Professional Documents
Culture Documents
WHO
CMHN
EPIDEMIOLOGICAL STUDY ON
PREVALENCE OF ALCOHOL
CONSUMPTION, ALCOHOL DRINKING
PATTERNS AND ALCOHOL RELATED
HARMS IN MONGOLIA
Ulaanbaatar - 2006
Mongolia
Acknowledgement
The EPIDEMIOLOGICAL STUDY ON PREVALENCE OF ALCOHOL CONSUMPTION,
ALCOHOL DRINKING PATTERNS AND ALCOHOL RELATED HARMS IN MONGOLIA
survey was supported by the World Health Organization special fund and successfully
conducted with the support and participation of the following organization and personnel.
Institutional and personnel acknowledgements
Ministry of Health of Mongolia
World Health Organization
Center of Mental Health and Narcology, Mongolia
Public Health Institute, Mongolia
Health Science University of Mongolia
Bayan Ulgii aimag Health Department
Uvs aimag Health Department
Uvurkhangai aimag Health Department
Bulgan aimag Health Department
Dundgobi aimag Health Department
Dornogobi aimag Health Department
Sukhbaatar aimag Health Department
Dornod aimag Health Department
Chingeltei district Health Center
Bayanzurkh district Health Center
New era against drug abuse association
Dr.Hao Wei, professor, Mental Health Insitute, WHO Collaborating Research Center for
Abuse and Health, Changsha, Hunan, China
Dr.Maximilian de Courten WHO consultant Assoc. Prof., Monash University, Australia.
Project coordinator
Dr. G.Tsetsegdary, MD, PhD, senior officer of Health Policy and Coordination Department,
Ministry of Health of Mongolia
Project Team
International consultant
Peter Anderson, MD, PhD, MPH, WHO Public Health Consultant
PhD Medical Sciences, University of Nijmegen, Netherlands
Local Scientific Consultants
G.Tsetsegdary, MD, PhD, Health Policy and Coordination Department, Ministry of Health of
Mongolia
S.Byambasuren, MD, PhD, Professor, Health Science University of Mongolia
Z. Khishigsuren, M.Sc., Health Science University of Mongolia
L.Erdenebayar, MD. Dr.Sc, Prof., Center of Mental Health and Narcology, Mongolia
N.Demidmaa, MD, PhD, Center of Mental Health and Narcology, Mongolia
B.Aushjav, MD, clinical prof., Center of Mental Health and Narcology, Mongolia
Dr. K.Tungalag, MD, epidemiology M.Sc.,Medical Insurance Council secretary
International contributors
Dr. S.R. Govind, Public Health Specialist, the office of the WHO Representative in Mongolia
Statistical analysis team
Dr. D.Otgontuya, Reseacher, Nutrition Research Center, Public Health Institute
Dr. S.Tsegmid, Reseacher, Nutrition Research Center, Public Health Institute
Nai. Tuya, clinical professor, Center of Mental Health and Narcology
B.Dolgorsuren, statistician, Center of Mental Health and Narcology
O.Soel-Erdene, statistic doctor, Center of Mental Health and Narcology
B.Enkhmaa, Reseacher, Center of Mental Health and Narcology
Local participants
N.Demidmaa, Consultant on narcology, Center of Mental Health and Narcology
G.Bertsetseg, narcologist, Center of Mental Health and Narcology
S.Munkhtuya, narcologist, Center of Mental Health and Narcology
B.Dorjmaa, narcologist, Center of Mental Health and Narcology
D.Ganbat, narcologist, Center of Mental Health and Narcology
B.Purevjargal, narcologist, Center of Mental Health and Narcology
O.Byambasuren, narcologist, Center of Mental Health and Narcology
Z.Tuya, narcologist, Center of Mental Health and Narcology
D.Chuluunbolor, narcologist, Center of Mental Health and Narcology
K.Elena, narcologist, Center of Mental Health and Narcology
B.Tuya, psychiatrists, Center of Mental Health and Narcology
S.Dashpilgee, psychiatrists, Center of Mental Health and Narcology
L.Altantsetseg, psychiatrists, Center of Mental Health and Narcology
Sh.Batpurev, clinical professor, Center of Mental Health and Narcology
G.Narantuya, psychiatrists, Center of Mental Health and Narcology
G.Tsogzolmaa, family doctor, Khasagt Erdene family clinic
P.Ichinkhorloo, family doctor, Khasagt Erdene family clinic
D.Unursaikhan, family doctor, Khasagt Erdene family clinic
Ch. Otgonbayar, family doctor, Khasagt Erdene family clinic
B. Tuul, family doctor, Khasagt Erdene family clinic
L.Bayarbat, family doctor, Khasagt Erdene family clinic
D.Batsuren, family doctor, Achlakhui family clinic
S.Bayarmaa, family doctor, Achlakhui family clinic
Ts.Enkhtuya, family doctor, Achlakhui family clinic
B.Ounchimeg, family doctor, Achlakhui family clinic
D.Oundelger, narcologist, Chingeltei district Health Center
N.Tuvshinbayar, family doctor, Chingeltei district Health Center
D.Narantsetseg, family doctor, Chingeltei district Health Center
G.Tugsjargal, family doctor, Chingeltei district Health Center
T.Enkhbold, family doctor, Chingeltei district Health Center
N.Ounchimeg, family doctor, Chingeltei district Health Center
O.Luvsanbud, family doctor, Chingeltei district Health Center
B.Nyamaa, family doctor, Chingeltei district Health Center
B.Budsuren, family doctor, Chingeltei district Health Center
D. Bartsetseg, narcologist, Sukhbaatar aimag Health Department
3
Report compiled by
Dr. K.Elena, Center of Mental Health and Narcology, Mongolia
Translators
Dr. K.Tungalag, Medical Insurance Council secretary
Dr. K.Elena, Center of Mental Health and Narcology
Editors
Mongolian editors
S.Byambasuren, MD, PhD, Professor, Health Science University of Mongolia
Z.Khishigsuren, MD, Lecturer teacher, Health Science University of Mongolia
English editor
4
Mongolia is a very large country with a relatively small population. It faces many difficulties
and challenges in the painful changes of transition from a long-term planned economy to a
market orientated one. Situated in the center of the Asian land mass Mongolia lies between
the Inner Mongolian provinces of China in the south and the Asian part of Russia in the
north, Mongolia covers 1.56 million square kilometres, with an ethnically mixed population
at 2.533.100 people with 49.6 percent living in rural areas, of which about 31% are children
below 15 years of age. Except for the million or so people who live in or near the capital
Ulaanbaatar, the countrys population is sparsely distributed across the vast Mongolian
steppes in nomadic herding communities that are constantly on the move across the vast
plains to find new grazing pastures for their sheep and cattle that form the mainstay of the
food and of economy of Mongolia. The country stretches for about 2500 kilometres from
east to west at its longest and about 1000 kilometres from north to south at its widest. The
Gobi desert covers about a third of the country, and lies to the south along the long border
with the Peoples Republic of China.
Mongolia is divided into 18 aimags or provinces and 4 independent municipalities (such as
the capital city of Ulaanbaatar) that are also sometimes called aimags like the larger
provinces. Each aimag is divided into sums. The capital city of Ulaanbaatar has a
population of about 870,000; the other 1.6 million people are distributed in the other 18
provinces, with some provinces having less than 100,000 people. The average life
expectancy in Mongolia on 2004 year was 64.58 years. The main religious is Buddhism
(80% of population), followed by Islam (10%), Christianity (4.7%), and other religions
(5.3%).
1.2
Adult per capita consumption data are very useful as an indicator of trends in alcoholrelated problems. Of international sources, the Food and Agriculture Organization (FAO)
provide the most reliable data. Studies done primarily in developed countries have found
that per capita consumption is a reliable proxy for the percentage of heavy drinkers in a
population, in the absence of national survey data (Edwards et al., 1994). Per capita alcohol
consumption in pure alcohol for adults is an essential predictor of alcohol related problems,
based on WHO data, the growth rate of per capita alcohol consumption was 402% from
1970 to 1996 (WHO, 1999). The figure for average annual alcohol consumption was still
low compared with that of the developed countries (WHO, 1999), which was about 10.01
yearly. For example, the recorded per capita consumption of pure alcohol per adult 15
years of age and over in 1996 was 11.90 liters in Austria, 11.67 liters in Germany, 11.27
liters in Switzerland, 9.62 liters in Italy, 9.55 liters in Australia, 9.41 liters in the UK and 8.90
liters in the US. The current global trends on alcohol use were that per capita alcohol
consumption in developed countries was decreasing sharply, and increasing steadily in
developing countries. In the countries of the Soviet Union and in many developing
countries, alcohol production for home use or for the informed sector is extremely
important, being as high as 80% of the total alcohol available for consumption.
Per capita consumption figures should be developed for the major categories of alcoholic
beverages available within a country. Most international sources limit these to beer, distilled
spirits and wine.
Ethanol conversion factors differ by country but generally are about 4-5% for beer, about 12
percent for wine and about 40 percent for distilled spirits. Common alcohol conversion
factors: 1 ml ethanol = 0.79 g.
The most commonly used measure of High Risk drinking for acute problems is the volume
of consumption (WHO, Int. Guide, 2002).
Low, Medium and high Risk average daily consumption levels for men and women
long-term of serious illness
LEVEL OF RISK
Gender
LOW
MEDIUM
HIGH
Male
1-40g
41-60g
61+g
Female
1-20g
21-40g
41+g
In different countries, health educators tend to employ different definitions of a standard unit
supposedly reflecting typical serving sizes in that country. For example, a unit or standard
drink in Canada is usually defined as 13.6 grams, in the UK it is 8 grams, in the USA it is
between 12 and 14 grams and in both New Zealand and Australia it is thought to be 10
grams of alcohol (WHO, Int. Guide, 2002). Turner et al., 1990 analyzed the size of these
units in 125 published studies, while these were mostly between 9 and 14 grams they were
also as low as 6 grams, and as high as 28 grams in one Japanese study.
The results of 2001 review in China showed that 6.7% of adults were heavy drinkers, who
consumed 55.3% of the total alcohol consumption.
The review by Shultz (Shultz et al., 1991) estimated that 50% of unspecified liver cirrhosis
cases in the US were due to alcohol. The study by English concluded that 54% of
6
unspecified cirrhosis in males and 43% of such cases among females in Australia could be
attributed to alcohol. However, this estimate will not apply to all countries, for example, it
has been estimated that only 7.6% of liver cirrhosis in China is caused by drinking alcohol
(Zhou et al., 1984).
Alcohol is a causal factor in alcoholic psychosis, alcohol dependence syndrome and
harmful alcohol use. For example, of all alcohol caused deaths in Canada in 1992, 10%
were due to alcohol-related mental disorders. In Russia, officially recorded rates of alcohol
dependence and alcoholic psychosis combined were 1.8% of the population while
epidemiological surveys suggest the higher rate of between 3 and 3.5% (Vroublevsky et al.,
1998).
Alcohol is the prime cause of alcoholic cardiomyopathy. In 1992, about 1.1% of all alcoholcaused deaths in Canada were recorded as due to alcoholic cardiomyopathy. Alcohol is
also considered a factor in cardiac dysrhythmias and heart failure, causing 1.5% and 0.18%
of all alcohol-caused deaths, respectively, in Canada in 1992 (WHO, Int. Guide, 2002).
Alcohol consumption is positively related to hypertension (high blood pressure). In
particular, one very recently conducted review (Campbell et all 1999) concluded that
observational studies have almost uniformly found a relationship between heavy alcohol
consumption and increased blood pressure.
Alcohol is the direct cause of a small number of deaths and hospitalizations each year from
gastritis. Alcohol gastritis comprised 1.06% of alcohol-caused deaths for Finland between
1987 and 1993 (Makela et al., 1997). The English et all (1995) review estimates that 24% of
acute pancreatitis and 84% of chronic pancreatitis cases are due to alcohol.
Violence occurs across all kinds of interpersonal relationships including those of relatives,
friends, acquaintances, and strangers. Alcohol is implicated as a factor in assault in two
ways: high alcohol intake represents a risk factor in becoming a victim of assault and
alcohol is also a potential causal factor in committing an assault. Studies in Zambia have
estimated that alcohol is involved in between half and two thirds of all violent deaths
(Haworth et al., 1998). In the Canadian cost study, it was estimated that 160 deaths and
3.175 hospitalizations occurred in Canada in 1992 as the result of alcohol attributable
assault.
1.2.2 Alcohol consumption in Mongolia
Alcohol dependence and the harm done by alcohol have become of major public health and
social concern in Mongolia.
The common alcoholic beverages available in Mongolia are commercially marketed legal
vodka (spirits), beer and wines and homemade milk vodka and fermented horse milk. In
2002, Mongolia produced 4.9 million litres of spirits, 9.4 million litres of vodka, and 3.3
million litres of beer. Fifteen million litres of alcoholic beverages were imported. Per capita
consumption in Mongolia is estimated to be 9.03 litres absolute alcohol per year. According
to 2004 data of the Special Control Division, there are currently 12 spirits factories, 173
vodka factories and 29 beer factories. There are 48 wholesale markets and 3482 shops,
338 restaurants and 1297 bars that sell alcoholic beverages. All aimags (provinces) have
at least one or two factories that produce alcoholic beverages. Traditionally, Mongolians
produce national alcoholic beverages, such as: fermented horse milk (airag) and distilled
milk vodka (nermel).
7
The study on alcohol and alcohol dependence, which was conducted by the Dr. L.
Erdenebayar of the Center of the Mental Health and Narcology in 1997, indicated that over
51% of the population used alcohol more than they should do, 8% of these being women.
UN survey on 1998 identified that 12.7% of adults were classified as heavy drinkers.
The Public Health Institute conducted KAP survey in 2001 (Public Health, 2002) and
indicated that 43.6 percent of respondents consumed 1-3 standard drinkers per week and
47.5 percent consumed more than 3 standard drinks per week, with the frequency of
alcohol use increasing in both high and low-income households.
However, there have been many changes in the country since the survey, and new and
reliable data are urgently needed to give a clearer picture of the problem. We conducted
the national epidemiological survey on alcohol consumption, alcohol drinking patterns and
alcohol related harms, with technical and financial support of the World Health
Organization.
1.3
Survey Goal
Survey objectives
1. To determine the prevalence of alcohol consumption
2. To identify the alcohol drinking patterns
3. To determine the prevalence of alcohol dependence
4. To identify health alcohol related harms
5. To identify social alcohol related harms
1.5
Survey rationale
Study sample
The study sample was a quota sample obtained from eight provinces (aimags): Bayan Ulgii
and Uvs aimags in the west, Dornod and Sukhbaatar aimags in the east, Dundgobi and
Dornogobi aimags in the south, Bulgan and Uvurkhangai aimags in the central parts of
Mongolia and in the two districts Chingeltei and Bayanzurkh in Ulaanbaatar city. The
sampling frame used a multistage, area probability design. After the ten sites were
selected, the sampling process continued with the selection of local government areas,
households, and finally, the respondents within the household. For the resident population a
representative sample was used based on households; for the nomadic population a
representative quota sample was used based on households (gers).
All people present in the household, aged 15 to 65 years old were invited for interview.
Face to face interviews were conducted within households, and households were selected
until the predesignated sample size was achieved (650 for each of the eight aimags and
2500 for each of the two districts in Ulaanbaatar. For the nomadic population, interviewers
went from ger to ger (nomadic household) until the predesignated sample size was
achieved (which differed from aimag to aimag, dependent on the estimated size of the
nomadic population). The questionnaire and the study protocol were approved by the Ethics
Committee of Ministry of Health, Mongolia. All respondents completed the questionnaire
voluntarily.
2.2
Study questionnaire
The questionnaire was developed in English, and then translated into Mongolian. Back
translation was undertaken from Mongolian to English to identify and correct any translation
difficulties. All interviews were conducted in the national Mongolian language. The
questionnaire comprised seven parts. Part 1 collected data about the interviewer and the
composition of the household; Part 2 collected demographic data of the respondent; Part 3
comprised the ten questions of the AUDIT; Part 4 comprised a series of graduated quantity
frequency questions to measure alcohol consumption (WHO); Part 5 measured social
harms and alcohol dependence with a 12 month reference period. The questions on social
harms were derived from a series of articles and reviews from the Journal of Alcohol
Studies published, which resulted from a scientific meeting on measures of social harm, as
well as the AUDADIS questionnaire. The alcohol dependence questions were derived from
the CIDI; Part 6 measured harm from someone elses drinking, including domestic violence,
with a 12 month reference period. The questions were derived from a series of articles and
reviews from the Journal of Alcohol Studies published in 2000 which resulted from a
scientific meeting on measures of social harm; Part 7 measured physical harm and
experience of help or treatment for harmful drinking or alcohol dependence with a 12 month
reference period, derived from AUDADIS. The questionnaire was pre-tested with a pilot
survey, held in Ulaanbaatar, 7-8 May, 2005.
2.3
Quality control
Interviewers were psychiatrists and family doctors, who were trained in two stages. A group
of 30 key interviewers were trained for 5 days training in Ulaanbaatar city, including two
days piloting the methodology and the questionnaire. The key interviewers trained a wider
group of interviewers on site. Didactic and participatory and skills based training were used
to explain the aims of survey, the variables of the questionnaires, and interview skills.
9
Instructions focused on guaranteeing the respondents anonymity, public relations with the
community and seeking the help of community leaders and officials from local government.
After each interview, the questionnaire was checked by the key interviewers.
Before of survey implementation an approval was taken from the Ethics Committee of MOH
on 15 of June, 2005
Definition of Mongolian drink A Delphi type technique was used to define a standard
drink, in the absence of empirical research. A group of 20 primary care physicians, 10
narcologists, and 10 scientists of the National Centre of Mental Health and Addictions,
representative of the whole country, met until agreement was reached. It was concluded
that a standard drink was the equivalent of: one 330ml glass, can, or bottle of beer (5%
concentration of absolute alcohol); one 500 ml bowl of fermented horse milk (5%
concentration of absolute alcohol); one 50 ml glass or cup of vodka (40% concentration of
absolute alcohol); one 100 ml glass or cup of milk vodka (15% concentration of absolute
alcohol); or one 100 ml glass of wine (100 ml) (12.5% concentration of absolute alcohol).
2.4
Eight teams each with 5 members collected data in the rural areas. Two teams each with
16 members collected data in Ulaanbaatar city. Each team consisted of a team leader and
4 to 16 interviewers. Data was collected during the period June 15 July 31, 2005.
2.5
The data from the completed questionnaire forms was first entered into the Epidata 3.1
created database, a Microsoft Windows based computer program. Data were double
entered and verified in the same Epidata 3.1 database and transferred into SPSS for
Windows 11.5 and analyzed.
Data entry into Epidata 3.1 was prepared by a team of two people under the kindly support
of WHO consultant Assoc. Prof. Maximilian de Courten, Monash University, Australia.
Data analyses were performed by a team of six people under the guidance of WHO Public
Health Consultant Dr. Peter Anderson.
Chapter III. Survey Results
A total of 10,157 respondents were interviewed, of whom 10,145 (99.8%) provided valid
data.
3.1
Demographic characteristics
The demographic characteristics of the sample for each of the eight aimags and two
districts of Ulaanbaatar are shown in Table 1.
10
Table 1. Demographic characteristics of respondents in eight aimags (provinces) and two districts of Ulaanbaatar.
Bayan
Ulgii
aimag
657
n
%
Gender
Male
Female
Age group
15 ~ 19
20 ~ 24
25 ~ 29
30 ~ 34
35 ~ 39
40 ~ 44
45 ~ 49
50 ~ 54
55 ~ 59
60 ~ 64
65
Ethnicity
Khalkh
Kazakh
Buriad
Uriankhai
Dorvod
Bayad
Torguud
Dariganga
Hoton
Burga
Zakhchin
Uvs
aimag
638
%
Bulgan
aimag
632
%
612
649
Dornod
aimag
646
%
Sukhbaatar
aimag
Chingeltei
district
649
n
2543
%
Bayanzurkh
district
Total
2456
10145
n
%
336 3.3
321 3.2
321
328
3.2
3.2
343
267
3.4
2.6
332
313
3.3
3.1
321 325
3.2 3.2
355
293
3.5
2.9
1230
1312
12.2
13.0
1190
1265
103
82
70
68
76
96
80
43
16
19
4
1.0
0.8
0.7
0.7
0.8
0.9
0.8
0.4
0.2
0.2
0.0
111
47
58
59
109
87
74
43
26
20
3
1.1
0.5
0.6
0.6
1.1
0.9
0.7
0.4
0.3
0.2
0.0
90
80
82
85
71
76
55
53
24
13
3
0.9
0.8
0.8
0.8
0.7
0.8
0.5
0.5
0.2
0.1
0.0
92
65
87
81
104
91
66
34
12
7
10
0.9
0.6
0.9
0.8
1.0
0.9
0.7
0.3
0.1
0.1
0.1
58
57
75
64
86
91
65
63
33
15
4
0.6
0.6
0.7
0.6
0.8
0.9
0.6
0.6
0.3
0.1
0.0
45
75
96
105
95
94
57
43
24
8
2
0.4
0.7
0.9
1.0
0.9
0.9
0.6
0.4
0.2
0.1
0.0
59
62
78
102
107
87
69
32
22
16
11
0.6
0.6
0.8
1.0
1.1
0.9
0.7
0.3
0.2
0.2
0.1
71
60
85
106
88
78
68
48
19
18
8
0.7
0.6
0.8
1.0
0.9
0.8
0.7
0.5
0.2
0.2
0.1
357
324
246
233
267
269
255
218
141
148
84
3.5
3.2
2.4
2.3
2.6
2.7
2.5
2.2
1.4
1.5
0.8
253
318
296
329
330
288
274
174
100
73
21
2.5
3.1
2.9
3.3
3.3
2.8
2.7
1.7
1.0
0.7
0.2
1239
1170
1173
1232
1333
1257
1063
751
417
337
150
17
592
1
13
14
17
1
-
0.2 33 0.3
5.9 3
0.0
0.0 1
0.0
0.1 2
0.0
0.1 161 1.6
0.2 348 3.4
4
0.0
0.0 84 0.8
-
549
3
44
2
10
18
1
-
5.4
0.0
0.4
0.0
0.1
0.2
0.0
-
629
3
1
5
6
3
-
6.2
0.0
0.0
0.0
0.1
0.0
-
589
1
1
19
1
1
-
5.8
0.0
0.0
0.2
0.0
0.0
-
599
15
6
17
5
1
1
5.9
0.1
0.1
0.2
0.0
0.0
0.0
279
3
289
1
25
11
20
1
7
4
2.8
0.0
2.9
0.0
0.2
0.1
0.2
0.0
0.1
0.0
193
3
5
1
4
32
408
1
1
1.9
0.0
0.0
0.0
0.0
0.3
4.8
0.0
0.0
2203
35
111
8
69
44
16
17
6
5
8
21.8
0.3
1.1
0.1
0.7
0.4
0.2
0.2
0.1
0.0
0.1
2096
20
101
22
87
37
9
32
2
5
19
20.7
0.2
1.0
0.2
0.9
0.4
0.1
0.3
0.0
0.0
0.2
7187 71.0
663 6.6
568 5.6
49
0.5
382 3.8
549 5.4
33
0.3
483 4.8
95
0.9
19
0.2
33
0.3
12.2
11.6
11.6
12.2
13.2
12.4
10.5
7.4
4.1
3.3
1.5
11
Oold
Other
Marital status
Married
Never married/single
Divorce/separated
Widow/ widower
Cohabited
Education
None
Primary or below
Middle
Special middle
High
Employment
Currently employed
Unemployed
Retired
Student
Occupation
Lawyer
Governmental worker
Engineer
Doctor, nurse
Teacher
Cattle breeder
Agricultural worker
Service and trade worker
Assistant
Factory worker
Heavy physical worker
Private business owner
Driver
Policeman
0.0
1
1
0.0
0.0
3
2
0.0
0.0
2
-
0.0
-
0.0
1
5
0.0
0.0
0.0
12
6
0.1
0.1
14
7
0.1
0.1
33
25
0.3
0.2
443
179
11
17
6
457
161
7
9
15
4.5
1.6
0.1
0.1
0.1
476
115
5
1
15
4.7
1.1
0.0
0.0
0.1
442
135
25
22
21
4.4
1.3
0.2
0.2
0.2
413
156
33
29
14
4.1
1.5
0.3
0.3
0.1
445
144
13
18
28
4.4
1.4
0.1
0.2
0.3
1573
659
99
168
43
15.5
6.5
1.0
1.7
0.4
1636
579
96
98
44
16.2
5.7
0.9
1.0
0.4
6747 66.7
2457 24.3
309 3.1
385 3.8
222 2.2
18
81
333
106
118
18
78
282
155
116
0.2
0.8
2.8
1.5
1.1
14
63
310
102
123
0.1
0.6
3.1
1.0
1.2
15
44
258
170
156
0.1
0.4
2.6
1.7
1.5
14
67
280
159
126
0.1
0.7
2.8
1.6
1.2
23
75
276
137
138
0.2
0.7
2.7
1.4
1.4
21
86
762
805
866
0.2
0.9
7.5
8.0
8.6
38
154
938
619
704
0.4
1.5
9.3
6.1
7.0
203 2.0
761 7.5
4008 39.6
2516 24.9
2629 26.0
187
309
35
125
271
260
22
96
2.7
2.6
0.2
0.9
319
174
53
65
3.2
1.7
0.5
0.6
344
231
25
44
3.4
2.3
0.2
0.4
265
262
49
69
2.6
2.6
0.5
0.7
305
215
45
83
3.0
2.1
0.4
0.8
1135
550
355
501
11.2
5.4
3.5
5.0
1126
755
160
411
11.1
7.5
1.6
4.1
4445 43.9
3248 32.1
821 8.1
1602 15.8
4
33
19
38
45
58
5
28
37
35
32
43
36
2
0.0
0.4
0.2
0.4
0.5
0.7
0.1
0.3
0.4
0.4
0.4
0.5
0.4
0.0
10
34
32
75
35
40
25
62
15
25
9
49
46
4
0.1
0.4
0.4
0.9
0.4
0.5
0.3
0.7
0.2
0.3
0.1
0.6
0.5
0.0
7
48
23
54
39
87
9
34
15
15
2
40
39
3
0.1
0.6
0.3
0.6
0.5
1.0
0.1
0.4
0.2
0.2
0.0
0.5
0.5
0.0
15
53
29
35
46
63
7
38
22
16
11
22
37
29
0.2
0.6
0.3
0.4
0.5
0.7
0.1
0.4
0.3
0.2
0.1
0.3
0.4
0.3
9
29
23
79
60
78
14
46
37
24
8
49
40
11
0.1
0.3
0.3
0.9
0.7
0.9
0.2
0.5
0.4
0.3
0.1
0.6
0.5
0.1
6
42
20
65
57
116
10
24
12
13
7
32
54
3
0.1
0.5
0.2
0.8
0.7
1.4
0.1
0.3
0.1
0.2
0.1
0.4
0.6
0.0
64
216
224
170
212
27
12
248
92
187
30
197
152
26
0.8
2.5
2.6
2.0
2.5
0.3
0.1
2.9
1.1
2.2
0.4
2.3
1.9
0.3
50
186
160
143
202
53
11
208
100
188
76
224
182
27
0.6
2.2
1.9
1.7
2.4
0.6
0.1
2.4
1.2
2.2
0.9
2.6
2.1
0.3
191
742
576
739
811
624
135
772
372
539
194
715
659
112
10
64
30
44
60
50
23
49
25
19
10
31
36
4
0.1
0.8
0.4
0.5
0.7
0.6
0.3
0.6
0.3
0.2
0.1
0.4
0.4
0.0
16
37
16
36
55
52
19
35
17
17
9
28
37
3
0.2
0.4
0.2
0.4
0.6
0.6
0.2
0.4
0.2
0.2
0.1
0.3
0.4
0.0
2.2
8.7
6.8
8.7
9.5
7.3
1.6
9.1
4.4
6.3
2.3
8.4
7.7
1.3
12
Other
117 1.4 60
Families income per person per month
20.000
411 4.1 297
20.001~
147 1.5 199
30.001 ~
66 0.7 60
40.001 ~
16 0.2 26
50.001 ~
12 0.1 29
60.001 ~
2
0.0
8
70.001 ~
1
0.0 11
80.001 ~
2
90.001 ~
5
100.001
1
0.0
-
0.7
169 2.0
92
1.1
132
1.6
175
2.1
70
0.8
103
1.2
182
2.1
229
2.7
1329 15.6
341
145
48
49
28
13
12
3
7
1
3.4
1.4
0.5
0.5
0.3
0.1
0.1
0.0
0.1
0.0
335
81
62
55
32
19
17
2
2
6
3.3
0.8
0.6
0.5
0.3
0.2
0.2
0.0
0.0
0.1
310
114
67
42
22
28
32
7
10
12
3.1
1.1
0.7
0.4
0.2
0.3
0.3
0.1
0.1
0.1
335
126
77
49
23
12
9
3
8
3
3.3
1.2
0.8
0.5
0.2
0.1
0.1
0.0
0.1
0.0
325
139
64
59
29
21
5
5
2
-
3.2
1.4
0.6
0.6
0.3
0.2
0.0
0.0
0.0
-
424
677
589
319
179
138
100
40
32
40
4.2
6.7
5.8
3.2
1.8
1.4
1.0
0.4
0.3
0.4
727
627
382
270
148
107
85
41
36
30
7.2
6.2
3.8
2.7
1.5
1.1
0.8
0.4
0.4
0.3
3780 37.4
2370 23.4
1526 15.1
936 9.3
522 5.2
368 3.6
295 2.9
108 1.1
112 1.1
95
0.9
NOTE: FOR SOME VARIABLES N MAY NOT EQUAL 10145 BECAUSE OF MISSING DATA.
13
In survey 5116 men and 5006 women provided data. The 8.3% of the interviewed women
were pregnant. There were significant differences among 10 areas in gender (2 = 44.101,
d.f. = 9, p<0.0001), age (2 = 444.318, d.f. = 9, p<0.0001), marital status (2 = 234.737, d.f.
= 3.6, p<0.0001), education (2 = 537.815, d.f. = 3.6, p<0.0001), employment (2 = 515.497,
d.f. = 27, p<0.0001), occupation (2 = 1448.143, d.f. = 126, p<0.0001).
The following age groups of respondents predominated from 35 to 39 years (13.2%), 40-44
years (12.5%), 15-19 years (12.2%), 30-34 years (12.2%), and 20-24 years (11.6%).
The Khalkh national constituted 71.0% of the sample, followed by Kazakh (proportion of
Kazakh was higher in the Bayan Ulgii site and composed 6.6% of all sample), Buriad
(5.6%), Bayad (5.4%) and other nationalities (11.4%) (2 = 20913.430, d.f. = 108,
p<0.0001).
The 39.6% of respondents had received middle education, 26.0% high education, 24.9%
special middle education, 7.5% primary education and only 2.0% no education.
Two thirds of respondents were married, 24.3% were single, 3.8% were widowed, 3.1%
were divorced/separated, and 2.2% cohabited (2 = 109.704, d.f. = 4, p<0.0001), Table2.
Table 2. Marital status by gender.
Marital status
Married
Never married/single
Divorce/separated
Widow/widower
Cohabited
Total
Gender of respondent
Male
Female
3545
3212
35.0%
31.7%
1240
1220
12.2%
12.0%
131
178
1.3%
1.8%
101
284
1.0%
2.8%
107
115
1.1%
1.1%
5124
5009
50.6%
49.4%
Number
% of Total
N
%
N
%
N
%
N
%
N
%
N
%
Total
6757
66.7%
2460
24.3%
309
3.0%
385
3.8%
222
2.2%
10133
100.0%
NOTE: FOR SOME VARIABLES N MAY NOT EQUAL 10145 BECAUSE OF MISSING DATA.
Table 3 shows that 18.0% of men were unemployed, compared with 14.1% of women and
general employment status was significantly different among men and women (2 = 79.312,
d.f. = 3, p<0.0001)
Table 3. Employment status by gender.
Employment
Currently employed
Unemployed
Retired
Number
% of Total
N
%
N
%
N
%
Gender of respondent
Male
2229
22.0%
1823
18.0%
354
3.5%
Female
2220
21.9%
1430
14.1%
469
4.6%
Total
4449
43.9%
3253
32.1%
823
8.1%
14
Student
Total
N
%
N
%
719
7.1%
5125
50.6%
885
8.7%
5004
49.4%
1604
15.8%
10129
100.0%
NOTE: FOR SOME VARIABLES N MAY NOT EQUAL 10145 BECAUSE OF MISSING DATA.
The 61.8% of respondents lived in a ger or small shack, 31.4% in an apartment or private
house, and 6.8% in a nomadic ger (Figure 1).
Figure 1. Hosehold types of respondents.
Nomadic ger
6.8%
Apartment or
house31.4%
Ger or small
shack61.8%
Consistent with the sampling methodology, equal numbers of respondents lived in urban
and rural areas, Figure 2.
Figure 2. Distribution of respondents in rural and urban areas.
Rural areas
50.6%
Urban areas
49.4%
The 26% of rural households had a family income of less than 20.000 tugrik per month,
compared with 11.4% of urban households and was different in all sites (2 = 1293.794, d.f.
= 81, p<0.0001), Figure 3.
Figure 3. Family income per family member per month (%).
15
30
25
20
15
10
5
0
20.00 20.001 30.001 40.001 50.001 60.001 70.001 80.001 90.001 100.0
0
~
~
~
~
~
~
~
~
01
Rural
26
10.5
5.5
3.4
1.9
1.1
1.1
0.3
0.4
0.2
Urban
11.4
12.9
9.6
5.9
3.3
2.5
1.8
0.8
0.7
0.7
3.2
Drinking frequency
The frequency of drinking, as measured by the frequency question of the AUDIT, by age,
gender, educational attainment, marital and employment status and rural-urban residence
is shown in Table 4. The proportion of life time abstainers and last year abstainers was
higher for women than men. The proportion of abstainers did not differ between rural and
urban residents.
Table 4. Frequency of drinking by selected socio-demographic characteristics (%)
Characteristics
Overall
Gender
Male
Female
Age
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65
Education
None
Primary or below
Middle
Lifetime
abstainers
2-4
times
a
month
2-3
times
a
week
Last year
abstainers
among life time
drinkers
10145
27.9
64.0
25.1
5.0
4 or
more
times
a
week
3.8
5126
5014
8.9
19.0
28.3
35.7
20.1
5.0
6.0
1.0
3.4
0.4
3.9
7.6
1242
1172
1173
1233
1333
1264
1064
753
418
337
151
74.3
38.5
23.2
18.7
16.3
17.8
16.1
19.5
21.1
21.1
29.8
79.4
76.4
66.7
59.2
60.9
63.0
58.1
55.2
63.5
73.4
73.8
11.4
18.3
25.8
29.9
25.9
25.8
27.9
30.6
21.6
21.7
15.9
5.2
2.5
5.6
7.9
8.9
7.6
8.7
7.6
10.0
2.7
6.5
3.7
2.8
2.0
3.0
4.2
3.7
5.4
6.6
4.9
2.3
3.7
23.8
14.9
10.4
11.6
8.1
8.3
7.7
10.3
12.9
26.9
19.6
204
760
4004
0.7
3.1
14.2
1.1
4.0
21.7
0.5
1.3
9.0
0.1
0.5
2.9
0.2
0.5
1.4
0.3
1.0
4.6
8.3
16
Special middle
High
Marital status
Married
Never
married/single
Divorce/separated
Widow/widower
Cohabited
Residence
Rural
Urban
Employment
Currently
employed
Unemployed
2521
2632
5.4
4.6
17.7
19.5
6.7
7.7
1.8
1.7
0.8
0.9
2.6
3.0
6757
2456
13.6
12.0
47.2
11.4
19.1
3.8
5.1
1.1
2.4
0.9
8.0
2.2
308
384
219
0.4
1.2
0.7
1.7
2.6
1.1
1.1
0.6
0.6
0.4
0.2
0.2
0.4
0.1
0.1
0.3
0.7
0.2
5125
4997
15.7
12.3
30.7
33.3
12.1
13.1
3.4
3.6
2.5
1.3
5.4
6.0
4450
7.8
32.3
13.9
3.0
1.2
4.4
3255
7.5
19.5
8.8
3.4
2.4
3.8
Retired
823
2.3
6.1
1.3
0.4
0.2
1.9
Student
1606
10.4
6.1
1.2
0.3
0.1
1.4
Note: for some variables N may not equal 10145 because of missing data.
Women
n5005
Abstinent
18.3%
39.7%
Level I*
76.2%
59.1%
Level II**
1.4%
0.8%
Level III***
4.1%
0.4%
* Non-heavy drinking
** Hazardous drinking
*** Harmful drinking
17
Women
n5014
Abstinent
18.3%
39.7%
5.6%
11.1%
Level I*
61.9%
44.7%
Level II**
4.3%
1.8%
Level III***
10.0%
2.8%
* Non-heavy drinking
** Hazardous drinking
*** Harmful drinking
The proportion of respondents who consumed 20g of alcohol or more per day by gender
and age is shown in Figure 4.
Figure 4. Proportion (%) of total population who drink more than 20g alcohol a day on
average
30
30.0
23.824.323.9
23.1
20.0
24.1
20
20.8
20.5
12.7
10.0
10
10.3
8.5
6.9
5.3
0.0
2.4
15-19
3.3
6.5 7.0
Male
4.5
2.6
25-29
20-24
5.2 4.7
4.5
35-39
30-34
45-49
40-44
55-59
50-54
Gender of respondent
1.8
Female
65
60-64
Age of respondent
18
5.0
4.9
4.0
4.2 4.1
4.1
%Dailybingedrinking
3.8
3.2
3.0
2.6
2.6
2.3
2.0
2.2
1.8
1.0
0.0
1.2
1.0 1.0
Gender of respondent
1.2
.9
Male
.5
.3
15-19
Female
25-29
20-24
35-39
30-34
45-49
40-44
55-59
50-54
65
60-64
Age of respondent
The highest level among males compose 19.7% of men in the age 30-34 years old, and
among females 4.7% of women in the age 45-49 years old, proportion of men that have
binge drink at least weekly significantly higher than women in all age groups (Figure 6).
Figure 6. Proportion (%) of total population who binge drink (>60g a day) at least
weekly in entire life
30.0
20.0
19.7
18.5
18.017.617.7
17.0
14.7
10.0
10.6
8.6
5.9
2.0
0.0
15-19
25-29
20-24
35-39
30-34
4.7
Gender of respondent
Male
3.8
1.5 2.0
45-49
40-44
7.4
55-59
50-54
Female
65
60-64
Age of respondent
19
The highest level among males compose 55.7% of men in the age 35-39 years old, and
among females 15.4% of women in the age 35-39 years old, proportion of men that have
binge drink monthly significantly higher than women in all age groups (Figure 7).
Figure 7. Proportion (%) of total population who binge drink (>60g a day) at least
monthly in entire life
60.0
55.7
50.0
51.7
50.0
48.047.7
44.5
40.0
43.1
30.0
26.525.5
25.6
20.0
10.0
0.0
Gender of respondent
15.4
13.9
13.9
12.5
11.6
10.8
9.6
10.5
2.9
Male
3.0
15-19
25-29
20-24
35-39
30-34
45-49
40-44
5.3
55-59
50-54
Female
65
60-64
Age of respondent
Figures 8, 9 and 10 shows the proportions of people who drank in the last year and who
binged drink >60g of alcohol a day daily (Figure 8), at least weekly (Figure 9), and at least
monthly (Figure 10).
The highest level among males compose 7.7% of men in the age 15-19 years old, and
among females 2.7% of women in the age 45-49 years old, proportion of men that have
binge drink daily in the last year significantly higher than women in all age groups (Figure
8).
Figure 8. Proportion (%) of people who drank in last year who binge drink (>60g a
day) daily
10.0
8.0
7.7
6.0
%Bingedrinkingdaily
5.8
4.2
4.0
3.5
2.0
4.9
4.5
4.0
3.6
3.2
2.3
2.5
2.2
2.0
1.2
Gender of respondent
2.7
Male
Female
0.0
15-19
25-29
20-24
35-39
30-34
45-49
40-44
55-59
50-54
65
60-64
Age of respondent
20
The highest level among males compose 23.2% of men in the age 30-34 years old, and
among females 9.1% of women in the age 15-19 years old, proportion of men that have
binge drink at least weekly in the last year significantly higher than women in all age groups
(Figure 9).
Figure 9. Proportion (%) of people who drank in last year who binge drink (>60g a
day) at least weekly
30.0
23.2
20.0
20.8
20.8
19.9
19.119.7
%Bingedrinkingweekly
18.9
17.8
16.3
10.0
10.9
9.1
6.4
4.8
7.3
5.3 5.5 5.8
6.4
9.6
5.3
Gender of respondent
Male
3.1
0.0
Female
15-19
25-29
20-24
35-39
30-34
45-49
40-44
55-59
50-54
65
60-64
Age of respondent
The highest level among males compose 63.3% of men in the age 35-39 years old, and
among females 24.9% of women in the age 25-29 years old, proportion of men that have
binge drink at least monthly in the last year significantly higher than women in all age
groups (Figure 10).
Figure 10. Proportion (%) of people who drank in last year who binge drink (>60g a
day) at least monthly
70.0
63.3
60.7
60.0
57.1
54.052.9
50.6
53.4
50.0
40.0
39.4
30.0
20.0
34.9
34.8
32.9
24.9
22.6
22.3
21.620.8
20.5
19.3
16.8
Gender of respondent
10.0
12.3
6.2
0.0
15-19
25-29
20-24
35-39
30-34
45-49
40-44
55-59
50-54
8.3
Male
Female
65
60-64
Age of respondent
21
70.0
60.0
59.6
55.2
50.0
60.4
54.4
53.4
50.0
40.0
38.7
35.7
30.0
26.6
23.5
20.0
Gender of respondent
10.0
8.5
0.0
15-19
25-29
20-24
9.5
Male
Female
35-39
30-34
10.811.6
7.2
45-49
40-44
55-59
50-54
65
60-64
Age of respondent
The 22% of the entire sample scored positive on the AUDIT (i.e. score of 8 or more), 5% of
all women and 39% of all men.
A positive score increased with alcohol consumption: From 0% among abstainers, to 5%
among those who did not drink in the last year, to 26% of those who drink <20g a day, 58%
of those who drink 20-40g a day, 72% of those who drink 40-40g a day and to 77% of those
who drink more than 60g a day, Figure 12.
22
Figure 12. Proportion (%) of population who scored positive for AUDIT by alcohol
consumption
90
Proportion (%)
80
77
72
70
58
60
50
40
26
30
20
5
10
0
<20 g
20-40g
40-60g
>60g
3.5
13.6% of the total population meet the criteria of being dependent on alcohol (a score of 4
or more on the CIDI, Composite International Diagnostic Interview, instrument), 22% of men
and 5% of women, and the highest proportion composed by the males 32.3% in the age 4549 years old, and among females 6.8% in the age 35-39 years old (Figure 13).
Figure 13. Proportion (%) of total population who score positive for alcohol
dependence (based on CIDI)
40.0
32.3
30.0
29.128.9
28.1
%alcohol dependent
22.1
20.9
21.7
20.0
16.8
10.0
12.2
9.6
0.0
4.3
2.3
15-19
6.8
Male
25-29
20-24
35-39
30-34
45-49
40-44
Gender of respondent
55-59
50-54
Female
65
60-64
Age of respondent
23
55
48
Proportion (%)
50
40
35
30
20
15
10
0
0
0
<20g
20-40g
40-60g
>60g
Beer
21%
Vodka
42%
24
The Figure 16 shows that 32% of women mostly consumed vodka, 34% fermented horse
milk, 19% beer, 5% milk vodka, 7% wine and 3% other alcohol beverages.
Figure 16. Distribution of alcohol consumed by beverage type for women.
Milk vodka
5%
Wine Other
7% 3%
Fhm*
34%
Beer
19%
Vodka
32%
Alcohol
consumed by
the other
drinkers
33%
Alcohol
consumed by
the 10% of the
heaviest
drinkers
67%
25
The Figure 17b shows that 25% of the heaviest drinkers (of all drinkers) consume over the
4/5 of all alcohol consumed.
Figure 17b. Distribution of consumed alcohol.
Alcohol
consumed by
the other
drinkers
14%
Alcohol
consumed by
the 25% of the
heaviest
drinkers
86%
Bulgan
Uvurkhangai
Dundgovi
Dornogovi
Dornod
Sukhbaatar
Chingeltei
district
Bayanzurkh
district
47.3
23.8
20.4
15.0
38.8
18.7
17.8
20.0
22.4
18.2
22.9
Female 82.9
59.6
35.3
34.1
71.5
49.2
36.6
47.8
41.7
49.9
48.8
Male
UVS
Total
Location of interview
Bayan Ulgii
Gender of respondent
Table 7. Proportion of respondents that Did not drink in last year by aimag and
gender (%).
26
The Figure 18 presents that proportion of population that not drinks in last year was a little
lower in Ulaanbaatar, compared with elsewhere.
Figure 18. Proportion of respondents that Did not drink in last year by place of
interview
55.3
60
49.7
Proportion (%)
50
48.9
45.7
40
30
28
22.9
22.9
20.4
20
10
0
Aimag, provincial
centre
Aimag, sum
Male
Ulaanbaatar
Total
Female
The Figure 19 presents that proportion of population that not drink in last year was higher in
gers than in apartments or houses.
Figure 19. Proportion of respondents that Did not drink in last year by household
type and gender.
70
58.4
Proportion (%)
60
51.2
50
48.9
42.5
40
30
20
25.5
23.1
18
23
10
0
Apartment or
house
Ger or small
shack
Male
Nomadic ger
Total
Female
The Table 8 presents that proportion of population that not drink in last year was highest in
the younger age groups, and then started to rise again in the older age groups.
27
15-19
20-24
25-29
30-34
Age of respondent
35-39
40-44
45-49
50-54
55-59
60-64
65
70.8
35.1
17.4
15.1
12.4
11.1
10.5
15.2
13.2
25.4
22.
3
86.7
58.4
44.9
40.5
32.5
37.5
35.4
41.4
51.0
62.5
78.
9
Female
Male
Gender
of
respondent
Table 8. Proportion of respondents that Did not drink in last year by age and
gender (%).
The Table 9 presents that proportion of population that not drink in last year was very high
in Kazakh ethnicity.
Table 9. Proportion of respondents that Did not drink in last year by ethnicity and
gender (%).
Gender
of
respondent
Khalkh
Kazakh
Buriad
Uriankhai
Dorvod
Bayad
Torguud
Dariganga
Hoton
Burga
Zakhchin
Oold
Other
Ethnicity
Male
21.7
47.3
16.9
21.7
19.1
21.1
22.2
20.9
28.6
16.7
5.9
20.0
25.0
Female
45.7
83.2
39.2
38.5
53.3
56.4
66.7
50.0
52.4
42.9
31.3
38.5
55.6
The Table 10 presents that proportion of population that not drink in last year was highest
for single people (presumably younger).
Table 10. Proportion of respondents that Did not drink in last year by marital status
and gender (%).
Gender of
respondent
Married
Male
16.1
Never married/
single
43.8
Female
42.7
66.6
Marital status
Divorce/
Widow/widower
separated
12.2
13.9
28.7
56.3
Cohabited
32.7
45.2
The Table 11 shows that proportion of population that not drink in last year decreased with
increasing education level.
28
Table 11. Proportion of respondents that Did not drink in last year by education
and gender (%).
Gender of
respondent
none
Male
28.6
primary
below
33.6
Female
60.9
69.0
or
Education
middle
special middle
high
29.5
16.3
14.1
60.0
39.4
37.2
The Figure 20 shows that proportion of population that not drinks in last year was highest
for students.
Proportion (%)
Figure 20. Proportion of respondents that Did not drink in last year by employment
status and gender.
90
80
70
60
50
40
30
20
10
0
79
61.2
59.7
49.0
34.5
25.1
17.6
14.7
Currently
employed
Unemployed
Male
Retired
Student
Female
The Table 12 presents that proportion of population that not drink in last year was not in a
simple relationship with family income, but it tended to be higher for lower income families.
Table 12. Proportion of respondents that Did not drink in last year by family
income and gender (%).
>100.00
1
60.00170.000
90.001100.000
50.00160.000
80.00190.000
40.00150.000
70.00180.000
30.00140.000
20.00130.000
<20.000
Gender of
respondent
Male
26.0
23.8
19.0
24.3
19.3
15.4
20.4
13.1
12.1
13.5
Female
54.4
49.1
45.9
41.9
49.8
33.9
40.3
51.1
48.1
20.9
29
Mean
95% CI
Male
Female
3892
2491
29.7198
10.0457
27.6967-31.7429
8.7797 11.3117
The Table 14 presents mean of alcohol consumption among men and women among
drinkers by aimags and districts.
Table 14. Mean alcohol consumption (g/day) by gender, aimags and districts for
drinkers.
Male
Mean
Female
Mean
Aimag,
district
Bayan Ulgii
168
30.4739 22.1957-38.7520
48
15.2497
UVS
Bulgan
252
289
29.1025 20.9026-37.3024
69.6569 56.5353-82.7784
148
163
5.5930
25.4716
Uvurkhangai
272
53.9271 44.3703-63.4839
216
24.4162
Dundgovi
208
20.8742 14.6674-27.0810
75
7.1385
Dornogovi
254
52.5038 41.8085-63.1992
136
22.6832
Dornod
Sukhbaatar
Chingeltei
district
Bayanzurkh
district
261
271
950
18.7620 14.2354-23.2886
23.3309 17.2713-29.3905
20.4053 17.5963-23.2143
204
135
757
3.1634
3.9783
7.5048
961
20.1132 17.0121-23.2143
608
5.8025 4.3665-7.2384
95% CI
95%CI
4.460126.0393
2.9090-8.2770
15.745435.1978
16.650032.1824
3.614910.6620
14.539930.8264
1.8389-4.4878
.4606-7.4959
5.9130-9.0967
The Table 15 presents mean of alcohol consumption among men and women among
drinkers by place of interview. The mean alcohol consumption g/day of men is higher than
in women.
Table 15. Mean alcohol consumption (g/day) by gender and place of interview for
drinkers.
M
a
l
Gender of
responde
nt
Place of
interview
Mean
95% CI
Aimag, provincial
1106
36.3955
31.6968 - 41.0941
30
Female
centre
Aimag, sum
872
42.0770
37.2414 -46.9127
Ulaanbaatar
1911
20.2541
18.1627 -22.3456
Aimag, provincial
centre
Aimag, sum
640
9.8499
7.4407 - 12.2592
481
19.7724
15.0467 -24.4980
Ulaanbaatar
1368
6.7305
5.6440 - 24.4980
The Table 16 presents mean of alcohol consumption among men and women among
drinkers by age. The young people in the age 15-19 years old have a highest mean of
alcohol consumption among drinkers.
Table 16. Mean alcohol consumption (g/day) by gender and age for drinkers.
Age
Male
Female
N
Mean
95% CI
N
Mean
95% CI
15-19 161 39.9611
25.2722-54.6499
78
21.2209 9.1065-33.3354
20-24 359 27.4858
19.6808-35.2908
240
8.7631 5.1561-12.3701
25-29 490 26.6434
21.7799-31.5069
303 10.1660 7.1756-13.1563
30-34 528 33.4851
27.8232-39.1469
339
9.8531 6.8161-12.8900
35-39 566 32.6374
27.4510-37.8238
448 10.9020 6.9446-14.8595
40-44 547 26.5768
22.3056-30.8479
394
8.2940 5.8909-10.6970
45-49 493 31.2518
25.0884-37.4151
324 11.1232 7.3802-14.8662
50-54 346 31.8549
24.0035-39.7062
202 11.0062 6.4756-15.5369
55-59 190 30.0877
22.2993-37.8760
91
5.4264
3.0024-7.8503
60-64 139 18.6269
11.2937-25.9601
58
5.6458
.6558-10.6359
65
72 11.7096
5.0301-18.3890
13
3.3987 -2.5065-9.3038
The Table 17 presents mean of alcohol consumption among men and women among
drinkers by ethnicity.
Table 17. Mean alcohol consumption (g/day) by ethnicity and gender for drinkers.
Ethnicity
Khalkh
Kazakh
Buriad
Uriankhai
Dorvod
Bayad
Torguud
Dariganga
Hoton
Burga
Zakhchin
Oold
Other
Male
N
2762
169
254
18
152
227
13
190
47
10
16
16
12
Mean
95% CI
N
30.7823 28.2654 - 33.2992 1896
31.3648 23.3548 - 39.3749
49
31.6617 24.0371 - 39.2862 159
45.4879 9.2713 - 81.7044
16
22.8867 14.4094 - 31.3640
96
23.4312 15.5450 -31.3174
117
31.5682 -4.0916 - 67.2280
5
18.7736 12.6862 - 24.8611
98
48.8201 27.0419 - 70.5983
27
15.1425 -7.4218 - 37.7067
4
21.4750 -.9177 - 43.8678
11
29.8502 3.0828 - 56.6175
8
20.1720 4.5965 - 35.7475
4
Female
Mean
10.5472
23.0249
10.4743
7.9430
4.6936
4.1480
1.7782
1.7629
23.9565
8.3405
5.7780
29.5100
2.0239
95% CI
9.0246- 12.0699
8.8834 - 37.1665
5.6836 - 15.2649
2.7339 - 13.1520
1.7916 - 7.5956
.0945 - 8.2014
-.3793 - 3.9357
1.3271 - 2.1986
10.4160 - 37.4969
-6.9673 - 23.6484
1.6706 - 9.8854
-8.7305 - 67.7506
-.0044 - 4.0522
31
The harms from someone who was intoxicated were different among men and women.
Table 18b. Harms from other peoples drinking (% of all men and % of all women).
In the past 12 months, has a stranger who was intoxicated:
Beat you up, mugged or attacked you?
10.9
0.9
5.1
0.5
Hit you with something?
11.4
0.9
4.7
0.3
Something from you by force or threat of
4.7
0.7
1.9
0.2
force?
Forced you to have sex with them?
1.2
0.3
1.0
0.1
The harms from family member that was intoxicated were different among men and women.
The women more than men have been exposed for harms from intoxicated family member.
Table 18c. Harms from other peoples drinking (% of all men and % of all women).
In the past 12 months, has a member of your family who was intoxicated:
Beat you up, mugged or attacked you?
6.0
1.2
12.1
Hit you with something?
6.7
0.8
10.7
Something from you by force or threat of
1.2
0.4
1.5
force?
Forced you to have sex with them?
0.9
0.3
2.9
3.4
2.6
0.8
0.6
Gender of respondent
Male
Female
n
%
n
%
Been admitted to hospital (apart 929
9.2
936
9.4
from delivery of live born child)
Total
n
1865
%
18.6
2.0
89
0.9
295
2.9
4.9
293
2.9
788
7.9
8.3
71
0.7
906
9.0
33
1.5
21
0.3
160
1.8
Received
treatment
from
neurologist for alcohol problems
a 298
3.0
33
0.3
331
3.3
3.4
50
0.5
394
3.9
Total
n
2578
%
25.9
821
8.3
or 1486
15.0
1525
15.4
3011
30.4
or 315
3.2
267
2.7
582
5.9
557
5.6
404
4.1
961
9.6
Gastritis
1154
11.7
1042
10.6
2196
22.4
Pancreatitis
518
5.2
441
4.4
959
9.6
Head injury
650
6.5
457
4.6
1107
11.1
791
7.9
780
7.8
1571
15.8
Anxiety or stress
1400
14.0
1555
15.6
2955
29.6
A figure 21, 22 and 23 shows the proportion of respondents with self-reported adverse
health outcomes by quantity of pure ethanol consuming per day. The proportion with
adverse health outcomes increased with increasing alcohol consumption.
34
Proportion (%)
Figure 21. Proportion of respondents with high blood pressure, cirrhosis of the liver
and rapid heart beat compare by quantity of alcohol consumed per day.
45
40
35
30
25
20
15
10
5
0
42.1
38.5
31.2
42.0
37.5
33.1
34.7
17.9
30.2
29.5
26.6
18.8
17.8
4.8
Abstainer
11.9
7.8
6.0
0 last year
<20g
22.1
20-40g
40-60g
>60g
Figure 22. Proportion of respondents with heart attack and head injury by quantity of
alcohol consumed per day.
40
Proportion (%)
35
22.1
30
15.0
25
20
15
6.8
10
4.3
24.1
10.6
10.8
7.0
5.4
7.7
13.1
4.2
0
Abstainer
0 last year
<20g
20-40g
40-60g
>60g
Head injury
Proportion (%)
Figure 23. Proportion of respondents with depression or low mood and anxiety or
stress by quantity of alcohol consumed per day.
45
40
35
30
25
20
15
10
5
0
42.8
35.7
32.7
22.4
17.7
Abstainer
34.0
30.3
28.6
9.1
41.9
13.2
0 last year
15.9
<20g
20-40g
40-60g
>60g
Anxiety or stress
35
Gender of respondent
Male
Female
n
%
n
%
1459 22.6 429 6.7
Total
n
1888
%
29.2
934
14.5
77
1.2
1011
15.7
1356
21.0
178
2.8
1534
23.8
1205
18.7
138
2.2
1145
17.8
924
14.3
94
1.5
869
13.5
1279
19.8
316
4.9
1595
24.7
1735
26.9
576
8.9
2311
35.9
699
10.9
164
2.5
863
13.4
1071
16.6
333
5.2
1404
21.8
36
1312
20.4
272
4.2
1584
24.7
694
10.8
168
2.6
862
13.4
684
10.6
183
2.8
867
13.5
1822
28.4
702
10.9
2524
39.3
1193
18.6
347
5.4
1540
24.0
Mean
95% CI
Male
Female
Total
3460
1989
5449
18223.1
11482.1
15762.5
17140.3-19305.9
10605.7-12358.4
14999.5-16525.5
37
The results showed that 10% of the heaviest drinkers (of all drinkers) consumed about 2/3
of all alcohol consumed and 25% of the heaviest drinkers (of all drinkers) consumed over
4/5 of all alcohol consumed.
The proportion of the total population who did not drink alcohol in the previous year by
gender was highest in Bayan Ulgii (47.3% male, and 82.9% female); this is probably due to
religious beliefs, because a most Islamic people live in Bayan Ulgii and the proportion of the
population that did not drink in last year was very high amongst Kazakh ethnic people also.
The lowest proportion of abstainers was in Uvurkhangai (15.0% male, and 34.1% female).
The proportion of the population that not drink alcohol in the last year was a little lower in
Ulaanbaatar, compared with elsewhere, and the proportion of the population that not drinks
in the last year was higher in gers than in apartments or houses, suggesting that
urbanization led to an increase in alcohol consumption. The proportion of the population
that not drink in last year was highest in the younger age groups, and then started to rise
again in the older age groups, and the proportion of the population that not drink alcohol in
the last year was highest for single people (presumably younger). The proportion of the
population that not drinks in the last year decreased with increasing education level, but
was highest among students. The proportion of the population that not drink alcohol in the
last year did not show a simple relationship with family income, but tended to be higher for
lower income families.
The mean alcohol consumption (g/day) was three times higher for men than for women, in
all places of interview such as provincial centers, sums and Ulaanbaatar city. The highest
mean alcohol consumption (g/day) amongst drinking men and women was for the 15-19
year old age group.
The harms from other peoples drinking were different among men and women; most men
had serious arguments or quarrels as a result of someone elses drinking; had been
disturbed by loud parties or the behaviour of other people drinking; and had been insulted
or humiliated by someone who had been drinking. Most women had been afraid of
intoxicated people that they had encountered on the street; had been insulted or humiliated
by someone who had been drinking; and had serious arguments or quarrels as a result of
someone elses drinking.
The harms from family members who were intoxicated were different among men and
women. More women than men have been exposed to harm (domestic violence) from an
intoxicated family member.
The survey showed that, during the previous 12 months, 18.6% of all respondents had
been admitted to the hospital, 2.9% had received medical care or treatment in a hospital
emergency room, 7.9% had suffered injuries that caused them to seek medical help or cut
down their usual activities for more than half a day, 9.0% had been admitted to a sobering
up station, 1.8 % had received compulsory treatment for alcohol problems, 3.3% had
received treatment from a narcologist for alcohol problems, and 3.9% had received advice
or treatment from a family doctor for alcohol problems.
Looking at self-reported health status, the survey found that the largest proportion
respondents reported having high blood pressure or hypertension, rapid heart beat or
tachycardia, gastritis, depression or low mood, and anxiety or stress, the reporting of all of
which increased with increasing alcohol consumption.
39
In relation to social problems, many respondents reported a period of drinking or being sick
from drinking with taking care at home, spending money on drinks which was needed for
essentials, and continued drinking even though they knew that it was causing trouble for
theirs family or friends.
Over half the respondents had spent on average 15762.5 tugrik for alcohol in the previous
month, the average amount of money spent by men in alcohol was significantly different
from women, and it was high when compared with the proportion that show that 37.4% of
population of survey have low family income per family member per month (<20.000 tugrik).
Chapter V. Conclusion
1. This is the first time that a countrywide Epidemiological study on prevalence of
alcohol consumption, alcohol drinking patterns and alcohol related harms in such
big sample as 10,000 of the population aged between 15 and 65 years has been
undertaken in Mongolia.
2. The Epidemiological study on prevalence of alcohol consumption, alcohol drinking
patterns and alcohol related harms in Mongolia used internationally based validated
tools and questionnaires to measure alcohol consumption, alcohol drinking patterns
and alcohol related harms.
3. According to the needs of the Mongolian National program on alcohol prevention
and control (2003) the survey identified the prevalence of alcohol dependence,
harmful and hazardous drinking, episodic heavy drinking and alcohol related harm.
4. In our survey, nearly 1.8% of women and 4.3% of men described themselves as
hazardous drinkers and 10.0% of men and 2.8% of women as harmful drinkers.
5. This survey found that 13.6% of the total population met the criteria of being
dependent on alcohol (a score of 4 or more on the CIDI, Composite International
Diagnostic Interview, instrument), 22% of men and 5% of women.
6. The risk of alcohol dependence increased with alcohol consumption from 0% in nondrinkers to 15% of those who drink, but less than 20g a day, to 35% of those who
drink between 20 and 40g a day, to 48% of those who drink between 40 and 60g a
day, and to 55% of those who drink more than 60g a day.
7. Nearly 40% of women and 18% of men described themselves as life-time abstainers,
and 5.6% of men and 11.1% of women as 1-year abstainers.
8. The level of daily, weekly and monthly episodic heavy drinking was very high.
9. In terms of volume, the highest consumed beverages were vodka, beer and
fermented horse milk.
10. The heaviest drinkers (of all drinkers) consume about 2/3 of all the alcohol
consumed.
11. The mean alcohol consumption (g/day) of men was almost three times higher than
that of women.
40
12. The harms caused from other peoples drinking were different among men and
women, with more women being exposed to domestic violence from an intoxicated
family member.
13. The following figures showed insufficient narcology care in all levels of health
system: 9.0% of all respondents had been admitted to a sobering up station during
the previous year, 1.8 % had received compulsory treatment for alcohol problems,
3.3% had received treatment from a narcologist for alcohol problems, and 3.9% had
received advice or treatment from a family doctor for alcohol problems.
14. Self-reported high blood pressure or hypertension, rapid heart beat or tachycardia,
gastritis, depression or low mood, and anxiety or stress increased with increasing
alcohol consumption and showed harm related to alcohol use.
15. Most respondents reported social problems related to alcohol use, such as having a
time when their drinking or being hung over interfered with their work at school, or a
job, or at home; having a time when they have more to drink than they intended to,
or drink much longer than they intended to; having a period of drinking or being sick
from drinking with taking care at home.
16. The average amount of money that was spent in the last month on buying alcohol
was high compared with an average low family income of respondents in our survey.
Chapter VI. Recommendations
An intersectoral ministerial committee responsible for the implementing of National
program of alcohol prevention and control that set up on 2004 in Mongolia should
be develop policies and programs to reduce the harm done by alcohol
A comprehensive alcohol policy under the National program of alcohol prevention
and control (2003) needs to be drawn up to reduce the harm done by alcohol in
Mongolia, and results of our survey needs to be used in the implementing of
National program on control and prevention from non-communicable diseases
(2005) in the actions that reduce alcohol consumption among population and adopt a
behaviour for responsible drinking.
The plan and program should be evidence based and based on the conclusions and
recommendations of recent scientific publications and those of the World Health
Organization
The plan and program needs to be implemented in stages over several years with
the wide community involvement, to ensure that there is wide spread support by the
population for the plan
Non-governmental organizations should be created and funded to involve civil
society in the implementation and monitoring of policies and programs.
A first important priority is to mount a comprehensive education and information
campaign to inform the public about the alcohol problem facing the country and the
need to do something about it
A second important priority is to ensure that primary health care providers throughout
the country are trained in the recognition of hazardous and harmful alcohol
consumption and are trained in the skills that are needed for delivering brief but
effective advice to hazardous and harmful drinkers to cut down on their drinking
41
A third important priority is to put impact on the developing of narcology care with
comprehensive advocacy and leadership role for all sectors of health system in the
term of constant supporting in the prevention and promotion
The accessibility to receiving narcology care need to be improved and developed in
all levels of health system
In the urban areas, an assessment should be made of the existing price structures,
availability and advertising and marketing of alcoholic products, so that these are
best made to reduce the harm done by alcohol; usually this means that alcohol
should not be too cheap, readily available or marketed.
Local municipalities and jurisdictions should draw up their own plans and programs
on how best to reduce the harm, and in particular the intoxicating harm, that can be
done by alcohol, ensuring the full involvement of the public in the design and
implementation of the plans; a local action committee should be set up, with
involvement of health care providers and other relevant personnel.
42
Part 1
1.1 Name of Interviewer:
1
1
2
3
4
5
6
7
8
9
10
10
1
2
3
11
1
2
3
13
14
15
16
43
1.8 Number of adults aged 15-65 who are now present in household:
17
Age
(years)
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
Part 2
READ OUT
First, I am going to ask some questions about yourself
2.1
Male
Female
2.2
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65
2.3
38
1
2
39
40
41
42
1
2
3
4
5
6
7
8
9
10
11
What is your ethnicity?
Khalkh
Kazakh
Buriad
Uriankhai
Dorvod
Bayad
Torguud
Dariganga
Hoton
1
2
3
4
5
6
7
8
9
44
Burga
Zahckin
Oold
Other
2.4
43
1
2
3
4
5
None
Primary or below
Middle
Special middle
High
2.6
Specify:
Married
Never married/single
Divorce/ separated
Widow/ widower
Cohabited
2.5
10
11
12
13
44
1
2
3
4
5
Are you?
Currently employed
Unemployed
Retired
Student
45
1
2
3
4
SKIP TO QU 2.8
2.7
46
47
48
49
50
51
20.000
20.001-30.000
30.001-40.000
40.001-50.000
50.001-60.000
60.001-70.000
1
2
3
4
5
6
45
70.001-80.000
7
80.001-90.000
8
90.001-100.000
9
100.001
10
2.10 If a woman aged between 15 and 49,
are you pregnant at this time?
Yes
1
No
2
52
Yes
No
Dont
know
3
53
3
54
3
55
56
Part 3
READ OUT
Now, I am going to ask you some questions about alcohol and its effects.
3.0
Yes
No
3.1
Monthly or less
2-4 times a month
2-3 times a week
4 or more times a week
57
58
1
2
3
4
READ OUT
The next two questions ask how often you drink various amounts of drinks. By drink, I mean the
equivalent of: one 330ml glass, can, or bottle of beer (5%); one 500 ml bowl of fermented horse milk
(5%); one 50 ml glass or cup of vodka (40%); one 100 ml glass or cup of milk vodka (15%); or one
100 ml glass of wine (100 ml) (12.5%).
3.2
59
60
1
46
61
3.5
How often during the last year have you needed a first drink in
the morning to get yourself going after a heavy drinking
session?
Never
1
Less than monthly
2
Monthly
3
Weekly
4
Daily or almost daily
5
62
3.6
How often during the last year have you had a feeling of guilt
or remorse after drinking?
Never
1
Less than monthly
2
Monthly
3
Weekly
4
Daily or almost daily
5
63
3.7
How often during the last year have you been unable to
remember what happened the night before because of you
drinking?
Never
1
Less than monthly
2
Monthly
3
Weekly
4
Daily or almost daily
5
3.9
Have you or someone else been injured because of your
drinking?
No
1
Yes, but not in the last year 2
Yes, during last year
3
64
3.8
65
66
3.10
67
47
Part 4
READ OUT
Now, I am going to ask you some more detailed questions about drinking beverages that contain
alcohol.
4.1
In the past year, have you consumed one or more drinks of any
type of alcoholic beverage?
68
Yes
1
No
2
SKIP TO PARTS 6 & 7
4.2
During the last 12 months, how often did you usually have any
kind of drink containing alcohol?
Every day
1
4 to 6 times a week
2
1 to 3 times a week
3
2 to 3 times a month
4
Once a month
5
3 to 11 times in the past year
6
1 or 2 times in the past year
7
69
READ OUT
The next few questions ask how often you drink various amounts of drinks. By drink, I mean the
equivalent of: one 330ml glass, can, or bottle of beer (5%); one 500 ml bowl of fermented horse milk
(5%); one 50 ml glass or cup of vodka (40%); one 100 ml glass or cup of milk vodka (15%); or one
100 ml glass of wine (100 ml) (12.5%).
3 to 11 times
in the past year
1 or 2 times in
the past year
Vodka
FHM*
Vodka
milk
Wine
Other
Once a month
2 to 3 times a
month
Beer
Every day
1 to3 times a
week
4.3
70
71
72
73
74
75
48
1 to3 times a
week
2 to 3 times a
month
3 to 11 times
in the past year
1 or 2 times in
the past year
Vodka
FHM*
Vodka
milk
Wine
Other
Once a month
4 to 6 times a
week
Every day
Beer
76
77
78
79
80
81
3 to 11 times
in the past year
1 or 2 times in
the past year
Vodka
FHM*
Vodka
milk
Wine
Other
Once a month
2 to 3 times a
month
Beer
Every day
1 to3 times a
week
4.5
82
83
84
85
86
87
49
1 to3 times a
week
2 to 3 times a
month
3 to 11 times
in the past year
1 or 2 times in
the past year
Vodka
FHM*
Vodka
milk
Wine
Other
Once a month
4 to 6 times a
week
Every day
Beer
88
89
90
91
92
93
3 to 11 times
in the past year
1 or 2 times in
the past year
Vodka
FHM*
Vodka
milk
Wine
Other
Once a month
2 to 3 times a
month
Beer
Every day
1 to3 times a
week
4.7
94
95
96
97
98
99
Part 5
READ OUT
Now, I am going to ask you some questions about various things that can happen to people when
they drink alcohol
5.1
Yes, 1-2
Yes, 3+
50
times
100
3
101
3
102
No
Yes, 1-2
times
Yes, 3+
times
5.2
times
103
104
105
Yes
No
2
106
Yes
No
107
108
109
110
111
2
112
2
113
Part 6
READ OUT
Now, I am going to ask you some questions about your experience with other people's drinking
6.1
Yes, 1-2
Yes, 3+
51
6.2
times
times
No
Yes, 1-2
times
Yes, 3+
times
iv
6.3
iv
116
117
118
119
120
121
122
3
124
125
126
127
128
1
1
Yes, 1-2
times
2
2
Yes, 3+
times
3
3
129
130
131
132
In the past 12 months, has a member of your family who was intoxicated:
No
i
ii
iii
115
123
No
i
ii
iii
114
1
1
Yes, 1-2
times
2
2
Yes, 3+
times
3
3
133
134
135
136
52
Part 7
READ OUT:
Finally, I am going to ask you some questions about your health.
7.1
7.2
No
Yes, 1-2
times
Yes, 3+
times
137
138
139
140
141
142
143
Yes
1
No
2
Yes
1
1
No
2
2
144
145
146
147
148
vi. Gastritis
149
vii. Pancreatitis
viii. Head injury
ix. Depression or low mood
x. Anxiety or stress
150
151
152
153
READ OUT
I now have one final question.
7.3
154
References:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Edwards. G., Anderson, P., Babor, T., Caswell, S., Ferrence, R., Giesbrecht, N.,
Godfrey, C., Holder, H., Lemmens, P., Makela, K., Midanik, L., Norstrom, T.,
Osterberg, E., Romelsio, A., Room, R., Simpura, J., & Skog, O.-J. (1994) Alcohol
Policy and the Public Good. Oxsford: Oxford University Press.
English, D. & Holman, D. et al. (1995) The quantification of Drug Caused Mortality in
Australia 1992, Commonwealth Department of Human Services and Health,
Canberra.
English, D., Holman, D. (1995) et al., The Quantification of Drug Caused Mortality in
Australia 1992, Commonwealth Department of Human Services and Health,
Canberra.
Erdenebayar L., Epidemiology, clinic, and management basis of prevention from
alcoholism in Mongolia. Aftoreferat. Tomsk, 1997.
Hao, W., Young, D.S. and He, M. Alcohol drinking in China: present, future and
policy. Chinese Journal of Clinical Psychology 3, 1995.
Hao, W., Su Z., Liu B., Zhang K., Yang H., Chen S., Biao M., Cui C. Drinking and
drinking patterns and health status in the general population of the five areas of
China. Alcohol & Alcoholism Vol. 39, No.1.
Haworth, A. & Acuda, W. (1998) Sub-Saharan Africa. In: Grant, m. (Ed) Alcohol and
Emerging Markets. International Center for Alcohol Policies: Washington.
Knowledge, attitude and practice towards risk factors of non-communicable
diseases, 2002. Public Health Institute, Ulaanbaatar, 2002.
Makela, P, Valkonen, T. & Martelin, T. (1997) Contribution of deaths related to
alcohol use to socioeconomic variation in mortality: register based folow up study.
British Medical Journal, 315.
Mongolian Steps Survey on Non-Communicable Disease Risk Factors 2006, Public
Health Institute, Ulaanbaatar, 2006.
Murray, C.J.L & Lopez, A.D. (1997) The global burden of disease: a comprehensive
assessment of mortality and disability from diseases, injuries, and risk factors in
1990/1996. Harvard Svchool of Public Health Cambridge, MA, for the World Health
Organization.
National program of alcohol prevention and control (2003), Ulaanbaatar, Mongolia
National program on control and prevention from non-communicable diseases
(2005), Ulaanbaatar, Mongolia
Shultz, J., Rice, D., Parker, D., Goodman, R., Stroh, G. & Chalmers, N. (1991)
Quantifying the disease impact of alcohol with ARDI software, Public Health
Reports,106, 1991.
Turner, C. (1990) How much alcocol is in a standard drink? An analysis of 125
studies. British Journal of addiction, 85.
Vroublevsky, A. & Harwin, J. (1998) Russia. In: Grant, M. (Ed) Alcohol and Emerging
Markets. International Center for Alcohol Policies: Washington.
World Health Organization.International Guide for Monitoring Alcohol Consumption
and Related Harm. Department of Mental Health and Substance Dependence, NCD
and MHC, WHO, 2000.
World Health Organization (2000) The Global Status Report on Alcohol. WHO:
Geneva, 1999.
Zhou, Shisi. (1984) Clinical analysis of 278 liver cirrhosis cases. Guangdong
Medicine, 5.
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