Socioeconomic and Cultural Determinants of Illicit Alcohol Consumption Among Patrons in Uganda: A Mixed-Methods Approach

Introduction With over 6.5 million Ugandans, more than half of all the estimated alcohol consumers relying on illicit alcohol, the magnitude of this challenge extends beyond individual health outcomes to national economic losses, weakened public institutions, and deteriorating social capital Objective To examine the socioeconomic and cultural determinants of illicit alcohol use in rural and urban areas of Uganda. Methods The study employed a cross-sectional study design. Alcohol consumption status, socioeconomic and cultural factors were examined among people who consumed illicit alcohol in the past twelve months. Unadjusted (OR) and adjusted multivariable logistic regression was used to obtain odds ratios (AOR) at a 95% confidence interval (CI). Results Of the 400 patrons who participated, 301(75.2%) had consumed illicit alcohol in the past week (61.2% males vs 38.8% females) Most (36%) were aged 25–34 years and with mainly primary level of education (44.3%). A large proportion (79.8%) were engaged in informal employment earning less than UGX 500,000 monthly (71.5%). Over 80% of the participants started drinking alcohol before the age of 25. 11% of the patrons needed a drink first thing in the morning 13.8% visited hhospital due to drinking illicit alcohol and 35% had problems with friends due to consumption of illicit alcohol. The logistic regression analysis revealed that factors significantly associated with decreased odds of past-week illicit alcohol consumption were religion (Protestant) (AOR = 0.17, 95%, CI: 0.05–0.60, p = 0.006), drinking pattern of 2–3 times a week (AOR = 0.29, 95%, CI: 0.11–0.72 p = 0.008), and not viewing illicit alcohol as a socially accepted part of gathering (AOR = 0.36, 95%, CI: 0.14–0.93, p = 0.036). Increased odds were associated with aged 24 years and below (AOR = 6.75, 95%, CI: 0.98–6.37, p = 0.042), self-employed (AOR = 4.31, 95%, CI: 1.04–17.87, p = 0.044), primary reason as lower cost (R = 14.14, 95%, CI: 2.98–67.16, p = 0.001), and peer influence (AOR = 7.19, 95%, CI: 2.02–25.69, p = 0.002). The above results were echoed in the qualitative results "Even if I have 500 shillings, I can get a sachet or Kabisa and feel okay." — FGD Men Arua. "With only 1,000 shillings, I can drink until morning if I take nguli or Kuber." — FGD Youth Arua. "Alcohol is part of our culture; you can’t chase away a visitor and you must give him local brew." Conclusion Among illicit alcohol drinkers, this study reveals a higher prevalence of recent illicit alcohol consumption among low-income, less-educated male youths. This behavior is driven by entrenched factors such as peer pressure, affordability, and using alcohol to cope with hardship. Tackling this issue demands a comprehensive, multi-pronged intervention approach that addresses the root causes emphasizing prevention, educational outreach, psychosocial support, and active community involvement.