Factors Associated with Alcohol Consumption Among Youth Men, Ethiopian 2016 Demographic Health Survey


 Background: Alcohol consumption is a global issue, both developed and underdeveloped countries' health trouble. Specifically in Ethiopia, youth men 15-24 years of age are engaged in psychoactive substances mainly alcohols. Alcoholic person has other concomitant mental illness the discord of school, unemployment and being low socio-economic status.Methods: A cross-sectional study using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set was applied. The samples were selected using a two-stage stratified cluster sampling technique. The data were analyzed with SPSS version 20. Multivariate logistic regression analysis was performed to identify factors associated with alcohol consumption by controlling confounders. An adjusted odds ratio with a 95 % confidence interval was considered to declare a statistically significant association.Results: The present study comprised of 4486 weight samples of youth men. The prevalence of alcohol consumption among youth men in this study was 39.3 %. Men aged 15-19 (AOR=1.27 (95% CI =1.01-1.60), being unemployed (AOR=1.62 (95% CI=1.27-2.07), don’t have awareness about HIV/AIDS (AOR=4.70 (95%=2.44-9.01),being married (AOD 0.58(0.39-0.85) and poorer youth men (AOD =1.75(95%CI=1.21-2.54) ,being orthodox (AOR=5.12(95%CI =2.47-10.64), protestant (AOR=0.42(95% CI =0.20- 0.87)Muslim (AOR=0.07(95% CI=0.03-0.16) religious followers were significantly associated with alcohol consumption.Conclusion: Alcohol consumption among youth men was relatively high when we compared with other countries study. Strengthening the awareness of HIV/AIDS, change alcohol drinking experience on religious ceremonies especially in orthodox, organizes the youth and job creation is suggested to avert alcohol consumption trajectory.

Conclusion: Alcohol consumption among youth men was relatively high when we compared with other countries study. Strengthening the awareness of HIV/AIDS, change alcohol drinking experience on religious ceremonies especially in orthodox, organizes the youth and job creation is suggested to avert alcohol consumption trajectory. Background Worldwide, alcohol use causes 1.8 million deaths and 4% of the total disease burden as measured by the WHO Global Burden of Disease study (1). In 2012, about 5.9% of all global deaths were attributable to alcohol consumption. There are sex differences in the proportion of global deaths attributable to alcohol 7.6% males and 4.0% females (2). Use of substances such as alcohol, khat, and tobacco have long been recognized as one of the leading causes of human suffering and become one of the rising major public health and socio-economic problems worldwide and the use of substances have dramatically increased particularly in developing countries (3)(4)(5).
In Ethiopia, alcohol is most frequently used substances which affect public health((5), and (6)). Many young people have more than one behavioral disorder, and present with other diagnosable "co morbidity" disorders (7). An estimated 37% of alcohol abusers and 53% of other drug abusers have at least one serious mental illness, and in ve individuals with a diagnosable mental illness suffer from a substance abuse disorder (7,8).
A study conducted in primary care group practice reviled that patients who have mental disorders have 50.0% alcohol use disorders and have a disability in social and occupational functioning (9).
Studies showed that alcohol consumption is associated with availability and cost of the substance, psychiatric disorders, social setting, and community attitude peer in uence, the paucity of other options for pleasure and diversion, low employment or educational opportunities, being male, age and family history (5,(9)(10)(11)(12)(13)(14)(15)(16)(17) Substance use among adolescents can lead to cigarette smoking, alcohol drinking, and cannabis use can increase accidental or intentional injuries, a commission of crimes, mood disorders, and mortality (18,19) Understanding the nature and magnitude of substance use as well as the factors that contribute to it should allow the design of effective intervention strategies. However, the pattern and magnitude of factors affecting Psycho Active Substance (PAS) use, especially the use of illicit drugs and NPS among Ethiopian youths, there is limited awareness. Though PAS use has common practices among youths in Ethiopia, few interventions have provided to address the magnitude and associated factors. Moreover, as per the literature review, there is no countrywide data on prevalence and associated factors of alcohol consumption among adolescents'. Thus, the objective of this study was to assess magnitude of alcohol consumption and associated factors among youth men in Ethiopia.

Methods
The current study uses secondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS).
EDHS data were collected from January 18, 2016, to June 27, 2016. In brief, the sampling frame used for the 2016 EDHS is the Ethiopia Population and Housing Census (PHC), which was conducted in 2007 by the Ethiopia Central Statistical Agency (20). The samples for the 2016 EDHS were collected using a strati ed cluster sampling design and were selected in two stages. In the rst stage, enumeration areas (EA) were selected with probability proportional to the EA size and with independent selection in each sampling stratum. In the second stage, 28 households per cluster were selected with an equal probability of systematic selection. All men age 15-24 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. A total of 12,526 men aged 15-59 participated in the survey. The analytic sample for the current study consisted of men aged 15-24 years (n = 4486).

Study Variables
The main outcome of interest was the self-reported history of alcohol consumption (yes/no). Men who responded to the question were considered to have engaged in alcohol consumption.
Independent variables were selected based on literature review on factors associated with alcohol consumption and include age, religion, education, and wealth index, type of residence, Khat use, and HIV/AIDS information, tobacco use, employment status.

Statistical Analysis
The data were analyzed using SPSS version 20. Frequencies and weighted percentage of study variables were calculated. Chi-square test was used to examine relationships between alcohol consumption and each of the independent variables was used. Multivariable logistic regression analysis was conducted to control confounders and to identify the factors associated with alcohol consumption. Signi cantly associated independent variables were entered in the multivariable regression model concerning p-values in the statistical signi cance in the bivariate analysis. An adjusted odds ratio with 95% con dence interval plus p-values was considered to declare a statistically signi cant association. As recommended, all statistical procedures incorporated sample weighting as complex sampling design was applied in the 2016 EDHS.

Result
Among the 2016 EDHS participants, subsamples of 4486 men with ages ranging from 15-24 were incorporated. Of the respondents, 2529 were less than 20 years old, and the median age was 19.09 with a standard deviation of 2.84. Eighty-one percent of the respondents didn't chew chat ever. Around 70 percent of the participants were rural residents; beyond ninety-ve percent of study subjects heard about HIV/AIDS. Around 43 percent of the participants were orthodox religious followers (Table 1).

The Prevalence Of Alcohol Consumption In Ethiopia
The overall prevalence of alcohol consumption in this study was 39.3% (Table 2).  Table 3.

Discussion
The overall alcohol consumption prevalence among youth men was 39.3%.The present study is higher than studies were done in Ethiopian undergraduate Aksum university students (28.4%) (11) and research done in Washington (18).In other words, the magnitude of alcohol consumption is consistent with Kenyan nearly conducted studies (21) and Hawassa (40.8%) (13).
This study also showed that being married, unemployed, being poorer, lack of awareness of HIV AIDS, Orthodox religious follower, age of the respondents (20-24 years of age) are factors correlated with alcohol consumption.
Our study is higher than studies conducted elsewhere (11,18) this might be due to the difference in sample size, lower accessibility of alcohol and being busy of clinical attachment and have better knowledge on the impact of alcohol consumption. However, our study is consistent with that of others studies (13,21). This might be due to all nations and nationalities of Ethiopian are residents of Hawassa and relatively same socio-economic status respectively.
Muslim religious followers are protective to alcohol consumption, the present study is supported by other studies done (22,23), this is due to highly religious learning started at childhood and their different books teach them not to drink and of course, drinking is evil behavior. nevertheless, Orthodox religion is signi cantly associated with alcohol consumption; this might be because of alcohol is usually used after fasting, holy service and bible and tradition of Christian think that wine is gift from God, even though drunkenness and intoxi cation are forbidden. Youth men aged 20-24 are increases alcohol consumption; this is experienced for different reasons; for instance, to stay with their friends to share dormitory while schooling is far from home plus peer pressure is a huge burden. Those youth men have no restrictions to consume alcohol and have higher opportunity. Families and relatives who have an alcohol consumption history or alcohol use disorder unable to provide adequate care for their son, they don't know with whom he plays. Being poorer is associated with increased alcohol consumption which is supported with studies done (24). Youth men with a lack of resource experienced low self-esteem, odd behave, feels despair, and feels anxious and depressed. So then to overcome such a psychological problem, they usually consume alcohol. Even though alcohol consumption calms anxiety initially, in the long run, it escalates anxiety and leads to an AUD. Furthermore, poorer alcohol consumers engaged mainly on homemade alcohol with a lower cost. Being married is inversely associated with alcohol consumption which is supported by studies done in (17,(25)(26)(27). Here are some of the factors, like reduced social relationships with others, reduction in disposable income that is associated with forming a new household may also encourage quitting on drinking, and wives attendance. There might be different reasons why unemployed youth men have a positive association with alcohol consumption. Such as, they have enough free time, stress and also economic de ciency. In turn stress may increase unemployment and alcohol consumption. Those who have no awareness of HIV AIDS were more likely to consume alcohol than have awareness, which is correlated with study (28), this might be due to misperception of the consequence of AC and bad health effects.

Strength And Limitation Of The Study
This study included a relatively huge dataset, which was representative of the general population and examined the impact of some very pertinent determinants of youth's alcohol consumption. Use of secondary data meant that we had no control over the selection of variables, quality of data, and the measurement of indicators. The information in the survey was self-reported, so there might be social desirability bias.