China is country with an alcohol problem. It is one of the few places in the world where there is no minimum age for purchasing alcohol, and it has limited legislation regarding its sale, manufacture or marketing. When alcohol is exported to China, notices relating to legal limits, alcohol content or standard drink amount are removed, with custom Chinese labels maximising the lack of regulation.
“When it comes to alcohol there really is no restrictions or policing,” says Dr Jason (Heng) Jiang, a research fellow in the Centre for Alcohol Policy Research (CAPR) at La Trobe University. “International companies take advantage of this absence - why attempt to limit alcohol intake if you aren’t required to by law?”
Dr Jiang grew up in the Hubei province of China and remembers being a child and buying alcohol for his relatives. There was little attempt to inform or educate the strong drinking culture.
“Alcohol is everywhere in China and it is a strong part of the way of life and culture,” says Dr Jiang. “It is easy to buy, it is advertised everywhere, and there’s no desire to limit or legislate it.”
Dr Jiang has been researching the implementation and effectiveness of alcohol and drug policy, with a particular focus on Asia. He collaborated with Chinese alcohol epidemiology and policy researchers at the Central South University, Changsha, Huna, to conduct a review of journal papers with a focus on alcohol consumption across eight different Asian countries,.
“We found that alcohol consumption per capita in Asian countries is comparatively lower than western countries, but those that are drinking are drinking a lot,” says Dr Jiang. “In countries like India, South Korea, Thailand and Vietnam it’s very pronounced. Asia has become the fastest growing alcohol market -- with over 30% of global alcohol sales in 2014, and an estimated increase of 176% from 2000 to 2019.”
“This is of major concern as the effects of excessive alcohol consumption can be life changing. Alcohol can lead to problems with physical and mental health, it affects the family and society, it leads to all kinds of social problems like stress, violence, injuries, suicide, and sexual and other risky behaviours.”
The review also highlighted that the drinking problem within the youth population of Asia is predominantly amongst males. In the majority of Asian countries in the study, over 15% of total deaths among young men and 6% among young women aged 15-29 years are attributable to alcohol use.
“There’s a high cost associated with excessive drinking in Asian cultures, and it’s the youth that is paying for it,” says Dr Jiang. “Effective alcohol control policies are the potential means to reduce harmful use of alcohol and related harm among young people in Asia.”
Most countries in the world have effective alcohol policy, such as restricting purchase and consumption to 18 or 21 years, strict legislation in place dictating use of advertising, licensing of sales, and labelling requirements for alcoholic containers.
In Asia there is a range of approaches - from no age restrictions in China and Cambodia, to the sale of alcohol to Muslims being legally banned in Pakistan.
“Many countries around the world have implemented effective policies to restrict harmful use of alcohol, or just make the practice of excessive drinking less attractive,” says Dr Jiang. ““Asia is falling behind in this. It is seen as the next big market for alcohol sales, and manufacturers are making the most of the unrestricted opportunities.”
Dr Jiang is now working on a new project examining the effects, effectiveness and cost benefits of alcohol tax in reducing risky drinking among populations in Australia. It is an intensely debated issue, and he hopes his research will provide the data needed for effective alcohol tax reform. The study is being funded by a National Health and Medical Research Council (NHMRC) grant.
The research will also provide a model for alcohol tax and pricing policy analysis which can be applied to other countries. This would give researchers the opportunity to draw comparisons and assess effectiveness with their own alcohol tax policies.
“While controlling alcohol price is one way to reduce the access to alcohol and limit drinking, it can be deeply unpopular, particularly with alcohol manufacturers and retailers,” says Dr Jiang. “Careful research is required to provide balance between commerce and national health, and that is what our data will provide in Australia.”