Alcohol Consumption and Its Associated Factors among Adolescents in a Rural Community in Central Thailand: A Mixed-Methods Study

Early onset of alcohol use was associated with alcohol dependence and other health problems. Although national data include information about alcohol consumption in Thailand,(1) sufficient information about the socio-ecological context associated with alcohol consumption among adolescents in a particular community is still limited. A few studies investigating alcohol consumption among adolescents were conducted in urban and suburban areas, presenting an estimated prevalence of current alcohol consumption ranging from 10.4% to 18.6%. Nowadays, one-half of the Thai population still resides in rural areas where healthcare provider characteristics, health literacy, and socioeconomic contexts may differ from those in urban areas. Recently, a related quantitative study about the substance abuse situation in a remote rural community, Chachoengsao Province, detected that 36.8% of adolescents reported being a current alcohol drinker and indicated that alcohol drinking was associated with substance abuse in the rural community, which was considered a major health issue in the Thai rural community. Unfortunately, information regarding risk factors for alcohol consumption among adolescents in this remote rural area was not uncovered. The present study aimed to identify the prevalence and factors associated with alcohol consumption among adolescents in a remote rural area using quantitative methods. Moreover, a qualitative study will explore the socio-ecological factors affecting alcohol consumption, including family members and friends, store and accessibility, and social and environmental factors. If factors associated with alcohol consumption among adolescents are explored, appropriate strategies and practical interventions may be implemented in this population to resolve this issue in the future. The study enrolled a total of 413 adolescents. On average, young adolescents initiated alcohol consumption at age 13. The lifetime drinking prevalence among adolescents was 60.5%, while the one-year drinking prevalence was 53.0%. The prevalence of hazardous drinking among current drinkers was 42.0%. Alcohol consumption was associated with females (adjusted prevalence ratio (APR): 1.19; 95% CI: 1.01–1.41), age ≥16 years (APR: 1.28; 95% CI: 1.09–1.50), having close friends consuming alcohol (APR: 1.75; 95% CI: 1.43–2.14), night out (APR: 1.93; 95% CI: 1.53–2.45), being a current smoker (APR: 1.39; 95% CI: 1.15–1.69), and having relationship (with boyfriend/girlfriend) problems (APR: 1.18; 95% CI: 1.01–1.38). Qualitative data demonstrated that individual and environmental factors, including friends, family, social media use, and alcohol accessibility, affect alcohol use in this population. Therefore, effective strategies should be implemented across multiple levels of the socio-ecological model simultaneously to alleviate alcohol consumption and attenuate its complications.