want to cope with school stress. It could also be because they want to gain the courage and confidence to participate in a class or any school activity that makes them anxious. Additionally, respondents with higher educational status are more likely to drink because of increased social stress. This finding is not in line with the findings of Onodugo OD et al., who showed a significant relationship between being in school and the level of education among current drinkers.²⁹ This study also contradicts the findings of Odeyemi et al., who reported a significant association between level of education and current alcohol consumption (the more senior a student is, the greater the likelihood of alcohol consumption).²⁶ This study showed no significant relationship between alcohol consumption and respondent's income among lifetime and current alcohol drinkers (Tables 4.34 and 4.35). The finding is against the findings of Dada et al. in Lagos State, Nigeria, who showed a significant relationship between income and alcohol consumption among current drinkers.³⁹

In this study, a significant relationship was observed between respondents’ age, sex, being students, level of education, being employed, monthly income, and duration of alcohol consumption (table 4.40; p<0.05). The significant association between age and span of alcohol consumption could be because those between 20-21 and 22-24 years are older than those between 15-17 and 18-19 years and thus would have been drinking for many years. Also, the association between male gender and duration of alcohol consumption may be because males start drinking at a younger age than females. Furthermore, a significant relationship was observed in this study between being employed and the period of last alcohol consumption (Table 4.36; p<0.05). Those who are gainfully employed had a higher prevalence of alcohol consumption within the previous seven days than the unemployed. This may be because the unemployed lack the financial resources to purchase alcoholic beverages. A significant relationship was also observed between respondents’ ages, being students, level of education, employment, monthly income, and age at initiation of alcohol consumption. The association between unemployment and the early onset of alcohol consumption may be due to idleness and personal problems.

This study also shows a significant relationship between the level of awareness of the health effects of alcohol consumption and respondents’ age, religion, and level of education (Table 4.41; p<0.05). The higher the level of education among drinkers, the better their awareness of its effects. This finding is similar to the findings of Odeyemi et al., who reported a significant relationship between the level of education and knowledge of the health effects of alcohol consumption (the more senior the student is, the higher the level of awareness).²⁶This study showed no significant association between the quantity of alcohol consumed and awareness of its health effects. This is similar to the findings of Eze et al., Dada et al., and Masibo et al. in Ebonyi and Enugu States, Nigeria, Lagos State, Nigeria, and Tanzania, respectively, who reported that the level of awareness of the health effects of alcohol consumption does not necessarily stop or prevent its use among drinkers.^27,33,39

5. Limitations of the Study

1. Alcoholic beverages in Nigeria have slight variations in their alcoholic contents, and there are no guidelines for standard drinks in Nigeria. Also, the calabashes used for consuming local alcoholic beverages such as burukutu, pito, and palm wine do not have a fixed size. Therefore, it may be difficult to estimate how much alcohol each person consumes.

2. The health effects of alcohol are not fully or comprehensively explored in this study.

3. The awareness of the health effects of alcohol consumption may vary with the type of alcohol consumed, and this study has not separated the health effects by alcohol type.

4. This study captures only a few factors (i.e., the association between alcohol consumption and respondents’ knowledge of its health effects with their socio-demographic characteristics, etc.) contributing to alcohol consumption; hence, it cannot explain all the reasons for alcohol consumption among young adults in the study area, such as peer pressure, culture, family, curiosity, poverty, pleasure, etc.

5. It may not be possible to generalize the results of this study given the small sample size (in this case, of young adults). Hence, there is a need for a larger sample size within this group. Hence, there is a need for a larger sample size within this group.

6. Recommendations

1. Parents at the family level should properly monitor and counsel their adolescent children on alcohol consumption and its effects on their health.

2. Local youth groups and leaders (such as Nhung Jjei Development Association (NJDA) and Bajju Development Association (BADA)) should organize regular seminars for young adults to provide education on the health-related harms associated with alcohol consumption.

3. Community leaders, religious leaders, and groups (such as pastors, imams, Bakunvwon Baranzan, Christian Association of Nigeria (CAN), Boys Brigade and Girls Brigade Nigeria, Islamic Educational Trust, Jama’atu Nasril Islam, etc.) through their local chapters in Zonkwa should educate their members about the health risks associated with alcohol consumption and encourage drinkers to abstain from alcohol consumption or avoid the harmful use of alcohol.

4. The Zangon Kataf LGA should support health education initiatives and health counseling programs that seek to reduce alcohol consumption by students. Teachers of health education, school health counselors, and school administrators should all be advocates for these programs.

5. School teachers, staff members, and parents can work together through Parent Teacher Associations (PTA) to educate adolescents on the health effects of alcohol consumption and apply appropriate corrective and disciplinary measures where necessary.

6. Zangon Kataf Local Government Council should develop and implement policies that will educate young adults, in particular, and the entire people of Zonkwa town, as well as the whole local government area, about alcohol-related health problems through local town criers, social media, radio, and television programs, posters, health talks in hospitals (both public and private), and community health programs.

7. The Kaduna State Government, through the Ministry of Education, should include psychoactive substance use and its risks and hazards in the curriculum of students and have this taught as a subject, particularly at the secondary school level.

8. The legislative branches of the Federal Government of Nigeria and Kaduna State should pass laws establishing a legal drinking and purchasing age for alcohol (for example, 18 years old, the age at which adolescents formally begin to assume adult roles and responsibilities). Also, alcohol and other psychoactive substances should carry fines or other penalties for possession.

7. Conclusion

The prevalence rates of lifetime and current alcohol consumption among the respondents in this study were relatively high (37.7% and 81.7%, respectively). The most vulnerable categories are males between the ages of 20 and 24, Christians, those who are single, those who are currently in school, those who are currently in school, those who have completed a tertiary degree, and those who are gainfully employed, regardless of their monthly salary. Nearly two-thirds (63.4%) of the drinkers say that friends introduced them to alcohol, and about a quarter (28.1%) report having their first alcoholic drink with friends. The significant justifications for drinking were to socialize and mingle with friends (42.5%), for the enjoyment and fun of it, and out of curiosity (at 22.9% and 12.4%, respectively). Family plays a significant role in determining the prevalence of alcohol use in the study area, as approximately 25.5% of alcohol users first learned about alcohol from family members.

Finally, only a third (36.5%) of the participants in the survey had a thorough understanding of how drinking alcohol affects their health. The majority (63.5%) had poor general awareness. The knowledge of respondents regarding the effects of alcohol consumption on health was significantly correlated (p<0.05) with respondents' age, religion, educational attainment, and monthly income. Lifetime drinking was significantly associated with the age, sex, religion, being in school, level of education, and employment status of the respondents (p<0.05). Current drinking was significantly associated with the marital and employment status of the respondents (p<0.05).

Acknowledgments

I am profoundly grateful to the editor and reviewers for their constructive remarks regarding this research. Many thanks to my research assistants, supporters, and all the young adults who made this study a success.

References

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PREVALENCE OF ALCOHOL CONSUMPTION AND AWARENESS OF ITS HEALTH EFFECTS AMONG YOUNG ADULTS IN ZONKWA, ZANGON KATAF LOCAL GOVERNMENT AREA, KADUNA STATE

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