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Alcohol abuse in Sri Lanka: Grave consequences

During the post-conflict period, Sri Lanka’s alcohol industry expanded and there was increased availability of alcohol.

by Dr. Daya Hewapathirane

About nine million or an estimated 40% of the population of Sri Lanka consume alcohol and 99% of them are males. Those consuming alcohol daily amount to more than 4 million. The alcohol market includes pure alcohol such as hard liquor mainly arrack and beer and illicit liquor or kasippu. Illicit alcohol accounts for most of the alcohol consumed in the country. Studies done in 2013 reveal that illicit alcohol or kasippu accounts for as much as 65% of the total volume of alcohol consumed in Sri Lanka.



Considering only those who consume pure alcohol the per capita consumption amounts to 14.9 litres per annum.

Males (age 15+) - 18.9 liters
Females (age 15+) - 6.7 litres
Both sexes (age 15+) - 14.9 litres

The annual per capita consumption of alcohol, both pure and illicit by male Sri Lankans has been estimated to be a staggering 16.2 liters. This incidentally, is the highest per capita alcohol use among the SAARC countries (India, Pakistan, Bangladesh, Nepal, Nepal, Bhutan, Maldives, Afghanistan). Alcohol dependence and abuse is a major health and social problem in the island often destroying our countrymen in the prime of their lives. About 23,000 alcohol related deaths occur annually in Sri Lanka or about 65 people die daily due to alcohol abuse. Sri Lanka spends about Rs. 247 million per day on hard liquors. The total expenditure for patients with alcohol related health problems amounts to about Rs. 145 billion, which is affecting the country’s economy substantially. The leading cause of death among Sri Lankan males between the ages of 25 to 45 is alcohol related diseases. It is reported that about 48% of about 4000 of suicide deaths in Sri Lanka are directly related to alcohol abuse. NATA reports that the government spends an enormous amount of Rs.140 billion annually on treatment of patients suffering diseases owing to alcohol consumption. Drunk driving is a major cause of road traffic accidents and related deaths and injuries.

A MALE PROBLEM

Alcohol abuse is an increasingly serious problem among a very large segment of the male population of Sri Lanka. This is not only having the effect of severely undermining their health and wellbeing, but also having increasingly harmful effects on the welfare and overall advancement of the country. The quality, competency, vitality and capability of the nation’s human resources are determining factors in overall development and prosperity of a nation. As the dominant component of the nation’s human resources, the male population of Sri Lanka is threatened with an increasingly serious alcohol abuse problem which calls for immediate attention on the part of the government.

The 2016 Global School-based Student Health Survey based on adolescent students of Sri Lanka revealed that the prevalence of alcohol consumption besides smoking and other illegal substance abuse is an increasingly serious problem among male adolescents in the country. Studies have revealed that adolescents and young adults among males are highly vulnerable to the onset and continuation of the habit of alcohol use. Urbanization, westernization, and the availability and affordability appear to contribute to the upward trend in the sale of alcohol.

The National Authority on Tobacco and Alcohol (NATA) reports that alcohol consumption in Sri Lanka is associated with a huge expenditure for the drinking public. A small village with around 300 families spends an average of Rs. 400,000 (USA $2,446) per month on alcohol and tobacco. This menace is one of the primary reasons for the perpetuation of poverty in the island. The economic consequences of expenditure on alcohol can be significant at household level. Besides money spent on alcohol, a heavy drinker also faces other adverse economic effects. These include low wages (because of missed work and reduced efficiency on the job), lost employment opportunities, increased medical expenses for illness and accidents, legal cost of drink-related offences, and decreased eligibility for loans. The opportunity cost of expenditure on alcohol is most severe for the lower income category as well. The negative economic consequences on households, inevitably exerts a substantial burden on the national economy.

Research has revealed that habitual drinkers among the Tamil Estate community spend a staggering 40% of their income on alcohol. Alcoholism is a serious problem among the Tamil plantation community. Statistics from Sri Lanka Sumithrayo which is a government assisted charity, reveal that in the Tamil plantation community, one in every 10 school-going children drop out from school due to alcohol consumption in their respective homes. Also, for every alcohol consuming person, at least 10 other persons in the family including extended family members get adversely affected. It has been reported that Sri Lanka’s tea production is on the decline because of increasing alcohol consumption among the Tamil plantation community.

INCREASED CONSUMPTION IN RECENT DECADES


According to WHO studies, alcohol consumption in Sri Lanka shows a significant increase in recent decades, especially since the 1980s and most prominently from 2005 to 2016. In most low and middle-income countries, economic development is known to be a key factor associated with increased alcohol consumption. Sri Lanka's economy picked up soon after the cessation of the armed conflict against Tamil terrorists, in 2009, and achieved middle-income country status in January 2010. The tourism industry, one of the country's main income sources, started to flourish at the end of the armed conflict. During this period, most likely due to rising incomes, globalization effects, and making alcohol more available and affordable to people, Sri Lanka experienced highly increased alcohol consumption. The so-called "open economy" introduced to the country in 1978, led to the serious socio-economic problems including the widespread proliferation of alcohol use and the aggravation of alcohol abuse in the country. Open economy resulted in increased relations and interactions with foreign countries, increased foreign investments within Sri Lanka and increased involvement of foreigners in Sri Lanka in various capacities, increased international travel and overseas employment of Sri Lankans and most importantly, the significant expansion of the tourism industry – all leading to increased importation of foreign liquor and the expansion of local alcohol production and the expansion of the local alcohol market, the opening of the so-called "wine stores" or liquor bars across the country, most often with the patronage of politicians.

EXPANSION DURING THE POST-CONFLICT PERIOD


During the post-conflict period, Sri Lanka’s alcohol industry expanded and there was increased availability of alcohol. Arrack and beer are the popular drinks of Sri Lanka and these are largely produced by two companies - The Distilleries Company of Sri Lanka (DCSL) is the leading arrack producer whereas the Lion Brewery (Ceylon) PLC, is the market leader of the beer industry. Both companies have seen market expansion since the end of the armed conflict. DCSL's net profit increased from 2682 million Sri Lankan Rupees in 2009 to 6873 million Rupees by 2013, an increment of 156% (Distilleries Company of Sri Lanka PLC, 2014). Lion Brewery's rapid market expansion increased its net profit from 88 million Rupees in 2009, to 1046 million Rupees by 2013, almost a 12-fold increment within 4 years (Lion Brewery (Ceylon) PLC).

Rapid socio-economic development, expansion of the alcohol industry, weak law enforcement and lack of alcohol control strategies during the post-conflict period brought about a rapid increase in alcohol consumption among Sri Lankans. Weak law enforcement and lack of alcohol control strategies were among other reasons for this rapid increase in consumption during the post-armed conflict period in Sri Lanka. Although the Sri Lankan government from 2005 to early 2015 developed an alcohol control strategy and a new alcohol control Act, they continued to provide licences for new liquor sales outlets and registered more alcohol producers. Conversely, intensive raids on illicit alcohol brewers carried out by the Excise Department and Police Department in 2010 may have forced people to consume legally produced alcohol products which would have made a positive contribution towards the increment of recorded alcohol sales.

ILLICIT LIQUOR

Illicitly distilled liquor production and sales, especially kasippu, is widespread and is consumed mostly by those with low income. It was reported in the media that in 2015, the Sri Lanka Excise and Police Departments detected as many as 97,000 illicit liquor dens or hide-outs. Controlling this menace has been severely hampered owing to the political patronage received by illicit liquor barons coupled with bribery and corruption on the part of Government agencies tasked with prevention and detection of this menace.

The difficulty in controlling the production, sales and consumption of illicit alcohol in Sri Lanka has been attributed to corruption in the enforcement agencies besides undue political interference. Those in the legal trade of pure alcohol argue that controls only serve to increase the consumption of illicit alcohol. Police involvement in connection with illicit liquor dens was mostly in connection with the range of crimes associated with these places. Illicit liquor is tied up with gambling dens and many other nefarious activities. Many acts of violence are committed at or in the vicinity of illicit dens. Media reports indicate that Illicit liquor barons are known to have close connections with the underworld. It has also been reported that crimes, including abduction, assault, robbery and murder have become a part of the process in auctions to win tenders for arrack taverns. In this situation, only thugs and illicit liquor barons have been in a position to take arrack taverns on rent. Illicit liquor barons have amassed enormous wealth and have become powerful and highly influential among politicians. They have been able to obtain large-scale contracts in many government projects across the country. A phenomenon observed in arrack business is the entry of unscrupulous business magnates into this business. They promote the sale of adulterated arrack, and often use the same push to pedal narcotics as well. This mafia is said to go all-out to sabotage any moves to combat its activities. This explains the huge amount of illicitly bottled arrack that finds its way to arrack taverns. Arrack business has always been big business and continues to get bigger and bigger.

ALCOHOL USE BECOMING A NATIONAL PASTIME

In recent decades, consuming alcohol has become a widespread national pastime in Sri Lanka. It is distressing to note that it has become a practice that is widely and socially accepted. In Sri Lanka, both in urban and rural settings, most events, including funerals, some religious and cultural events are made into occasions to drink. In addition to recreation and fun with friends, alcohol consumption has become a panacea for everything - for joy and sorrow, for insomnia, for energy or laziness, for tiredness, for heat or cold, for courage or fear, or sometimes for no reason at all!

For some people, consuming alcohol with others ‘for fun’, in social groups generates social ties and connections. To serve and consume alcohol is expected in certain settings, especially at popular events such as weddings, Birthday parties, New Year celebrations etc. In fact, alcohol has become a necessary component in most household parties. In some quarters, social status is communicated and judged by the abundant amounts of expensive liquor served at social events.

SPIRITUAL VALUES

Alcoholism has led to a marked deterioration of moral and spiritual values and standards in Sri Lanka. It is a disgrace in a nation which claims to be founded on Buddhist principles. Refraining from alcohol and other intoxicants is the fifth precept of Buddhism and unfortunately, most Buddhist males appear to be ignoring this basic precept. The use of alcohol blunts the shame and moral dread and thus leads almost inevitably to a breach of the other precepts. One addicted to liquor will have little hesitation to lie or steal, will lose all sense of sexual decency and may easily be provoked even to murder. Alcoholism is indeed a costly burden on our entire society. To indulge in intoxicating drinks is to deteriorate through all stages of morality, concentration and wisdom.

There is no evidence of alcohol consumption in Sri Lanka, prior to the arrival of European colonial powers. It was the Portuguese, Dutch and British that introduced and promoted alcohol consumption in Sri Lanka. In the late eighteenth century, it was the British who issued liquor licenses to open-up taverns all over the country. They increased state coffers by tax collections and promoted the drinking habit widely via the "Toddy act "of 1912.


MOTIVES FOR ALCOHOL USE AND ABUSE


Comprehensive studies have not been done on reasons and motives for alcohol use and abuse among people in Sri Lanka. It is possible that males, and different age groups develop different motivations towards alcohol use. These motivations may be influenced by varied factors, including genetic, environmental and cultural factors. Genes that influence the metabolism of alcohol also influence the risk of alcoholism, as can a family history of alcoholism. Culture plays a significant role in motivating or de-motivating people toward various behaviors. Proper understanding of motives that direct people, especially young people to drink would help public health and education authorities to formulate effective public health policies and develop cost-effective measures to curb the alcohol problem.

Prominent among the varied domains of drinking motives are personal enjoyment, social pressure, and tension or anxiety reduction. The personal enjoyment motive perhaps is associated with heavy drinking whereas social pressure may be associated with lighter drinking patterns. Some say that drinks help them to relax, forget their worries and helps them to cheer up and feel good. Some young males in Sri Lanka appear to drink in order to become more prominent among peers and sometimes, especially in social gatherings, to attract the attention of others, especially females. To some, alcohol use symbolizes manhood, and thus, drinking behaviors are occasionally used to dominate others. Tension-reduction motivations appear to be an important social-cognitive factor in drinking behavior of many young Sri Lankan males. Such motives are often related to solitary and excessive drinking. Among some members of the younger generation, in addition to the access to and availability of alcohol, the media, especially television and movies which glamorize alcohol use, appear to have a strong influence in shaping of alcohol motives among the young. In-depth research is required to better understand the diverse psycho-social-cultural and environmental factors associated with alcohol use behavior among the younger generation of Sri Lankans.

Consumption of alcohol over a period of time leads to physical and psychological dependence and the development of tolerance. It is also addictive and psycho active like heroin. It is most worrisome to see that the country’s younger generation being drawn into this despicable practice. As far as the adolescents are concerned, increased autonomy during this period in life, willingness to experiment, and peer influence/pressure create an environment encouraging high-risk decisions which influence adolescents’ health, such as substance abuse and smoking. Seeking higher levels of sensation during the developmental stage among males compared to greater inhibitory control among females is evident. Thus, males are more likely to experiment with risky behaviors, and this could be one reason for the higher risk among males. Use of alcohol and tobacco by parents and seeing on television and media, popular movie stars, entertainers and sports celebrities consuming alcohol has increased the risk of alcohol consumption and smoking among the younger generation.


A research investigation in selected rural and sub-urban settings in Sri Lanka has revealed that there is a special group of males with a problematic drinking practice, who drink heavily in solitude on a daily basis. They often have the tendency to display embarrassing behavior in public, using unacceptable language, sometimes resorting to violent and anti-social behavior creating problems for others. Consumption of alcohol, specially binge drinking is associated with the development of "Dutch courage". This leads many alcoholics to engage in violent behaviour and commit crimes that they would never had attempted in a sober state. Media often reports of tragic stories especially from rural and sub-urban areas where husbands come home drunk and physically harass and abuse their wives and children. Also, driving under the influence of alcohol often results in fatal road accidents. Some drunk drivers are overconfident and resort to reckless driving and excessive speed. Some suffer from fatigue and drowsiness under the influence of alcohol, and make wrong judgements leading to serious accidents.

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