Introduction Indian is in a state of epidemiological transition with changes in urbanisation and risk factor profiles. In this context, our objective was to study the epidemiology of alcohol use among urban and rural populations.

Methods The study was conducted in Ballabgarh block, India, during January–October 2006 using the WHO-STEPs approach. Participants were selected using multi-stage sampling for rural and urban stratum (sub-divided across town and slum). We targeted enrolling 250 male and female participants each in 10 year age-groups across 25–65 years and enrolled 5005 participants. In a 20% sub-sample, information was collected about the exposure to health communication messages regarding alcohol.

Results One rural female reported current alcohol use. The prevalence of current consumption of alcohol, defined as consumption within preceding 12 months, was highest among urban males (26.2%; 95% CI 20.8 to 32.1) followed by urban slums (25.6%; 95% CI 19.2 to 32.4) and rural (23.2%; 95% CI 18.2 to 28.9). Among alcohol consumers 15.3% urban, 7.3% slum and 15.3% rural males reported reduction in alcohol use in preceding 1 year. 7.2% urban, 10.9% slum and 7.2% rural respondents who were current alcohol users reported intermittent cessation of alcohol consumption in preceding 1 year. 59.2%(n=603) urban, 27.2%(n=185) urban-slum and 39.5%(n=646) rural respondents reported receiving information (IEC) on health effects of alcohol with Mass media as the most common source of information.

Conclusion Alcohol is a public health problem among males in Ballabgarh area. Interventions should focus on alcohol cessation services and improved IEC. Urbanisation does not appear to be associated with alcohol use in this community.