Author: Akau B.Z.
INTRODUCTION
Many interrelated factors influence the complex behavior of alcohol consumption. Understanding these multifaceted influences is crucial to comprehending why people consume alcohol and the implications of their drinking habits on personal health and society at large. These factors interact differently with every individual. These factors can be individual risk factors (such as gender, age, genetic factors, family history, personality factors like attention deficit hypersensitivity disorder, impulsivity, delinquency, and personal traits) or environmental risk factors (such as stress, peer pressure, job loss, grief, the availability of alcohol, policy environment, and economic status). Many factors influence how much and how an individual drinks. These include social conditions like where a person lives, whether they have a job (or not), and if so, what it involves, childhood experiences, social networks, social norms surrounding its consumption (acceptability), availability and cost of alcohol, etc. There are three main factors associated with higher alcohol consumption in Africa. These include accessibility to alcohol, availability, and the price of alcohol. Other factors leading to increased consumption in African countries are heterogenic production, a lack of restrictions on alcohol advertisement, and the absence of effective alcohol control policies.
INDIVIDUALS FACTORS
1. Genetic Factors
Genetics can increase the risk of alcohol consumption and the development of alcohol use disorder (AUD) through several mechanisms. Researchers have found some specific chromosome regions that correlate with the consumption pattern of alcohol. Numerous genes, such as serotonin transporter polymorphism (5-HTTLPR), gamma-aminobutyric (GABA) receptor genes (GABRA2 and GABRG3), and ε-opioid receptor (OPRM1) polymorphism, have been connected to alcohol-related alcohol use disorders. Research on twin behavioral genetics has demonstrated a significant hereditary component to alcohol-related disorders (38.5%), frequent alcohol use (43%), and alcohol dependence (58%). Alcohol metabolism-related genes, such as those encoding aldehyde dehydrogenase (ALDH) and alcohol dehydrogenase (ADH), can affect how the body breaks down alcohol.
Some individuals may have variations that result in faster or slower alcohol metabolism, affecting how quickly they feel the effects and how long alcohol stays in their system. These differences in metabolism can influence an individual's drinking patterns. Genetic factors can affect an individual's sensitivity to the effects of alcohol. Some people may be more sensitive to the pleasurable effects of alcohol due to genetic variations in neurotransmitter systems, particularly those involved in the brain's reward pathways, such as dopamine, serotonin, and other neurotransmitters. This increased sensitivity might lead to a higher likelihood of continuing to drink to experience those effects.
2. Familial Factor
A family history of alcoholism plays a role in the likelihood that an individual may develop alcoholism even at an early age. Children of parents with alcoholism are four times more likely to develop alcoholism. The family is often viewed as the primary source of strength, nurturing and supporting its members, ensuring stability and generational continuity for the community and its culture. According to Moore, interactions within the family unit will play a significant role in adolescent personality or self-concept formation. Growing up in a home where binge drinking is accepted is associated with an increased risk of developing alcoholism.
In these families, alcohol consumption is normalized and glamorized; it becomes socially acceptable and potentially desirable. If parents or family members display problematic drinking behaviors, it can influence the perceptions of alcohol use in children and young adults. Having a family history of alcoholism, or AUD, indicates a genetic predisposition to alcohol-related issues. There is a genetic component linked to alcohol addiction and use that can be passed down through the generations, raising the likelihood that children will drink alcohol. Genetics contributes to about 40–60% of the risk for alcohol use disorder (AUD).
3. Personality Risk
Factors
Personality traits can significantly influence alcohol consumption patterns and the relationship an individual has with alcohol. Several personality factors play a role in determining how a person approaches and responds to alcohol. Intra-personal risk factors predict alcohol-related problems among adolescents and young adults. Some of them have behavioral regulation and attention deficit hyperactivity disorder, delinquency, and personality traits like sensation-seeking, extraversion, conduct problems, self-esteem challenges, emotional pain, depression, anxiety, impulsivity, and neuroticism. People who are more likely to engage in thrill-seeking or novelty-seeking activities may find alcohol's perceived enjoyment or excitement appealing. They might consume alcohol for the stimulation it provides.
Those prone to impulsivity may engage in risky drinking behaviors without considering the potential consequences. They might have a higher propensity to drink more alcohol faster. The expectations and motives an individual has about drinking also play a role. Several studies have reported that positive alcohol expectations predict alcohol consumption and other problems. Most people drink to relax, have fun, or gain social recognition. Alcoholics are 21 times more likely to suffer from antisocial personality disorder, and those who already suffer from it are more likely to develop alcoholism.
4. Age
A person's age strongly influences the likelihood of alcohol abuse. Alcohol consumption tends to begin in the late teens or early twenties, peak in the middle and late twenties, and slow by the early thirties. An individual's chance of developing alcohol dependence later in life increases with the age at which they begin drinking. Several studies have shown that young people consume enormous amounts of alcohol than adults. This is because young people are typically less sensitive to some of the aversive effects of acute alcohol intoxication than adults are, and they are also generally more sensitive to the stimulating (positive) effects of alcohol.
Research findings have shown that young people are more affected by alcohol-related harm than older people, especially those with heavy or binge drinking. Brain development during this stage might render individuals more susceptible to the effects of alcohol, impacting decision-making and impulse control. According to the 2014 WHO global report, about 25% of young people`s deaths were attributable to alcohol consumption. Starting to drink alcohol at a young age, during teenage years, can lead to a higher chance of developing an addiction to alcohol later on in life. People who begin drinking at a young age are also more likely to experience alcohol-related problems and harm than those who start drinking later in life. Alcohol may have more immediate and severe effects on young people because their muscle mass is smaller than that of adults. These direct effects of alcohol are usually due to acute intoxication from heavy drinking.
5. Gender
Gender significantly influences alcohol consumption patterns, with notable differences observed between men and women in terms of drinking behaviors, motivations, and associated risks. Men are more affected by alcohol consumption than women are, according to reports from around the world. This is because men consume more alcohol than women, and they also exhibit other risky behaviors such as tobacco smoking and a poor diet. Thom and Green identified three factors why women drink less and suffer fewer burdens from alcohol: (i) women see their problems differently from men, with a greater tendency not to be identified as alcoholics; (ii) they are more likely to be stigmatized for drinking than men and have concerns about their children being taken into institutionalized care; and (iii) women regard the services (child-care facilities or women-only services) as less suited to their needs than men do and are more likely to seek help for alcohol misuse than men do.
Nevertheless, some studies have indicated that even though women consume less alcohol than men, they are more affected by the harmful effects of alcohol. Hormone fluctuations or differences in the metabolism of alcohol may be the cause of this. Physiological factors such as lower body water content and different enzyme levels affect how women metabolize alcohol, leading to higher blood alcohol concentration levels. Men are more likely than women to participate in heavy episodic drinking or binge drinking, which involves downing several drinks quickly. Gendered expectations and norms surrounding drinking behaviors influence how men and women perceive alcohol and their drinking habits.
ENVIRONMENTAL FACTORS
The environment has a significant impact on the habits and patterns of alcohol consumption. These variables cover a broad spectrum of social, cultural, economic, and physical effects that affect how people view, obtain, and use alcohol.
1. Socio-cultural factors
Social and cultural factors strongly influence alcoholism. Drinking is more likely to become an addiction when it is encouraged and accepted, particularly among members of specific subcultures. Social norms also increase the risk of heavy drinking among younger populations. Different cultures have varying attitudes towards alcohol. While drinking alcohol may be stigmatized in some societies, it may also be an essential component of social events and religious ceremonies in others. Cultural norms dictate when, where, and how much alcohol is acceptable to drink. People often adapt their behaviors to fit within social norms. Peer pressure and social acceptance can influence individuals to consume alcohol, especially in social settings where drinking is encouraged or seen as a way to bond or relax. Family attitudes and behaviors towards alcohol play a crucial role in shaping an individual's relationship with alcohol. Growing up in a home where alcohol use is accepted or where binge drinking is standard can have an impact on future habits.
Advertising and media portrayals of alcohol can shape perceptions. Positive depictions of alcohol consumption in the media, especially when coupled with images of success, social status, or fun, can influence behavior. Laws and policies around the sale, distribution, and advertising of alcohol can impact consumption habits. For instance, stricter regulations on sales or higher drinking ages may deter some individuals from consuming alcohol. Religious beliefs and cultural practices often have guidelines regarding alcohol consumption. Some religions prohibit alcohol altogether, while others may allow it in moderation or in specific contexts.
2. Economic Status
Wealthier societies tend to have higher rates of alcohol consumption, except for those where the majority of people are Muslims and alcohol is prohibited by religious law. Research has shown that the greater the economic wealth of a country, the higher the prevalence rate of alcohol consumption and the lower the number of abstainers. Low-income countries have a smaller number of drinkers, but they engage in more heavy drinking than high-income countries. Economic downturns or high unemployment rates can lead to stress and anxiety, which might, in turn, influence alcohol consumption. Some individuals may turn to alcohol as a coping mechanism during difficult financial times.
Changes in alcohol prices can significantly affect consumption patterns. Higher prices might reduce consumption, especially among price-sensitive consumers, while lower prices or promotions can lead to increased drinking. Economic factors can influence how aggressively alcohol companies market their products. During economic booms, companies might invest more in advertising, potentially leading to increased consumption. Economic conditions, including bars, restaurants, and entertainment venues, impact the hospitality sector. During economic downturns, people may choose to stay home more, potentially decreasing alcohol consumption outside the home. Economic factors influence global trade and, consequently, the availability of various types of alcohol. Trade agreements and financial policies can impact the diversity and availability of alcoholic beverages in different regions.
3. Peer Pressure
Peer pressure and the influence of one's social circle can significantly affect an individual's alcohol consumption. Adolescents are highly vulnerable to social impact and tend to copy their friends to feel accepted. Peer effects on risk-taking are robust in this age group. According to the United Nations, alcohol users like approval for their behavior from their peers, and the use of alcohol is symbolic of belonging to the group. This shows that having drinking friends increases a person's likelihood of drinking as well. Peer groups often establish norms and behaviors, including attitudes toward alcohol. If a social circle views drinking as a norm or a way to socialize, individuals within that group might feel pressured to conform to those behaviors to fit in or be accepted.
It is in our nature as humans to look to our peers for validation and approval. When friends or acquaintances encourage or engage in drinking, individuals may feel compelled to join in to gain acceptance or avoid social exclusion. Friends or peers might actively encourage drinking, whether through direct suggestions, persuasion, or even teasing or mocking those who choose not to drink. The fear of missing out on social experiences or being excluded from activities where alcohol is involved can drive individuals to drink just to feel included, even if they might not want to. Observing peers consuming alcohol, particularly in a positive or enjoyable context, can influence an individual's perception of alcohol's role in social interactions, making it more likely for them to participate.
4. Accessibility and Availability
Accessibility and availability of alcohol can significantly impact consumption patterns. The availability of alcohol at stores, bars, restaurants, and social events affects consumption significantly. Alcohol consumption is more likely when it is easily accessible, particularly when it is prominently displayed and easily accessible. The number of alcohol-selling outlets in a given area can affect consumption rates. Alcohol consumption may be higher in places with a high concentration of bars or liquor stores than in places with a lower concentration of these establishments. Extended operating hours for alcohol-selling establishments can contribute to increased consumption. Longer opening hours provide more opportunities for people to purchase and consume alcohol. Advertising and promotion tactics used by alcohol companies can influence consumption patterns.
Promotions, discounts, and marketing campaigns can make alcohol seem more attractive and increase its perceived value. With the rise of e-commerce, the accessibility of alcohol through online sales and delivery services has increased. This convenience makes it easier for individuals to purchase alcohol without leaving their homes, potentially leading to higher consumption. The availability of alcohol at social events and gatherings can heavily influence consumption behaviors. When alcohol is readily provided or encouraged in such settings, individuals are more likely to consume it. Cultural norms and legal restrictions on the distribution and sale of alcohol affect accessibility. For example, limiting the sale of alcohol in certain areas on specific days or during distinctive hours may impact accessibility.
5. Legal and policy factors
Laws setting the minimum legal drinking age can significantly influence consumption patterns. Higher MLDA has been linked to fewer alcohol-related issues and lower alcohol consumption in young people. Taxation policies affect the price of alcohol. Price increases brought about by tax increases usually result in lower consumption, especially from price-sensitive consumers. Licensing, store hours, outlet density, and other laws that control the distribution and sale of alcohol can all have an impact on how accessible alcohol is. Stricter regulations might lead to reduced availability and, subsequently, lower consumption. Policies regulating alcohol advertising and marketing, especially those targeting minors or portraying alcohol in a misleadingly positive light, can impact consumption behaviors.
Restrictions can reduce exposure and have a potential influence on drinking habits. Policies aimed at public health, such as educational campaigns, interventions targeting high-risk populations, and support services for individuals struggling with alcohol-related issues, can help reduce alcohol consumption and its negative consequences. The enforcement of laws about public intoxication and driving under the influence (DUI) can discourage binge drinking. Penalties and legal effects for alcohol-related offenses may influence behavior. Legal and policy factors can also shape cultural attitudes towards alcohol. Over time, changes in laws and policies can influence societal norms and perceptions regarding alcohol consumption.
6. Stress, Job loss, and Bereavement
Stress, the death of a loved one, losing one's job, and other negative life events are strongly associated with the onset of alcohol consumption and binge drinking, which can eventually result in alcohol dependence. Children under certain forms of stress are more likely to start drinking at an early age and may have more frequent consumption. All three situations can induce intense emotional distress. People who are experiencing high levels of stress, have experienced the loss of a loved one, or are experiencing anxiety and uneasiness due to job loss frequently turn to alcoholism as a coping mechanism. People may use alcohol as a form of self-medication to temporarily alleviate emotional pain, numb feelings of sadness or anxiety, or help them sleep during challenging times.
Stress, grief, and job loss can all heighten an individual's emotional susceptibility. This vulnerability might lead them to seek relief through alcohol to cope with the emotional upheaval. Significant life events disrupt daily routines and coping mechanisms. Individuals might adopt new behaviors, including increased alcohol consumption, as they struggle to navigate through these difficult periods. Job loss can bring financial strain, and stress due to financial worries might contribute to increased alcohol consumption as a way to escape or cope.
CONCLUSION
Numerous interrelated factors from the biological, social, psychological, and environmental domains all have an impact on alcohol consumption. Recognizing and understanding these risk factors is crucial in devising targeted interventions and prevention strategies aimed at reducing excessive alcohol use and its associated harms. Addressing these factors comprehensively through education, policy changes, support networks, and individual interventions can help mitigate the risks associated with alcohol consumption
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