title: Rising alcohol consumption and a high prevalence of problem drinking in black men and women in Cape Town: the CRIBSA study.
abstract: BACKGROUND
  To determine the prevalence and determinants of problematic alcohol use (CAGE ≥2) in 25-74-year-old black population in Cape Town in 2008/2009 and examine the changes in self-reported alcohol consumption between 1990 and 2008/2009 in 25-64-year-olds.
  
  
  METHODS
  In 2008/2009, a representative cross-sectional sample, stratified for age and sex, was randomly selected from the same townships sampled in 1990. Socio-demographic characteristics, the ability to cope with psychosocial stress (sense of coherence) and adverse life events were determined. Ordinal logistic regression analysis assessed the determinants of problem drinking.
  
  
  RESULTS
  There were 1099 participants, 392 men and 707 women, in 2008/2009. Prevalence of alcohol consumption in 2008/2009 (men: 68.5%, 95% CI 62.7 to 73.7; women: 27.4%, 95% CI 23.7 to 31.5) was higher than in 1990 (men: 56.7%, women: 15.1%). Prevalence of problem drinking was significantly higher in men (49.7%, 95% CI 44.6 to 54.9) than in women (18.1% 95% CI 15.3 to 21.2) (p<0.001). In men, greater alcohol use was associated with >7 years of education (p=0.012), being unemployed compared with employed (p=0.008) and coping poorly with stress (OR 1.02, 95% CI 1.01 to 1.05, p=0.042), and in women with spending more than half their life in the city (p<0.001) and coping poorly with stress (OR 1.02, 95% CI 1.01 to 1.04, p=0.039). The odds for greater alcohol use with increasing number of adverse life events, after adjusting for the other factors, was significant in men (OR 1.11, 95% CI 1.02 to 1.19, p=0.010) and women (OR 1.09, 95% CI 1.03 to 1.16, p=0.005).
  
  
  CONCLUSIONS
  Problem drinking is a major problem in this population and requires urgent interventions to curtail the misuse.
authors.affiliation: Non-communicable Disease Research Unit, Medical Research Council (MRC), , Durban, South Africa.
authors.forename: Nasheeta
authors.initials: N
authors.lastname: Peer
authors.forename: Carl
authors.initials: C
authors.lastname: Lombard
authors.forename: Krisela
authors.initials: K
authors.lastname: Steyn
authors.forename: Naomi
authors.initials: N
authors.lastname: Levitt
mesh_terms: D000223:Adaptation, Psychological / Q000187:drug effects; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D044383:Black People / Q000706:statistics & numerical data*; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D017678:Sex Distribution; D012931:Social Environment; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D014478:Unemployment