Ever imagined how many people get killed by our “cool party drink” ??

1 person every 10 seconds !!

Can’t believe it??

Read the facts below given in WHO – Global status report on alcohol, 2014

  • Alcohol caused around 33,00,000 deaths in 2012, which is more than the deaths caused by AIDS, tuberculosis and violence combined!
  • Alcohol caused 7.6% of all global male deaths and 4.0% of female deaths!
  • We find this surprising because liver cirrhosis is the only mode of death which we generally associate with alcohol. But in reality, liver cirrhosis accounts for just 15% of the alcohol attributable deaths.
  • Distribution of alcohol-attributable deaths, as a percentage of all alcohol-attributable
    deaths by broad disease category, 2012
  • Alcohol caused around 33,00,000 deaths in 2012, which is more than the deaths caused by AIDS, tuberculosis and violence combined!
  • Alcohol caused 7.6% of all global male deaths and 4.0% of female deaths!
  • We find this surprising because liver cirrhosis is the only mode of death which we generally associate with alcohol. But in reality, liver cirrhosis accounts for just 15% of the alcohol attributable deaths.

Distribution of alcohol-attributable deaths, as a percentage of all alcohol-attributable deaths by broad disease category, 2012

         Mode of death Proportion of deaths attributable to alcohol
Heart attacks 33.4 %
Unintentional injuries

(Accidents, falls, drownings, hypothermia, choking, animal bites, etc.)

17.1 %
Liver Cirrhosis & pancreatitis 16.2%
Cancers 12.5 %
Intentional injuries

(Murders, suicides)

8.7 %
Infectious diseases (TB, HIV/ AIDS, etc.) (due to decreased immune capacity) 8.0 %
Neuropsychiatric disorders

(Epilepsy, strokes, alcohol use disorders)

4.0 %
Fetal alcohol syndrome 0.1 %

                                                                                        (WHO Global status report on alcohol, 2014)

So while you think of alcohol, keep in mind that Unintentional injuries, heart attacks, strokes & cancers are also common ways in which it kills us.


Even in developed countries, alcohol has been consistently found to be the cause of a huge proportion of road traffic accidents…..

Percentage of all road traffic accident fatalities involving alcohol























                                   ( Source: WHO Global Information System on Alcohol and Health)

Someone will ask, “why to blame the poor alcohol for the accidents/ rapes/ murder which irresponsible people do?” Yes, alcohol is not the sole factor responsible for these crimes. But it is a major contributor in a large proportion of these crimes. It is physiological property of alcohol to impair your eye-motor co-ordination and to impair your judgement – your sense of right & wrong. Being its physiological property, these effects are bound to be seen in anyone who drinks it. Anyone who drives under intoxication is bound to make accidents. In the Delhi gang rape case, intoxicated men got crazy enough to shove a rod up into the vagina. But later when out of intoxication, one of them committed suicide and another accepted before court that for the kind of crime he has done, he deserves to be hanged till death. There are a lot of husbands who assault their wives only on the days that they are drunk and never when they are not drunk! Hence, these crimes are attributable to alcohol.


Like tobacco, alcohol also causes a lot of cancer deaths… It has been established in scientific studies that alcohol causes cancers of mouth, pharynx, larynx, esophagus, colon-rectum, liver & breast.


As per WHO, around 22% of all suicide deaths and 22% of deaths due to violence are due to alcohol!

The issue of farmers suicide has received a lot of attention recently. But not many are aware that behind a lot of farmer suicides, alcohol addiction is a bigger reason than crop failure. A person who is trapped in this addiction is frequently absent at work, soon loses his professional skills and ultimately loses his job. However, the expenditure over alcohol & the illnesses it brings continue. Soon the family loses all their property & savings and ends up under a debt. This along with the domestic violence which accompanies it, makes life hell for the entire family. Suffocated by the inability to come out of the addiction and ashamed of himself, the person starts finding suicide to be the best solution. Or frustrated by the violence & poverty, the wife takes that route.


According to ‘Global burden of Disease, injury and risk factors study, 2010’,

  • Alcohol has now become 3rd leading risk factor for death & disability!
  • In the young age group of 15-49 yrs, it has become the most common risk factor for death & disability!
  • Proportion of alcohol-related DALYs lost (disease burden) rose from 3.5% to 5.5% over the past 20 year period

And yet alcohol continues to be perceived as a harmless party drink even by the well-educated! Paradoxically, centres of higher education are becoming breeding grounds for the spread of substance abuse! Increasingly, the heroines in films are shown to be drinking alcohol. Till now only drinking amongst males was being normalised through marketing strategies. Now as female drinking is also being projected as normal; young girls are also getting tempted to experiment with it in large numbers. One market analyst told us that, the sector of alcohol consumption by women in India is claimed to be growing at a rate of 40-45% every year!


Hence it is has become very imperative that we empower ourselves and youngsters around us with above mentioned research evidence.

These ‘pleasure giving’ substances actually decrease the quality of your life !

“Though tobacco and alcohol kill a person early,

Till he lives he lives a great and happy life!”


Utter nonsense… Even before they finally kill, tobacco & alcohol harms the quality of your life in multiple ways!


I.   They cause a number of disabling diseases which cause distress and decrease a person’s capacity to work and to enjoy life.
II.   Impotence & sterility
III.   Stamina for physical effort decreases

IV.   A lot of money gets wasted

V.   The person’s attractiveness is decreased

  Thus, contrary to what alcohol and tobacco companies want to make us believe,

  by all parameters, alcohol & tobacco make you less masculine, not more!

VI.   They create a state of physical and psychological dependence:

(Since quitting addictive substances is so difficult, the best way to protect yourself from them is to not touch them even once. Keep in mind, withdrawal & tolerance are characteristics of addictive substances. They have nothing to do with your will power. Anyone who touches an addictive substance runs a risk of getting addicted to it.)

VII.   They impair mental health

VIII.   They decrease academic performance

IX.   Alcohol & tobacco act as gateway drugs; introducing the youth to other harmful drugs, bad company & crime.
X.   They harm your family too: through passive smoking, domestic violence, children picking up the addiction, fetus getting harmed and the family suffering socio-economic disadvantages.

Yes, everyone will not face all the problems listed above. But a significantly large proportion of people who touch these addictive poisons end up having these problems; and spoiling their own quality of life. If you wish to take the risk – its your choice. But we would strongly recommend that the momentary pleasure of intoxicating substances is not worth risking so much in life.


For a detailed description of above points, read below:  

 I.        They can cause a number of disabling diseases which cause distress and decrease a person’s capacity to work and to enjoy life.

   Few of the diseases caused by tobacco:

  1. Peripheral vascular disease: Like tobacco causes blockage in arteries to heart & brain, it can block the arteries of hands or legs too. Consequently, the legs start paining after minimal exertion, then it starts becoming black and finally it has to be amputed. 90% of the people who get this disease, get it because of their tobacco habit.
  2. High blood pressure: with life-long medications and it’s attending complications.
  3. Premature fusion of long bones: thereby an adolescent doesn’t reach his full height possible.
  4. Acidity, peptic ulcers and impaired digestion: which results in intermittent distressing abdominal pain every now and then.
  5. Painful mouth ulcers and submucous fibrosis: Tobacco irritates the inner lining of mouth and on repeated use this leads of fibrosis. When this happens, the extent to which the person can open his mouth keeps decreasing progressively; such that even eating and talking become difficult. Submucous fibrosis is a pre-cancerous condition – it can progress to cancer if the person is not able to stop tobacco.
  6. Sore throat, cough & breathing difficulties: Smoking damages the respiratory tract and at times the cough is so severe, that they are not even able to get restful sleep.
  7. Trembling of hands: which can interfere with any type of skilled work.
  8. Chrons disease: This leads to recurrent diarrhea.


Few of the diseases caused by alcohol:

Alcohol is a causative or contributing cause in 210 disease categories under ICD 10! (International Classification of Dieseases) A few of them are:

  1. Fetal alcohol syndrome
  2. Cancers: Mouth and oropharynx, Oesophageal; colon and rectal; liver; breast; etc.
  3. Alcohol dependence & Alcohol Abuse: Once a person becomes addicted, it not only has health consequences, but also harms the person economically, professionally, socially, legally & spiritually. Infact it makes life hell for the entire family.
  4. Alcohol induced psychosis
  5. Depressive disorders
  6. Epilepsy
  7. Hypertensive heart disease
  8. Ischaemic heart disease
  9. Haemorrhagic stroke ; Ischaemic stroke
  10. Cirrhosis of the liver
  11. Nutritional deficiencies
  12. Impaired immunity – making a person more vulnerable to infectious dieases.
  13. Alcohol-induced pancreatitis
  14. Alcohol is a contributory factor for risky sexual behaviour, sexually transmitted diseases and HIV infection.
  15. Wernicke’s Encephelitis, Korsakoff’s Psychosis, Alcohol related Dementia and various other diseases of central nervous system. If you compare the CT scan of brain of a person who has consumed alcohol for many years with that of a healthy individual, you will see for yourself that the brain appears shrunken and the empty black spaces appear widened; a proof that alcohol causes atrophy of all parts of the brain.

We wont write the entire list. We will just request you to consider, if the body & mind are not healthy, can one really enjoy life? Now lets see other than causing various diseases, what are the other ways in which these addictive substances impair the quality of our life?


II.        Impotence & sterility:  Impotence means decreased ability or inability to achieve erection of the penis & Sterility means inability to have a child. Out of the organic causes of impotence, the 4 most common causes are Diabetes, high blood pressure, tobacco and alcohol. Also, alcohol is an aphrodisiac i.e. it increases the desire to have sex. Thus it’s a double blow – the person desires a lot but can have nothing!! There is mounting evidence that tobacco increases the chances of sterility in both genders; it causes a delay in conception and it increases the chances of abortion. Hypothesised mechanisms are decrease in the sperm count, damage to the follicles in ovaries, menstrual cycle disturbances, mutagenesis in gametes & embryo, and damage to cilia of fallopian tubes leading to implantation of embryo at abnormal sites.


III.    Stamina for physical effort decreases:You would have observed that your friends who start smoking, can no longer play football after a few years. Its obvious that when your lungs, heart, limb muscles and various other organs of the body are damaged and when your overall nutritional status is bad, your ability to do work that requires physically fitness & your ability to play physical sports decreases.


IV.     A lot of money gets wasted: Drop by drop makes the ocean. A person smoking 10 cigarettes a day, would lose around Rs 50/ day. This comes to Rs 1500/month and Rs18,000 every year. For alcohol it is even higher. Even a labourer ends up spending Rs 100/day à Rs 3000/month à Rs 36,000 every year. According to a study done by Dr. Vivek Benegal, et.al at NIMHANS, the percentage of family income spent on alcohol was 24% in rural areas and 32% in urban areas of Bangalore. Imagine the possibilities which will open up for the family if all this money gets saved. And besides this there are the indirect costs of work-absenteeism/ loss of professional skills, money lost in treatment of alcohol related diseases, and premature death of earning member. Collectively, it results in a financial disaster for the family; which gets trapped in a whirlpool of debt & drinking. They are forced to sell off their possessions one by one and at times the frustration leads to suicide.


V.        The person’s attractiveness is decreased:

Tobacco causes staining of teeth, blackening of lips and early wrinkling of skin. It increases chances of gum infection and is a common cause of tooth fall in adults. Your smile is your best ornament; and using tobacco spoils that J Alcohol causes various nutritional deficiencies which results in drying of skin, fissuring around lips and various other skin diseases. Besides, whether you drink or smoke, your mouth stinks and you have to take some mouth freshening chewing gum before talking to people, if you want to avoid creating a bad impression. Alcohol & tobacco companies try hard to create an illusion that women get attracted to men who smoke/ drink. However the fact is that surveys have consistently shown that women dislike men who use addictive substances.


To summarise, an alcohol or tobacco user:

  • stands a chance of becoming impotent,
  • his physical stamina decreases,
  • his occupational performance can deteriorate,
  • his financial power decreases and
  • he also looks less attractive.

Thus, contrary to what alcohol and tobacco companies want to make us believe,

by all parameters, alcohol & tobacco make you less masculine, not more!


VI.        They create a state of physical and psychological dependence:

      The first time a person smokes he gets a quick high. But that is short lasting and soon he starts feeling worse than normal. To remove the discomfort he smokes again. This time the positive effect is less than the 1st smoke and after the temporary euphoria, his distress increases still further. He keeps feeling anxious, restless & depressed, he is not able to get proper sleep and his concentration also decreases. An addict cannot enter the library without puffing his cigarette. Right? This phenomenon is called as withdrawal. A stage comes that as soon as he wakes up, he needs a cigarette just to feel normal and get started. Eg. a person addicted to tobacco is not even able to pass stools in the morning till he chews or smokes his tobacco. The body just doesn’t function without it. This is how a person becomes dependent on tobacco and becomes its slave. Also, gradually he needs to smoke more and more number of cigarettes to get the same feeling which he previously got with just 1 cigarette – a phenomenon known as tolerance. It is often difficult to decide, whether the person is enjoying the cigarette or the cigarette is enjoying the person! Such withdrawal symptoms & tolerance are observed with all other addictive substances as well, like alcohol, cannabis, brown sugar, etc. 


Because of these withdrawal symptoms and craving, a person gets trapped and is unable to quit the addiction even though he wants to. There are so many people who get discharged from de-addiction centres after many weeks or many months; and then end up drinking on the day of discharge itself. Ofcourse, some people do manage to quit it completely or intermittently. But for many families – they find themselves trapped in a hell from which there is no escape. Since quitting addictive substances is so difficult, the best way to protect yourself from them is to not touch them even once. If you are taking alcohol occasionally in parties then the time to quit is now; because once it gets out of control you will not be able to quit it even though you would want to.


Keep in mind, withdrawal & tolerance are characteristics of addictive substances. They have nothing to do with your will power. For some people it may develop faster for some it may develop slowly. There are some risk factors which increase the risk. However that doesn’t mean that others are safe. Anyone who touches an addictive substance runs a risk of getting addicted to it, irrespective of his will power or other qualities – There are enough number of successful businessman, doctors, engineers, etc. who have ruined their lives just because someday they chose to use an addictive substance like alcohol, tobacco, cannabis, etc. for their recreation….


VII.        They impair mental health: Contrary to what advertisements promise, alcohol and tobacco use have been seen to be associated with low self esteem, anxiety and depression. This is because of the direct impact of these substances on the brain physiology as well as because of the physical, social, professional and economic damage which they bring along.


VIII.        They decrease academic performance: Their use has been observed to be associated with poor school performance, truancy, low aspirations for future success and early school drop outs. The reasons hypothesised for this are:

1)    Decreased ability to concentrate on studies due to withdrawal symptoms.

2)    More and more time starts going in procuring and consuming addictive substances. Decreased interest in all other activities including studies & sports.

3)    Their company gets spoilt and they spend most of their time with youth who have little or no interest in studies.

4)    Once they get used to the easily obtainable and instant gratification of addictive substances, probably they are not left with the drive to consistently work hard over something in which the rewards come only after a long period of effort.


IX.        Alcohol & tobacco act as gateway drugs: Besides being extremely harmful themselves alcohol and tobacco often act as the 1st step; leading the person to more harmful substances. People who take illicit drugs like brown sugar, cocaine, ganja, etc. don’t directly starts with them. Invariably, the 1st drugs experimented with are the ones which are easily available, widely marketed and perceived to be relatively harmless eg. alcohol, cigarettes, gutkha, pan masala, etc. Then they meet up with new friends who introduce them to “better”/ “real” stuff – and then gradually, without even realising, they get sucked up into a world of illicit drugs, unproductive lifestyle, crime, etc. If you can convince youngsters in your family to stay away from alcohol/ tobacco/ cannabis – then you can be reasonably sure that he is never going to touch any other intoxicating substance/ party drug either.


X.        They harm your family too: A person using addictive substances loves his / her family members; but still ends up harming them in multiple ways:

1)  Passive smoking: All these adverse effects of tobacco smoke are suffered by other people living around smokers too. Tobacco smoke remains suspended in the room for hours, though it may not be seen. So even if a person smokes only when his family members are not at home, they still get affected. Infact, 10% of the tobacco attributable deaths are amongst innocent near & dear ones of smokers, due to passive smoking!


After a study consisting of 24 research projects, spread over 8 countries, US Environment Protection Agency has proclaimed passive smoke also to be a group A carcinogen – i.e. definitely producing cancer. It is because of such strong evidence, that public smoking is banned in all countries.


2) Your children too pick up the addiction from you: Most of the attitudes & behaviours in children get shaped by what they observe in their parents; and this holds true for tobacco & alcohol use too. If youngsters see elders in their family drink/ smoke they are bound to think, “Though alcohol/ tobacco are said to be unhealthy; they cant be that bad either. Otherwise why would my elders take these substances?”


3)     Domestic violence and Socio-economic backwardness: More than half of the domestic violence episodes take place under alcohol intoxication. Daily witnessing their father assaulting their mother and at times even themselves, children develop anxiety & depressive disorders and are not able to focus on their studies. Later on, many of them themselves take up addictions to deal with their pain. Also, because the money is squandered and the person doesn’t earn, the family remains poor & backward – often not having enough money even for basic needs like schooling, food, etc.


4)     They have to lose you around 10 years early: Alcohol & tobacco are two of the leading causes of untimely avoidable deaths. The family is left with no other option but to cry and curse the alcohol/ tobacco companies. And if


5)     Effects on pregnancy: If a pregnant female consumes tobacco or if she passively takes in smoke from her husband:

  • It increases the chances of spontaneous abortion.
  • Risk of ectopic pregnancy gets doubled
  • Birth weight decreases by 150 to 250 gms on an average!
  • And it’s a major cause of sudden infant death syndrome (SIDS). I.e. the newborn is all fine and well. But suddenly 1 day, without any apparent reason, it just dies.

Similarly, we all know that if a pregnant woman consumes alcohol, the fetus gets harmed. The condition is called fetal alcohol syndrome and is characterised by low birth weight and various body anomalies. Each mother knows about this and yet some of them are not able to stop alcohol even while they are pregnant! That’s how addictive alcohol can get. Before starting to drink alcohol in parties, shouldn’t girls give this a thought?


A person using addictive substances loves his family and doesn’t want to harm them. But still he just cant control and ends up hurting & harming them unintentionally. Hence, while looking out for a life partner it might be a very wise thing to make sure that he/she doesn’t drink/smoke or that he/ she gives up the addictive poison completely before you decide to go ahead. Today he or she might be completely healthy, just drinking occasionally in parties. But one can never be sure how will things be after 10 years…

Understanding tobacco – going beyond cancer…

We call it one of the biggest enemies of mankind, because

  • Tobacco is the largest cause of preventable premature deaths across the world!
  •  10% of premature male deaths in age bracket of 30-44 yrs and 19% of premature male deaths in age bracket of 45-59 yrs are attributable to tobacco use!   (WHO Global Report, mortality attributable to tobacco, 2012)
  • On an average, tobacco smokers end up dying around 10 years earlier than non-smokers!

These premature deaths are very painful for the family members to accept; because a lot of active life years are lost and because these death were avoidable. Also, the person has to undergo pain and disability for a lot of months before death finally arrives…


Sounds impossible! But these statistics have been derived from large, authentic studies. Have a look at some of them:

  1. In a 20 yrs prospective study of over 1 million people, conducted by the American Cancer Society, in 1960s, tobacco alone was found responsible for:

30% of Cancer deaths

22% of deaths due to heart attacks

27% of deaths due to strokes and

72% of deaths due to COPDs (Chronic obstructive lung diseases).

Just imagine, the prevalence of cancers can decrease by 30% in 1 shot; if only mankind gave up its habit of using tobacco !

  1. After 1965, with increasing awareness about its dangers, its use has decreased significantly. But still as per 2004 statistics: In men,

    most oral cancers

    78% lung cancers

    16% heart attacks

    10% deaths due to brain strokes

    9% of TB deaths and

    49% of deaths due to COPDs (chronic obstructive pulmonary diseases – diseases resulting from damage to the internal structure of lungs)

    are attributable to tobacco! Infact 50% of premature heart attacks in males (age group 30-44yrs) are attributable to tobacco!

    -          WHO global report: mortality attributable to tobacoo. WHO, 2012.


  2.  According to a 50 year follow up study on British doctors, more than half of the long term tobacco smoking doctors (>50%) died earlier than their expected life span! On an average they lost 10 years compared to non-smokers. Those who died in middle life lost around 20 years.

  1. According to a huge study, which included 11 lakh homes from different parts of India,

  • Smoking is responsible for 20% male deaths and for 5% female deaths which occur prematurely between the ages of 30 and 69 years.
  • For men, the rate of premature deaths in smokers was 1.7 times that in nonsmokers of similar age, educational level and alcohol status. For women who smoked, the chances of a premature death got doubled
  • With increasing severity of smoking, the risk of premature death also increases. This dose response relationship is a strong proof of the causative association between smoking & deaths.

    Dose per day

    Relative risk of premature death

    1-7 bidis /day

    ≥ 8 bidis /day


  1. Dose per day

    Relative risk

    of premature death

    1-7cigarettes /day


     ≥8 cigarettes /day


    Oral Cancer: It is a rare cancer in western countries.However in India, because of our favourite habit of chewing tobacco & supari, it has become the most common cancer! India has become the oral cancer capital of the world; with 86% of the world’s cases recorded in our country! (Remember supari is also carcinogenic, not just tobacco.) Tobacco damages the genes. This leads to uncontrolled cell division, giving rise to various cancers.

  1. Besides oral and lung cancers, tobacco is responsible for a large proportion of cancers of upper respiratory tract, oesophagus, urinary bladder, kidney, pancreas, blood cells & stomach also.

  1. 50% of the heart attacks occurring in young males in the age group of 30-44years are just because of tobacco!

Alcohol and tobacco damage the inner lining of arteries, making them more prone for deposition of cholesterol, hardening and narrowing – a process called atherosclerosis. This ultimately results in the arteries getting blocked completely. When the artery to the heart is blocked and the heart muscle dies out, we call it a heart attack.

  1. Smoking damages the lungs badly. And then the damaged lungs easily catch various infections. Hence deaths from tuberculosis, pneumonia, etc. are common in smokers.

  1. Tobacco alone causes more than 10,00,000 deaths/ year in India! What is more disturbing is that 10% of these, i.e. 1,00,000 deaths are amongst innocent near & dear ones of smokers due to passive smoking!

You might be getting a question which I had got – If tobacco and alcohol are such big killers, how come we don’t know about it? This is because:

1. Our awareness about tobacco is limited to oral & lung cancer and our awareness about alcohol is limited to liver cirrhosis: Besides cancer, tobacco kills through many other diseases also; like COPDs (emphysema, bronchitis, etc.), heart attacks, brain strokes, TB, pneumonia, etc. It causes cancers of many organs like lung, mouth, oesophagus, stomach, kidney, liver, urinary bladder, cervix, blood, etc. What the mind doesn’t know, the eyes don’t see! Because we are not aware about all these causes, we dont realise the magnitude of deaths tobacco is causing. 

2. Because there is a lag period between the onset of regular smoking and the resulting death.Yes, It doesn’t kill immediately; but studies have proven beyond doubt that it kills for sure. And be it cancer, heart disease, stroke, or respiratory disease – its a slow painful death involving a lot of pain, disability and dependency.

3. Dead bodies cant speak: People who take alcohol & tobacco keep claiming for many years that they have not had any health consequences because of their addiction. However, after they get struck by a disease they don’t keep publicising their pain with equal enthusiasm and after they die their souls are not able to communicate with us what happened! Consequently, the damage done by these addictive poisons doesn’t come to our attention; unless we are working in a hospital.

Another interesting paradox about tobacco is that though it is regarded to be a minor addiction by most Indians, it is the most addictive and all other drugs!

According to values given in Stephen Stahl’s Textbook of Psychopharmacology, one of the most authoritative textbooks in Psychiatry, Out of every 100 people who touch addictive substances, percentage of people who get trapped in the addiction is as follows:


Percentage of people who get addicted on using it









Inspite of tobacco being the most addictive substance known to mankind and inspite of it killing so many people 47% adult males in our country take it!! Are they fools? I don’t think so. Its sheer lack of ignorance about what this addictive poison actually is; because of which people themselves give tobacco to their near & dear ones.

Is it not the duty of the educated class to take these facts to our less privileged brothers & sisters in India; and protect them from this addictive poison?

While our country is developing economically, this epidemic has the potential to turn it all into vain…

Alcohol consumption has been rapidly rising in the developing countries of the world especially India & China; while traditional markets in Europe are showing declining trends of alcohol consumption.   Alcohol companies are also focusing their attention on these new upcoming potential markets, targetting the youth through various promotional strategies. And they are getting good results – sales of alcohol are increasing by 6 to 8 % every year!

As alcohol is becoming more & more trendy amongst youngsters and as its easy of availability is increasing, the age of initiation of drinking it has been decreasing rapidly. In Kerala, the percentage of drinking population under 21 years has increased from 2 to 18%; and age of initiation has decreased from 19 to 13.5 years in just the past 2 decades!!Similar trends are being seen in all states

Average age of initiation of alcohol use in Kerala

Year 1986 1990 1994 1998 2002 2006
Age (yrs) 19 17 15 14.5 14 13.5

Source:  Johnson J. Edayaranmula, ADIC-INDIA, 2007 Drinking Patterns in Kerala,

Because the bodies and brains of young people, especially teenagers, are still developing; they are more sensitive to the damaging effects of alcohol use. Studies around the world are conclusively underscoring that early alcohol use results in a much higher risk of alcohol dependence and abuse.

In this age of equality, women are catching up too! With drinking alcohol becoming an accepted social norm which even well educated men indulge in, women are also increasingly joining their male counterparts in experimenting with this addiction and are falling prey to it. A recent study in Karnataka reported no major difference between the amounts of alcohol drunk by men or women on any typical drinking occasion.

Paradoxically, centres of higher education are becoming breeding grounds for the spread of substance abuse! Youngsters are going to bigger towns and living in hostels where they are largely unsupervised and the peer pressure to take addictive substances is high. Also a lot of youngsters have a lot of spare money and the result is obvious. Hence it has become imperative that before a child steps in college, parents educate their children thoroughly about the truth of these addictive poisons.

Studies have shown that in countries with growing economies where the purchasing power is increasing, if there is an unregulated alcohol-policy environment, there is a rapid increase in alcohol consumption and alcohol-related harm. A large proportion of benefits of development gets squandered over alcohol. Lets see what happened in Thailand, which experienced the development boom a few years ahead of us. Historically, alcohol use by Thai people was low. But then around 40 years back, politicians made laws favouring the alcohol industry claiming that it will help the economy (something very similar to what is being witnessed in India now). The result is that, recent surveys show that around one third of their population has started to drink; and 22.7% of the Thai drinkers have alcohol use disorders! The per head alcohol consumption has increased 33 times, from 0.26L in 1961 to 8.47L in 2001; and there is a pronounced rise in the rates of drinking among young women too! Correspondingly there has been an increase in alcohol related harm like deaths from liver diseases, frequency of traffic accidents, family violence, etc.

We need to wake up to this epidemic if we don’t want India to go the Thailand way. Unless we urgently educate youngsters in our families & vicinity and unless we press for better legislative control over the sale of addictive poisons like alcohol & tobacco, a grim future awaits our next generation….

We found these websites & articles interesting. Check them out ….

1)      A wonderful short animation film of 5 mins describing the phenomenon of addiction


2)      We have uploaded our presentation on the impact of the alcohol epidemic and its possible solutions, in a medical college on you-tube. The link is : https://youtu.be/gLPJD3-AYIE

3)      WHO, Global status report on alcohol and health 2014; and other useful info compiled by WHO:  http://www.who.int/substance_abuse/publications/global_alcohol_report/en/

4)      A 6 min podcast titled  ‘Alice – reached breaking point’. The wife of an alcohol dependent person describes how she coped with it. http://www.al-anonuk.org.uk/public/podcasts

5)      A 17 minutes video introducing the concept of motivational interviewing – how to help a person to increase his motivation for any behavioural change eg. to quit alcohol, to exercise regularly, etc. http://www.youtube.com/watch?v=s3MCJZ7OGRk

6)      A detailed manual for those who would like to start practicing the skill of motivational interviewing:  http://www.motivationalinterviewing.org/sites/default/files/MATCH.pdf

7)      To read more on craving management techniques, you can check out:   http://www.drnespor.eu/BaKlaE2.pdf )

8)      Marlatt & Gordon have given a model of relapse prevention that is very useful in understanding why relapse takes place and how to prevent it. Its overview: http://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf  )

9)      Manual on brief intervention for harmful alcohol use, by WHO: http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6b.pdf

10)  Psychosocial Interventions for helping people with substance use disorders. Content developed by Centre for Addiction Medicine, NIMHANS.    http://nimhans.ac.in/cam/CAM/Psychosocialintervention_2.pdf

11)  website of National Institute on Alcohol Abuse & Alcoholism, USA http://www.niaaa.nih.gov/publications

12)  Book: Substance use disorder; Manual for physicians. Published by AIIMS. http://www.aiims.edu/aiims/departments/spcenter/nddtc/Substance%20Use%20Disorder%20-%20Manual%20for%20Physicians.pdf

13)  Medical students of MGIMS, Sewagram formed a group called ‘White Coat Army’ and did an awareness campaign in the hospital premises during evening hours. A video of one of their awareness talks in Marathi:  https://www.youtube.com/watch?v=8D_3j6C6pzQ     (volume gets clear after the 1min mark)

14)  A radio interview on tobacco use in our society & associated problems in Marathi:

Part 1: https://www.mixcloud.com/mgims/dr-d-shah-poisons-we-love-part-ii/

Part 2: https://www.mixcloud.com/mgims/dr-d-shah-poisons-we-love-part-iii/


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