The prevalence of and factors associated with high-risk alcohol consumption in Korean adults: The 2009–2011 Korea National Health and Nutrition Examination Survey

BACKGROUND The consequences of alcohol consumption on health outcomes are largely determined by two separate, but related, dimensions of drinking: the total volume of alcohol consumed and the pattern of drinking. Most epidemiological studies focus on the amount of alcohol consumed and do not consider the pattern of drinking. OBJECTIVES This study evaluated the prevalence of and factors associated with high-risk and heavy alcohol drinking in Korean adults. METHODS This study analyzed 15,215 of the 28,009 participants in the 2009-2011 Korea National Health and Nutrition Examination Survey (KNHANES). High-risk alcohol drinking was defined as Alcohol Use Disorders Identification Test (AUDIT) scores ≥16, which provides a framework for intervention to identify hazardous and harmful drinking patterns as the cause of alcohol-use disorders, according to World Health Organization guidelines. RESULTS The prevalence of high-risk drinking was 15.1%, with the highest prevalence of 17.2% in middle-aged adults (45-64 years). In men, the prevalence of high-risk alcohol drinking was 23.7%, with the highest prevalence found in middle-aged adults. In women, the prevalence of high-risk alcohol drinking was 4.2%, with the highest prevalence found in younger adults. Men had higher weighted mean AUDIT scores than women (10.0 vs. 4.0, P<0.001), and age was negatively associated with the AUDIT score (P<0.001). Elementary school graduates had higher mean AUDIT scores than senior high school (P = 0.003) or college (P<0.001) graduates. Regarding occupation, clerical support workers (P = 0.002) and service and sales workers (P<0.001) had higher mean AUDIT scores than managers and professionals. Logistic regression analyses of high-risk alcohol drinking using sex, age, education level, number of family members, household income, and occupation as covariates was performed. Women had a lower risk of high-risk alcohol drinking (odds ratio (OR) 0.14, 95% CI: 0.13-0.16, P<0.001) than men. Regarding age, compared to control subjects aged 19-29 years, adults aged 60-69 and older than 70 years had 0.67- (95% CI: 0.51-0.89, P = 0.005) and 0.29-fold (95% CI: 0.20-0.70, P<0.001) lower risks, respectively, of high-risk alcohol drinking, whereas adults aged 30-59 had an increased risk of high-risk alcohol drinking. Using elementary school graduates as controls, senior high school (OR: 0.70, 95% CI: 0.55-0.87, P = 0.002) and college (OR: 0.54, 95% CI: 0.42-0. 70, P<0.001) graduates had lower risks of high-risk alcohol drinking. Regarding occupation, compared to managers and professionals as controls, service and sales workers had a greater risk of high-risk alcohol drinking (OR: 1.36, 95% CI: 1.07-1.73, P = 0.011). The number of family members and household income did not influence high-risk alcohol drinking. CONCLUSIONS In a representative sample of Korean adults, the prevalence of high-risk alcohol drinking was 15.1%, with the highest prevalence of 28.3% found in middle-aged men (45-64 years). This study suggests that younger age, male sex, low education level, and service and sales workers are at risk for a high-risk drinking pattern.