Rahma Mkuu, MPH, CPH
Globally, the consumption of alcohol is associated with increased risk for leading causes of death such as heart disease, injuries from automobile accidents, liver disease, HIV infection and others. In order to address and understand the extent of alcohol consumption, it is important to first be able to measure how much is being consumed and who is consuming.
In developed countries such as the United States, most of the alcohol that is consumed is recorded, meaning that the alcohol is regulated, controlled, and traced. Laws such as those prohibiting individuals who are younger than 21 years of age or prohibiting purchasing alcohol on specific days and times all result from examining consumption patterns of the alcohol consumed.
In developing countries such as Kenya, unrecorded alcohol is alcohol that is not regulated and is also consumed.. There are several types of unrecorded alcohol; (1) alcohol produced illegally - moonshine, (2) illegally imported alcohol - cross-boarder smuggling, (3) homemade alcohol - homebrew, (4) alcohol not intended for consumption such as aftershave, and (5) alcohol that is consumed where it is not registered - duty free shops. In Kenya, the most common unrecorded alcohol is homebrew alcohol. In the United States, homebrew alcohol is legal in all states as long as it is not sold. In Kenya, unrecorded alcohol such as homebrew has recently been legalized but is typically sold to other citizens.
The issue with unrecorded homebrew in places like Kenya is that it is reported to be the most consumed type of alcohol but it cannot be traced or regulated as it is made and purchased in homes. Media has reported several deaths from consumption of homebrew that is sometimes contaminated with lethal substances. Over 100 people died in 2010 as a result of drinking contaminated brew from a local home brewer. The homebrewed alcohol sold is substantially cheaper than regulated alcohol. In addition to being extremely low cost, the homebrew is typically perceived and has been measured to be extremely potent and is nicknamed "kill me quick". The ill effects of the homebrew in Kenya are associated with substances that are used to make it more potent and low cost. For example, adding substances such as methanol. Ethanol, battery acid, has been reported as a method to increase potency of the alcohol.
Our study examined if there were differences between individuals who consume recorded and unrecorded (homebrew) alcohol in Kenya. We used data from the Kenya Ministry of Health and found that individuals who consume homebrew in Kenya are more likely to binge drink (have more than 6 standard drinks for each drinking occasion) compared to those who drink recorded alcohol. Individuals who drink homebrew were also more likely to have lower than a primary education (8th grade education), to be smokers, and be poor. Learning the characteristics of those who consume both recorded and unrecorded alcohol assists in identifying target individuals to provide education to on how alcohol influences health.