Center for Health Policy/Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California, USA
Center for Health Policy/Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California, USA.
BMJ Open. 2021 Mar 2;11(3):e043261. doi: 10.1136/bmjopen-2020-043261.
To estimate the age patterns and cohort trends in heavy drinking among Chinese men from 1993 to 2011 and to project the future burden of heavy drinking through 2027.
We constructed a Markov cohort model that simulates age-specific heavy drinking behaviours for a series of cohorts of Chinese men born between 1922 and 1993 and fitted the model to longitudinal data on drinking patterns (1993-2015). We projected male prevalence of heavy drinking from 2015 through 2027 with and without modification of heavy drinking behaviours.
A cohort of Chinese men who were born between 1922 and 1993.
Outcomes included age-specific and birth cohort-specific rates of initiating, quitting and reinitiating heavy drinking from 1993 through 2011, projected prevalence of heavy drinking from 2015 to 2027, and total reduction in prevalence and total averted deaths with hypothetical elimination of heavy drinking behaviours.
Across multiple birth cohorts, middle-aged Chinese men have consistently higher risks of starting and resuming heavy drinking and lower probabilities of quitting their current heavy drinking than men in other age groups. From 1993 to 2011, the risk of starting or resuming heavy drinking continued to decrease over generations. Our model projected that the prevalence of heavy drinking among Chinese men will decrease by 33% (95% CI 11.5% to 54.6%) between 2015 and the end of 2027. Complete elimination of or acceptance of a change in heavy drinking behaviours among Chinese men could accelerate this decrease by 12 percentage points (95% CI 7.8 to 18.2) and avert 377 000 deaths (95% CI 228 000 to 577 000) in total from 2015 to 2027.
Heavy drinking prevalence will continue to decrease through 2027 if current age-specific and birth cohort-specific patterns of starting, quitting and resuming heavy drinking continue. Effective mitigation policy should consider age-specific patterns in heavy drinking behaviours to further reduce the burden of heavy drinking.
估计 1993 年至 2011 年中国男性重度饮酒的年龄模式和队列趋势，并预测至 2027 年重度饮酒的未来负担。
我们构建了一个马尔可夫队列模型，模拟了一系列出生于 1922 年至 1993 年的中国男性的特定年龄的重度饮酒行为，并将该模型拟合到 1993 年至 2015 年的饮酒模式的纵向数据上。我们根据重度饮酒行为的改变与否，对 2015 年至 2027 年男性重度饮酒的流行率进行了预测。
出生于 1922 年至 1993 年的中国男性队列。
结果包括 1993 年至 2011 年期间开始、停止和重新开始重度饮酒的特定年龄和出生队列特定的发生率，2015 年至 2027 年重度饮酒的流行率预测，以及假设消除重度饮酒行为后，流行率的总体降低和总避免死亡人数。
在多个出生队列中，中年中国男性开始和恢复重度饮酒的风险始终高于其他年龄组的男性，而停止当前重度饮酒的可能性则较低。从 1993 年到 2011 年，开始或恢复重度饮酒的风险随着世代的推移而继续下降。我们的模型预测，2015 年至 2027 年底，中国男性重度饮酒的流行率将下降 33%（95%置信区间 11.5%至 54.6%）。如果中国男性完全消除或接受改变重度饮酒行为，这一降幅可能会再增加 12 个百分点（95%置信区间 7.8 至 18.2），并从 2015 年至 2027 年总共避免 37.7 万人死亡（95%置信区间 22.8 万人至 57.7 万人）。
如果当前特定年龄和出生队列开始、停止和重新开始重度饮酒的模式继续下去，2027 年之前，重度饮酒的流行率将继续下降。有效的缓解政策应考虑重度饮酒行为的年龄特异性模式，以进一步降低重度饮酒的负担。
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