SOCIAL DETERMINANTS AND CONSEQUENCES OF ALCOHOL USE AMONG DRIVERS OF COMMERCIAL VEHICLES IN CALABAR, NIGERIA

Abstract

Hazardous use of alcohol is a public health problem which accounts for 4.0% of global disease burden. The prevalence of alcohol use among drivers of commercial vehicles has been documented, but little is known about the social determinants and consequences of alcohol use among them. This study was therefore carried out to assess the pattern, social determinants and consequences of alcohol use among commercial drivers in Calabar. A cross-sectional descriptive study was conducted among 360 commercial drivers. Eighteen out of 32 clusters of motor parks in Calabar were selected by balloting and all driver's in the selected clusters were enrolled. An interviewer-administered, semi-structured questionnaire which included the World Health Organization alcohol use disorders identification test was used to collect data on socio-demographic characteristics of respondents, pattern of use, alcohol-related harm and features of dependence. Descriptive statistics were used to describe the pattern and consequences of alcohol use while Chi-square test and logistic regression were used to identify social determinants of alcohol use. The mean age of respondents was 38.5 ± 9.5 years. All were males and 77.8% were married. Over half (53.3%) of the respondents had at least secondary education and 63.3% were long distance drivers. The prevalence of alcohol use was 84.4%. Types of alcoholic drink most commonly used included beer (92.1%) and palm wine (77.6%). The mean age at which respondents started consuming alcohol was 20.9 ±7.7 years. About a quarter (23.3%) of respondents used alcohol in high quantity. Many respondents (57.9%) drank at least twice a week. Eighty-eight percent of alcohol users took up to four drinks (one drink 10g alcohol content) on a typical day while 26.3% were indulged in heavy episodic drinking (six or more drinks at a sitting). Most respondents (90.8%) drank after work. The commonest reason for alcohol use was for pleasure (59.2%). Determinants of alcohol use were: history of use by parents (OR= 2,7; 95% CI=1.1-6.3) friends (OR- 3.2; 95% CI= 1.3-7.8) and ready availability (OR- 4.1; 95% CI= 1.9.8.8) while determinants of hazardous use (score of eight or more) were history of use by parents (OR= 5.1; 95% 1.9-13.5), siblings (OR=3.1; 95% CI= 1.3-7.4), friends (OR=3.4; 95% CI= 1.1-11-3). hostile upbringing environment (OR=2.8; 95% CI= 1.2- 6.5) membership of a social club (OR= 6.6; 95% CI: 2.8-15.7), use of other drugs (OR 10.8; 95% CI: 4.5-26.2) and low self-esteem (OR=4.5; 95% CI =1.9-10.7). Features of dependence were exhibited by 36.8% alcohol users. Forty-five percent had experienced alcohol-related harm, while 11.7% exhibited risky sexual behaviours. Twelve percent of income of alcohol users was spent on alcoholic drinks. The prevalence of alcohol use among drivers of commercial vehicles was high and this was associated with family, peer and drug-use related factors. Health education interventions are needed to tackle the problems associated with alcohol use among the commercial vehicle drivers.