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- Noncommercial alcohol exists in many forms, both licit and illicit, and is estimated to account for a significant portion of all alcohol consumed worldwide.
- Since noncommercial alcohol is not taxed, regulated, or recorded, there is a dearth of information about the patterns of its consumption and related outcomes.
- Traditional home-produced beverages are part of the local culture of many countries and generally are not associated with increased risk for harm.
- In some countries, noncommercial alcohol—especially illicit, counterfeit, or smuggled beverages—represents a serious social, economic, and public health problem.
- Problematic drinking patterns around noncommercial alcohol are often the result of complex social and economic conditions and may be influenced by restrictive government policies.
- Harm reduction approaches can be applied successfully to prevent the harm and to develop policies around noncommercial alcohol.
- For examples of interventions, see the online database Initiatives Reporting: Industry Actions to Reduce Harmful Drinking.
Noncommercial alcohol goes by many names: moonshine, bootlegged, local, illicit, or unrecorded alcohol. It includes alcohol beverages that are not produced within a commercial setting and are therefore not reflected in official statistics, such as sales figures. These beverages are largely outside of government control and as a result are not taxed. Finally, noncommercial alcohol is often not subject to the same standards of quality and purity as its commercially produced counterparts.
Noncommercial alcohol accounts for “at least two thirds of all alcohol consumption in the Indian subcontinent, about half of consumption in Africa, and about one third in eastern Europe and Latin America” (World Health Organization, 2004, p. 15). However, the lack of data about noncommercial alcohol makes research into the drinking patterns around it difficult. There is currently a dearth of scientific evidence about noncommercial alcohol, its production, consumption patterns, and related outcomes (Gudmundsdottir, 1988; Heath, 2000; Larson & Hanson, 1992; Martinic, 1998; Nordlund, Holme, & Tamsfoss, 1994).
Although the production of many noncommercial beverages meets high standards of quality (Haworth & Simpson, 2004), a lot of what is included under this heading is of poor quality, often contaminated and toxic. This latter category represents a serious public health problem in many countries, particularly in the developing world and in countries undergoing rapid social and economic transition (Grant, 1998; Ryan, 1995).
Types of noncommercial alcohol
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Noncommercial alcohol is found in virtually every country around the world and includes a range of traditional drinks that are home-produced, largely for personal consumption, but also for sale. Another category includes beverages that are produced illegally for commercial (but illicit sale) or counterfeit alcohol that is passed off as commercial products.
Noncommercial alcohol often takes the form of traditional beverages that reflect the local drinking culture and occupy a particular place within a given society. These beverages may be distilled, fermented, or brewed from a wide range of different ingredients. For example (Haworth & Simpson, 2004):
- In Brazil, cachaça, a distillate made from sugarcane, is the national alcohol beverage. Cachaça is produced both legally and illegally. While exact figures are lacking, there is evidence that the overwhelming proportion of production is illicit. Out of the distilleries in just a single Brazilian state, for example, only 10% are registered. The remaining 90% produce noncommercial cachaça.
- In Mexico, traditional alcohols run the gamut from tequila to pulque and aquardiente. While tequila and aguardiente may be both legally and illegally produced, pulque (fermented from the agave plant) is a noncommercial beverage type found most commonly in rural areas.
- In Zambia, the most popular types of beverages are homebrewed beers (opaque beers) and kachasu, a distilled spirit made of sorghum, maize, sour beer, sugar, and yeast.
- Russian samogon, distilled spirits with similar alcohol content to vodka, is not commercially produced but typically made in the home.
- Although Hungarian palinkas, or fruit brandies, may be produced and purchased commercially, they are largely produced as noncommercial products.
- Traditional beverages in India include toddy, fermented from the flower of coconut and other palms, urrack, a distillate from the fruit of the cashew tree, and arrack, distilled from paddy or wheat.
- In the Mediterranean regions of France, Italy, Spain, Greece, Croatia, and other countries, home production of wine is a long-standing tradition.
The production and drinking patterns accompanying the consumption of traditional alcohol is an integral part of many local cultures (Heath, 2000; Mateos, Paramo, Carrera, & Rodriguez Lopez, 2002). For example, communal drinking of local beers from a common vessel is part of the drinking culture in many rural areas of Africa.
Traditional beverages are mostly produced noncommercially, generally for personal consumption, but also for sale. Some countries allow the home production of a certain amount of beverage alcohol for sale. As a result, most traditional beverages are of high quality in order to encourage repeat customers to buy a particular product (Nuzhnyi, 2004).
However, not all products are of consistent quality. Many local alcohols are contaminated, toxic, and, thus, represent a health hazard (Mosha, Wangabo, & Mhinzi, 1996). Even when one excludes the deliberate adulteration of beverages and the use of dangerous and low-quality ingredients to produce cheap beverage alcohol, the production process itself may pose considerable risk. For example, there have been reports of local beers brewed in old oil drums, thereby introducing toxic contaminants. Similarly, the fermentation process of pulque often relies on the use of animal excrement that contributes to high levels of bacterial contamination, representing a significant health risk (Rosovsky, 2004).
While traditional beverages produced and consumed in the home environment represent much of noncommercial alcohol, a large proportion of it is illicit and is made for the purposes of sale (Rossow, 2003). This includes (Lemmens, 2000; Room & West, 1998):
- Beverages produced commercially but passed on informally, for example by smuggling or cross-border trade (Willis, 2003). For instance, where taxes are high, other jurisdictions can offer the same product for a lower price on the black market. In other cases, consumers themselves may purchase beverage alcohol in neighboring countries where the taxes are lower.
- Beverages produced illegally but for commercial (often illicit) sale. This includes poor quality products manufactured and sold cheaply. There have been numerous reports of contamination of very cheap beverage alcohol with methanol or battery acid (e.g., Willis, 2003). Counterfeit beverage alcohol, packaged as legitimate commercial products, is a serious problem in some countries, particularly where the substituted product is of poor quality. Such illicit alcohol becomes the alternative of choice especially in countries where sales and production may have been severely restricted (e.g., in the Soviet Union during the 1980s).
In addition to being a public health concern, illicit alcohol production and trade are also often associated with organized crime and thus represent a significant public order and safety issue (e.g., Junninen & Aromaa, 2000).
Public health and social considerations
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What people drink is one of the key components of drinking patterns and can be at least as important as how much they drink. This includes both commercially produced and noncommercial alcohol, legal and illicit. The quality of the product has a significant impact on the potential health outcomes for its consumers.
As with commercially produced beverages, moderate drinking patterns of high quality traditional beverages and noncommercial alcohol are associated with health benefits for many people.
However, noncommercial alcohol that is contaminated or in some way adulterated presents a serious risk to health (Holstege, Ferguson, Wolf, Baer, & Poklis, 2004). For example, methanol contamination can lead to blindness and even death, and there have been reports of bad batches of beverages contaminated by methanol, lead, and arsenic from countries around the world abound (Haworth & Simpson, 2004, pp. 6–7; Holstege et al., 2004; Hudson, Crecelius, & Gerhardt, 1980; Silverberg, Chu, & Nelson, 2001; Tonkabony, 1975). Similarly, high levels of liver cirrhosis have been reported among those who drink beverages with the bacterial contamination, even when these individuals are not heavy or frequent drinkers (Lovelace & Nyathi, 1977).
For the purposes of prevention, the relationships between beverage type and health outcome is an important one to consider. For some people, what they consume is more important than how much they consume when it comes to health risks.
To date, research data on noncommercial alcohol is inadequate. Given the difficulty of tracking these beverage types, particularly those that are illicit, figures about consumption and sales and data on drinking patterns are hard to collect.
Problems associated with some noncommercial beverages are closely connected to a number of social, economic, and cultural issues. As a general rule, noncommercial alcohol is often the choice of the poor and marginalized (MODULE 8: “At-risk” Populations). For many people, especially in developing and transition economies, it provides a cheaper substitute for beverages that are often heavily taxed and therefore inaccessible to certain population groups. Studies have shown that particularly the elderly in many countries are among the primary consumers of noncommercial beverages, and that young people in some countries are also increasingly choosing these cheaper alternatives (Kelleher, Rickert, Hardin, & Pope, 1991; Larson & Hanson, 1992; Österberg, 1989).
Government policies, often focused on reducing consumption by limiting availability and access, can be a direct contributor to public health and social problems around noncommercial alcohol. Restricted availability and high taxation rates have been shown to shift trade toward the gray and black markets where quality standards do not apply and cannot be enforced (Hauge & Amundsen, 1994).
The economic impact of unrecorded alcohol is difficult to evaluate. However, in some areas, the home production of beverage alcohol is a vital part of the local economy. In many places, women may be its primary producers, contributing significantly to the support of their families. In other countries, limited legal sale of home-produced beverages is also an economic contributor.
At the same time, illegal sales, cross-border traffic, and smuggling represent a significant drain on government revenue. Governments stand to gain by the sale of taxed beverage alcohol within their jurisdictions. When these sales shift to other jurisdictions, revenue is lost (Nordlund & Österberg, 2000).
Unrecorded alcohol, whether legal or illicit, also represents a loss of revenue for commercial producers. Since it is in direct competition with commercial products and a cheaper alternative due to its untaxed status, noncommercial alcohol represents an economic threat to commercial producers.
Implications for policy and prevention
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Regulating the production and consumption of noncommercial alcohol presents a challenge and a balancing act. On the one hand, there is the need to reduce problems by increasing regulation of these products. On the other, policy-makers must ensure the wellbeing and safety of the population and minimize the potential for harm (Single, 2004).
It is important that policies around noncommercial alcohol take into account the strong cultural role that these beverages play in many communities and traditions (Heath, 1995). Effective policies require popular support and should take into consideration local practices, making reasonable allowances for them.
However, where noncommercial alcohol production and consumption are problematic, policy approaches may require special attention to several areas:
1. The relationship between consumption patterns and health/social outcomes
- More research is needed around drinking patterns associated with beverage alcohol and should be a priority, particularly in developing and transition societies.
- Better data are needed around what people drink in different countries, the demographics of the drinkers, trends in the consumption of noncommercial alcohol, shifts that may coincide with the implementation of policy measures, and accurate data on the health outcomes of particular drinking patterns.
2. Policy measures to address the potential for harm that may result from certain types of noncommercial alcohol
- Prevention approaches are needed to reduce the potential for harm and possible adverse consequences.
- Education and information about noncommercial alcohol are necessary policy and prevention tools.
- Particularly where noncommercial alcohol is associated with high levels of problems, education on the subject may be needed.
- Information may be directed at consumers, raising awareness about potential risks and drinking patterns.
- Producers of noncommercial beverages could also benefit from education about hygienic production practices and what ingredients to use (or not to use).
- Education should also include raising awareness about existing laws, enforcement, and possible punitive measures.
3. Prevention approaches that specifically target poor quality, illicit, or counterfeit products
- Kits for testing toxins in noncommercial beverages already exist, but have been used in a limited way. For example, methanol testing kits developed by commercial producers for testing noncommercial and possibly counterfeit products have been used in India.
- Making such tools available in areas where toxicity of noncommercial alcohol is a problem should be a priority for governments.
- Chemical markers that indicate product integrity can be added for identification of commercially produced beverages.
- Prevention measures need the support and participation of regulators, enforcement agencies, and commercial producers of beverage alcohol.
- Random testing of beverages suspected to be illicit or of legal home-produced beverages should be conducted by governments.
- Competitions and awards for quality can serve as incentives to home-producers to raise and maintain the standards of their beverages. This approach is being used in Hungary targeting noncommercial brandy-makers who are allowed to sell allotted amounts of their products on the market.
- Punitive measures (e.g., fines) can be used to discourage retailers from selling illicit and counterfeit beverage alcohol.
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While some noncommercial alcohol may represent a serious threat to public health, much of the unrecorded alcohol consumed around the world does not represent a cause for concern.
However, where problems are related to these types of beverages, pragmatic and culturally sensitive policy and prevention measures are needed to reduce the potential for harm. The challenge is to avoid undue restrictions on free access to commercial products that may shift the market to poor quality and potentially hazardous noncommercial alternatives. Harmonized alcohol policies that do not create disparities in access to commercial alcohol may be a realistic measure in addressing problems associated with noncommercial products.
Addressing issues around unrecorded alcohol is in the best interest of government policy-makers, law enforcement, and the beverage alcohol industry. As a result, there is ample room for cooperation and approaches that are based on partnership and directed at a common goal.
POLICY OPTIONS: Noncommercial Alcohol
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In developing policies and approaches, several key components need to be taken into consideration. While some may be necessary under most conditions, others may not be appropriate or may be difficult to implement in all cases. The list below offers a menu of areas that need to be addressed, based on effective approaches that have been implemented elsewhere. Specific examples are provided in the online database Initiatives Reporting: Industry Actions to Reduce Harmful Drinking.
Clear definitions of illicit and licit alcohol and adequate enforcement.
- Legislation around noncommercial beverage production.
- Regulation of cross-border traffic, especially smuggling.
- Enforcement of laws to prevent criminal activity.
- Ensure reasonable and realistic regulations in keeping with local culture and tradition around drinking.
- Especially in developing countries, consider social context and contribution of home production to economy.
Harmonization of pricing and availability measures with neighboring jurisdictions to prevent cross-border traffic.
Quality and purity standards for noncommercial licit beverages.
- Enforcement of standards and quality control.
- Random testing of products.
Provision of accurate and accessible information.
- Education about health implications of purity and quality, especially for producers. Information on hygienic production practices, ingredients, and contamination.
- Awareness of drinking patterns and relationship to health and social outcomes.
Raise awareness about existing laws, enforcement, and punitive measures.
Target poor quality, particularly in illicit and counterfeit products.
- Incentives to producers to raise and maintain standards (e.g., competitions for home-produced beverages).
- Introduction of contaminant testing kits or chemical markers of authenticity, where feasible.
Involvement of commercial producers in joint efforts with regulators, law enforcement, and public health.
Increased research around drinking patterns of noncommercial products and relationship of such consumption with outcomes.
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