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Alcohol use and internal migration in Nepal: a cross-sectional study

Abstract

Background Alcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country.

Methods A representative sample of 7435 individuals, aged 15–59 from Nepal were interviewed in 2016–2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes.

Results Net of individual sociodemographic characteristics, internal migration was associated with increased odds of opportunity to drink (OR 1.32, 95% CI 1.14 to 1.53), onset of regular alcohol use given lifetime use (OR 1.29, 95% CI 1.13 to 1.48) and AUD given lifetime use (OR 1.24, 95% CI 0.99 to 1.57). The statistically significant association between internal migration and opportunity to drink was specific to females, whereas the associations between migration and regular use and disorder were statistically significant for males.

Conclusions Despite high rates of internal migration worldwide, most research studying migration and alcohol use focuses on international migrants. Findings suggest that internal migrants are at increased risk to transition into alcohol use and disorders. Support services for internal migrants could prevent problematic alcohol use among this underserved population.

  • ALCOHOLISM
  • HUMAN MIGRATION
  • DEMOGRAPHY
  • MENTAL HEALTH

Data availability statement

Data are available on reasonable request. The data used in this study come from the Chitwan Valley Family Study (CVFS). Deidentified CVFS data and documentation are archived at the Inter-university Consortium for Political and Social Research (ICPSR). For more information on using CVFS data, please go to https://cvfs.isr.umich.edu/. The mental health data presented here are available upon request and will be archived at ICPSR soon. They will be available to the scientific community following ICPSR protocols for restricted-use data.

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