Socio-demographic and socio-contextual factors associated with problematic alcohol drinking in the Eastern Hills of Nepal: a case-control study

<i>Background:</i> In Nepal, alcohol consumption is traditionally accepted within the religious and cultural practices of tribal communities. The Dhankuta district of Nepal, a hilly area of Eastern Nepal, is home to many indigenous and tribal communities. However, the socio-demographic and socio-contextual factors related to problematic alcohol drinking in these high-risk groups remain unexplored.<i>Objectives:</i> To examine how socio-demographic and socio-contextual factors contribute to predictors of problematic drinking in the Eastern Hills of Nepal.<i>Methods:</i> A case-control study was conducted in the Dhankuta district of Eastern Nepal in 2019. The CAGE questionnaire and AUDIT scale were used to identify problematic drinking. A sample size of 100 cases (male: female = 2.1) and 100 controls (male: female = 1.9) were purposively selected. Socio-demographic factors and socio-contextual factors were assessed. Bivariate and multiple logistic regression were used for analysis. The predictive ability of the regression model was assessed using diagnostic test characteristics.<i>Results:</i> In multivariable analysis, five factors remained significantly associated with problematic drinking after potential confounders were included: strongly disagreeing parental attitude toward individual's alcohol use [OR = 0.42 (0.18-0.98), <i>p</i> = .045], peer alcohol use [OR = 9.03 (1.21-67.38), <i>p</i> < .001], accepting alcohol offers made by friends (susceptibility) [OR = 33.10 (12.30-89.07), <i>p</i> < .001], lower socio-economic status [OR = 2.81 (1.12-7.04), <i>p</i> = .027] and nicotine use disorder [OR = 4.01 (1.28-12.54), <i>p</i> = .017]<i>Conclusion:</i> Predictors of problematic alcohol use in a tribal region of the Eastern Hills of Nepal resemble those observed globally, suggesting the potential applicability of cross-cultural public health strategies.