Traditional grain alcohol (bai jiu, 白酒) production and use in rural central China: implications for public health

Background: An estimated 25 % of the alcohol consumed in China is traditional unrecorded alcohol produced and distributed informally. Consequently there is concern about its safety and its contribution to public health risk. Little has been written about this type of alcohol in China. Methods: Researchers observed the manufacture of traditional bai jiu in a rural area of Hubei Province, Central China. Two hundred fifty-nine individuals were interviewed, either individually or in small groups, about their use of and attitudes toward bai jiu. Individuals who made or sold bai jiu were interviewed about local production, distribution, and sale. Key community leaders were asked about risks from local bai jiu production, sale, and use. Results: All of the bai jiu makers followed the same basic traditional procedure. Most had learned their craft from a family member or by apprenticeship, and their product was sold to neighbors or nearby villagers. Bai jiu makers typically had a business license and a health certificate. The shops that bought and sold traditional bai jiu were family-run businesses that sold both traditional bai jiu and commercial alcohol to clientele within a close social network. Alcohol (all types) was consumed by 79.9 % of interviewed villagers (89.7 % of males, 50.0 % of females). Of the 207 drinkers in the sample, 72.9 % drank bai jiu, 59.4 % drank beer, and 22.7 % drank commercial spirits. Bai jiu was most often consumed at mealtimes. Bai jiu drinkers believed moderate drinking was healthy and that drinking improved the social atmosphere, and about one-third of them believed drinking too much could result in quarrels and family problems. The bai jiu business provided two sources of income for makers because spent grain from the distillation process could be fed to livestock. Conclusions: Production, sale, and use of traditional bai jiu occurred within the context of local traditions, values, customs, and social networks. The data did not suggest any significant issues related to contamination. Drinking patterns were similar to those found in other studies of alcohol use in China. Bai jiu was sold mainly to middle-aged or older men, suggesting bai jiu production and use could gradually disappear without intervention.