Patterns and perception of alcohol drinking among the Lahu people, Northern Thailand

Abstract

Purpose

The purpose of this paper is to understand the pattern and perception of alcohol drinking among the Lahu people in northern Thailand.

Design/methodology/approach

A qualitative method was used to elicit information on the patterns and perceptions of alcohol drinking amongst the Lahu tribespeople. Question guidelines had been developed from literature reviews and approved by three experts in the field of public health and alcohol studies. A total of 21 participants of different ages and sexes from 3 separate Lahu villages were invited to provide information. All interviews were taped and transcribed before analysis. A content analysis was used.

Findings

Lahu people begin alcohol consumption at an average of 12 years, with males usually beginning before females of the same age. Consuming alcohol is perceived to be a sign of adulthood and is also used as a means of gaining social acceptance from others in the community. Alcohol is consumed throughout the year with young and old, male and females, describing varied reasons for drinking. Income, parental behavior, and peer pressure contributes to the onset of alcohol drinking among young Lahu people. Several factors contributed to the use of alcohol among the Lahu people such as sex, age, occupation and income, peer pressure, taste and price as well as cultural adaptations amongst the farming community that play a significant role in the frequency of alcohol consumption amongst the Lahu community.

Originality/value

The results should support the development of peer education on the negative impact of alcohol use among the young people, and development of a community agreement on reducing excessive alcohol use in the Lahu community should be implemented.

Citation

Detpitukyon, S., Apidechkul, T., Sunsern, R., Anuwatnonthakate, A., Singhhorn, O., Putsa, B. and Thutsanti, P. (2018), "Patterns and perception of alcohol drinking among the Lahu people, Northern Thailand", Journal of Health Research, Vol. 32 No. 3, pp. 185-197. https://doi.org/10.1108/JHR-05-2018-020

Introduction

In 2016, the WHO reported that more than a billion people consume alcohol annually[1], with 3.3 million people experiencing health problems caused by the consumption of alcohol[2]. Alcohol-induced behavior has been defined as a major cause of human health problems[2]. Alcohol drinking leads to many chronic health outcomes such as cancer, hypertension, diabetes mellitus, etc.[3]. There are different doses and different brands of alcohol as well as various choices of use depending on the culture, traditional patterns, and life styles[4]. Additionally, some communities have their own brand of alcohol used within their community[5].

The patterns and perceptions of alcohol drinking in different populations or communities are related to their culture and belief[4] including religion[6]. Different patterns and perceptions are mostly based on a community culture and related to human health impacts in different ways such as accident, suicide, and also family violence. Northern Thailand is the favored location of the hill tribe populations which are divided into six different groups: Lahu, Akha, Lisu, Hmong, Yoa, and Karen[7]. The hill tribe people originated from south China, and moved to the northern region of Thailand approximately 150 years ago[8, 9]. The hill tribe people also have their own patterns and perceptions of alcohol use which is related to their culture[10]. In the past, most hill tribe communities produced their own traditional alcohol for drinking and religious rituals[10]. However, new commercial brands of alcohol have increasingly replaced the traditional brands during religious rituals including community festivals.

The Lahu tribe is the second largest population among the hill tribe communities in northern Thailand[10]. There are 217 villages in Chiang Rai comprising a population of 53,470 in 2016[7]. The Lahu tribe is also known as one of the biggest alcohol drinkers among the hill tribes[7]. They have many festivals that involve alcohol use[7]. However, there is no information available on the pattern and perception of alcohol drinking among the Lahu in Thailand, and no data on the effect of globalization on their drinking habits and practices. Therefore, the main objective of the study was to understand the pattern and perception of alcohol drinking among the Lahu people in northern Thailand. The results of this study will inform future health education and health implementation programs in the region in reducing the use of alcohol among the Lahu population.

Materials and methods

Study design and setting

A qualitative method was used to gather information from key informants in two Lahu villages, Ja Seur and Ja Peur, in Mae Fah Laung district, Chiang Rai province, Thailand. All participants were selected from these two villages to provide information by a purposive selection technique and used the same methods for gathering information.

Study populations

The study population comprised individuals who had identified as Lahu tribespeople and lived in the selected communities for at least two years. Lahu people who identified themselves as alcohol users were eligible for the study.

Study sample

The study samples were Lahu people living in the two selected villages who were the inclusion criteria.

Inclusion criteria

The inclusion criteria were: those people who identified as Lahu people; had a history of alcohol drinking at least six months before the commencement of the interview; aged ⩾12 years; and fluent in Thai communication.

Research instrument

A question guideline was developed from literature review and the opinion of experts in the field of public health and alcohol studies. There were 13 items: 3 questions related to general information on the village, and 10 questions related to alcohol drinking patterns and perceptions. The aspect of pattern of alcohol drinking was defined by type, volume, frequency, and reason of alcohol consumption in different ages and sexes. Regarding perception of alcohol consumption, information on personal perception, family perception, and community perception on alcohol drinking in the Lahu community were included in the study.

The guideline had been tested for validity and reliability before use in the field using four subjects (two men and two women) who consumed alcohol, were of Lahu extraction, and were aged between 15 and 24 years. The guideline had been reviewed before use by three external experts experienced in the item objective congruence (IOC) index technique. All questions had been approved by the experts at IOC>0.7. A tape recorder (brand and model) was used as an instrument of research in order to record interviews.

Data gathering procedures

The village headmen from two different Lahu villages were contacted to conduct the project in their villages. In total, 11 males and 10 females were recruited into the study using a purposive sampling method. There were 3 categories: four persons aged under 15 years (two males and two females), 10 persons aged 15-25 (5 males and 5 females), and another 7 aged 26 and above (four males and three females). The reason for gathering the information from different age categories was to ensure that all essential information regarding the pattern and perception of alcohol use among the Lahu people was covered. Appointments were made with the participants in their respective villages. The in-depth interview was conducted in a private and confidential room by male and female researchers. A male interviewer conducted the interview with male participants, and a female interviewer conducted the interview with female participants. Before commencing the interview, informed consent had been obtained from the participants. Researchers conducted the interview after all questions had been understood and explained. The interview lasted approximate 50 minutes with each participant. All interviews were recorded by a tape recorder after getting approval from the participants. Interviewers introduced themselves to the interviewee at the beginning of the interview, and provided all essential information of the research such as the objective and process of interview to the participants. The interviews were conducted two or three times with each participant before the information had met the saturation. Upon completion of the interview, a gift for personal use was presented to each participant as a token of appreciation for their time and for completing the survey.

Data analysis

All interviews were transcribed into Thai text after the recording was completed. All texts were reviewed by researchers to confirm the language and accuracy of transcription. All relevant information from the text was extracted by seven researchers (two psychiatric nurses, an epidemiologist, a medical anthropologist, two public health advisors, and a physical therapist) and by the NviVo program (NVivo qualitative data analysis Software; QSR International Pty Ltd Version 11, 2015). All key findings were interpreted in terms of its association, frame, and also link between variables. Finally, the information was used to explain the patterns and perception of alcohol drinking among the Lahu people.

Ethical consideration

All research documents and its instruments had been approved by the committee of human research of Mae Fah Laung University before use in the field (No. 024/2560).

Results

Lahu villages include inhabitants from other tribes such as Yunan Chinese and Yao living amongst them. Village leaders had a strong commitment to alcohol control in their village. Lahu people are free to follow the religion of their choice and consequently; Christian Lahu and Buddhist Lahu families lived together in the same village. There was no report of conflict between the two religions and no difference in behaviors of alcohol use.

The five key components explain the patterns and perception of alcohol drinking among the Lahu people in Figure 1.

Personal factors

Gender and age

Males started to drink alcohol earlier than females and prefer to drink whisky whereas females started drinking beer later. In terms of volume, males drank alcohol much more than females. There were different reasons for drinking alcohol between males and females. Males started drinking because of a need to get acceptance from peers and as a rite of passage into adulthood, but females started drinking alcohol not just to indicate adulthood, but because they felt that drinking alcohol gave them an increased sense of relaxation, safety, and strength. This can be explained by the statements that females usually consumed alcohol while living with their friends or people they had known well, but were reluctant to drink in unfamiliar settings or in the company of unfamiliar people. A woman also said:

When I was young and started drinking alcohol, boys used to harass me physically and verbally. Then people in our community taught their girls that if they cannot protect themselves from harassment at parties, they should not start drinking alcohol.

Among the Lahu, it is acceptable to start drinking at the age of 15, regardless of sex. However, a closer look at the context of community acceptance regarding the age when people start drinking indicates that the community discouraged alcohol consumption if the individual of 15 or above was still attending school.

Occupation and income

Most Lahu people get income from agricultural work, while others aged 15 years and more gained their income from a daily wage job. Non-professional jobs with low pay are not hard to find in the Lahu village community, making it possible for young people to get a job locally. Having a job and being able to get an income was used as a criterion to start drinking without any complaints from family and community members. This was evidenced in the findings that students had a lower rate of drinking alcohol than those out of school in the same age category as students tended to restrict their drinking to weekends only. A man said:

Now, I’m a student, if I graduate from high school, I can drink alcohol.

Most Lahu people had their own daily wage by working in their village or in nearby villages, particularly with Thai people in villages which share border with Lahu villages. Income was the major factor for early alcohol use. This was supported from all sectors in the village including community leaders. The level of income was related to volume and frequency of drinking alcohol among the Lahu people. The available alcohol in the Lahu village is not expensive. Sometimes they cost 35-70 baht per bottle. Sometimes, a group of Lahu members would share their money to buy a bottle of alcohol. Due to the low price and easy access, there is a high frequency of drinking in Lahu villages. A young man said:

Jobs are easy to find. You can get money from farming corn. When we get money we go to buy alcohol. My family does not rebuke me because I can make my own income.

Knowledge and attitude

Most Lahu people had a low level of education with most of them graduating from primary school. Most of the Lahu people believe that alcohol is not a narcotic drug and not prohibited by the Thai law. A young woman said:

I can stop anytime when I do not want to drink, therefore, I think it is not a narcotic drug.

Few people had correctly understood the impact of alcohol use in both the short and long term. They also believe that alcohol is a good thing because it is legal in the Thai law. A man said:

I feel that drinking alcohol is a good thing because you are not bothered by police while you are drunk.

Many people know that drinking alcohol causes slight headache, liver cancer, and getting involved in road accidents. Nobody mentioned the prolonged impacts such as chronic diseases, mental disorders and also other family and social impacts. However, most Lahu people claimed that drinking alcohol results in good health, and was a pastime that any gender and age group could enjoy. A man said:

Alcohol is good for all sexes and ages, it supports your health in maintaining a healthy stage particularly in older people. Drinking alcohol also is appetizing for elderly people.

Lahu people believed that alcohol is a beverage that everyone could access and is good for mental health. A man said:

Once you have a small glass you will feel happy, it is very good for mental health.

Lahu people see alcohol as a “symbol” of ceremony. Alcohol plays a part in all ceremonies and celebrations in the Lahu village. In the past, the most favored alcohol type was the traditional locally produced, fermented alcohol. This traditionally produced alcohol had been used on all occasions in Lahu villages including wedding and funeral ceremonies, etc.

Alcohol is presented as a sign of respect to some people such as the elderly people or the community leaders who join the ceremony. Currently, different brands of alcohol are presented to signify different levels of respect. To respect the community leader, the common trade whisky brand was used such as Lao Dang, Sean Some, or BENMORE. Most ceremonies provided beer for the women.

Experience in alcohol drinking

Lahu people usually drink alcohol in the evening after finishing their work. The purpose of drinking in the evening is to relax after working. However, students reportedly drank on weekends too. The opportunity to drink increased during long festival seasons such as the New Year holiday when alcohol consumption was common for four-five days of non-stop drinking among the Lahu villagers.

Experience is a factor that influences continued drinking among Lahu people because in the past, many Lahu people experienced happiness and felt more relaxed after drinking alcohol. A man said:

I felt very happy while drinking alcohol with my friends last time during our new year festival, then I still feel good to drink today.

One advantage of drinking alcohol is people dare to express themselves, particularly women. Lahu woman have been suppressed in expressing their feelings particularly in terms of sexual needs. Therefore, some women said that it is easy to express their feelings for a man they were attracted to after consuming alcohol. A young woman said:

I used to drink alcohol to express my feelings to a boy and it feels good.

Taste and curiosity

Some people expressed that many Lahu people started drinking because they are eager to know more about drinking, particularly among young adults. Most of them said that this was the major influencing factor that comes up with drinking behavior later among the Lahu males. A young man said that:

Nobody can force us if we do not need to drink, but we drink because we want to and are eager to know.

Taste is also a factor to stop or continue with a brand. However, most Lahu alcohol drinkers started with a low concentration of alcohol such as beer. However, among the males, they progressed on to drinking whisky because it is seen as a sign of strength and increased masculinity. Beer is seen as a soft drink and, in a Lahu alcohol drinker’s view, it is good for females and not for males.

Among the Lahu males, most of them drink traditional whisky or community whisky. Lahu drinkers choose the traditional whisky due to its taste and price.

Drug abuse during alcohol drinking

Most of the Lahu drinkers, both male and female, stated that they used to smoke cigarettes while drinking alcohol. A few Lahu drinkers mentioned having experience of methamphetamine use. A man said that:

Sometimes, I use amphetamine while drinking alcohol.

Another man said that:

Actually I did not smoke while drinking alcohol, but I always use cigarette while going to a club. Women like a man who smokes!

Family factors

Experience of having a family member who drank alcohol

Having a family member who drinks was a factor that contributes to drinking among the young Lahu. Some young Lahu claimed that they became drinkers because their parents were alcohol drinkers. A young man said that:

Yes, drinking alcohol is very common because my father drinks every day. Sometimes he asks me to join him.

A young woman said that:

I used to buy cooking stuff for my parents while they drank alcohol. I have to do so because many of my father’s friends come to my house. My mother asked me to help her in preparing food. I have been asked to buy alcohol for them sometimes.

However, some Lahu youth had negative impressions of their personal experience with family members who drank alcohol. A young girl who joined in the interview said that:

I had a very scary experience a few weeks ago, my father drank alcohol and after that he squeezed my hand. It was so painful.

The same girl said:

I could not get out of my room because there were many people drinking outside my room, I felt so scared.

Another young man said he had a bad experience in his family while his parents drank alcohol together. He said that:

It is very often I have a bad experience from my parents while they drank alcohol, they are always fighting with each other. I felt unhappy about staying in my home. Sometimes, I want to go away from my family. This made me decide not to consume alcohol.

Parental behaviors

Children who grew up in a strict family that prohibits alcohol drinking behavior ignore drinking alcohol. Some participants said that they grew up in a strict family that prohibits alcohol drinking, so they did not drink alcohol after initial experience of drinking in their youths.

Whereas, participants who continued to drink alcohol said that their parents did not prohibit them from doing so. Most parents believe that their children can access alcohol if the children are not in school, do not have a job, and income. These three criteria are always used in classification of having access to alcohol for a boy or girl in their family. However, young boys in some families began drinking alcohol soon after leaving school. In such a case, their family members did not condone their drinking habits as it was compared to other boys of a similar age (average 13 years) who had a job and a small income.

Family relationship

Among the Lahu, children from families with constant conflict tend to drink alcohol. A typical situation is a family where the mother drinks alcohol and engages in conflict with family members thereby giving the children the opportunity to do same. A young man said that:

If there is conflict in my family, I go to clubs at night.

Peer group

Among the Lahu youths, there are several reasons they started drinking alcohol. Normally, young Lahu people start drinking alcohol with their friends in the community. Peer pressure appeared to be the most influencing factor for starting an alcohol drinking habit. A young man said:

I started drinking alcohol because my friend persuaded me.

One very important reason to continue drinking among the Lahu youth was that because it was a means of maintaining relations with peers, Lahu youth prefer to engage in group pastimes and leisure activities, and to this end, they needed to be accepted by their peers. Alcohol consumption played an important role in group relationships and friendships. A young woman said:

I have to go with my friend who wants to drink alcohol, otherwise she will be angry with me.

Community

Alcohol drinking and Lahu culture

Alcohol drinking is common in every Lahu festival including weddings, funerals, and other religious rituals. Alcohol drinking is a part of Lahu culture. In the past, Lahu people made alcohol for use on several occasions using their own traditional methods. Alcohol was produced by every family and it has become a part of all ceremony in communities. A man said that:

Alcohol drinking among Lahu people is common. We drink when we feel happy or sad.

Some Lahu villages are close to Thai villages. Thai low-land people have a culture of providing food and alcoholic beverages to their waged workers and co-workers at the end of each day’s work in the field. This is a common scenario among Thai low land people and their Lahu employees who earned a daily wage in this way. Over time, the Lahu community also absorbed this practice into their culture by providing food and alcoholic beverages for their own farm workers. This has now become a common pattern in most Lahu villages.

One community member said:

In the past, we did not drink alcohol after work, but it became a common practice to drink after work every day after someone had worked with people in the Low land.

Symbolic of celebration and social status

Alcohol consumption makes up a part of all celebrations amongst the Lahu people. Serving alcohol to all guests is a way of showing respect to them. The type of alcohol served depends on the social standing and position of the guest. For example, community leaders are served an expensive grade of commercial alcohol while general guests are served the 45-60 Baht bottle, and older men are served herb liquor as a sign of respect. A man said that:

In any celebration, if whisky or beer is not provided, the guests will complain. They said that it is not enjoyable anymore. I feel something is missing in the party.

An old man said;

I’m an elder in this village, I have been asked to do things as the leader of our religious ritual. Whenever I join the ritual, I am served with whisky to show their respect to me.

Access and control of alcohol in the Lahu community

Most Lahu villages have village rules regarding control of alcohol drinking among the community members. An amount of 500-1,000 baht is charged for every offense by members. To date, a few persons have been charged. The rule is being used to control the inhabitants of the village.

Another important rule in the village to control their members is to denigrate those that drink alcohol in excess. This practice is particularly effective amongst the females and is perceived as a form of social control. Parents who are informed of their children’s drinking habits from others in the community would normally discourage their children from excessive drinking.

Lahu villages do not have a local grocery store where alcohol can be purchased as it is a characteristic rule of the Lahu village community that the sale of alcohol is not permitted within the village. However, there are many groceries in neighboring villages where alcohol can be easily purchased. This serves as a means of reducing excessive alcoholism in the community and also serves as a deterrent to new drinkers. The village headman said:

We have implemented the rule prohibiting the sale of alcohol in the village for 5-6 years. This has led to having small proportion of new drinkers in the village. If the youths are not often exposed to alcohol it reduces the possibility to drink in the village.

Alcohol as a tool for control and preventing mystery

Lahu villages have their own patterns and beliefs regarding the use of alcohol in controlling the effect of bad things or mystery in their lives. In some cases, alcohol is used in ritual ceremonies to wash away bad things. For example, an old woman who became ill after returning from her farm had prayers recited over her with traditional alcohol used on her to wash away the bad things in her body.

Factors from outside of the village

There are some factors from outside the village that impact the drinking behaviors of the villagers. These include access to alcohol, occasion and location of drinking, price, and the impact of mass media.

The main concern of the Lahu community leaders is that they cannot control what is bought and sold outside of the community. The sale of alcohol is prohibited within the village, but villagers can still purchase their alcohol with relative ease from outside the village. The inability to control the purchase of alcohol outside the village is made more difficult by the inability to restrict the consumption of it within the village.

Furthermore, Lahu village life provides many opportunities such as festivals and ceremonies for the consumption of alcohol. Additionally, birthdays were not celebrated in the past and are considered to be a modern development, and now, birthday celebrations where alcohol is served have become increasingly popular. Additionally, Lahu youth like to drink socially on a Saturday and gather in popular places near the village such as dams, local restaurants, and clubs where they drink socially.

The price of alcohol is one important factor that motivates new drinkers among Lahu youths. Lahu villagers have had access to many varieties of alcohol for many years with prices per bottle varying from as low as 35 to 250 Baht for more expensive varieties. Some first-time drinkers prefer beer but the price remains as the main factor in choice of alcohol consumed amongst Lahu youth.

Today, because television sets can be found in every Lahu household, information from government and commercial sectors is easily accessible. Advertisements on alcohol are released at night time, and some youths have based their choice of alcohol after advertisements from local beverage companies. However, the majority of Lahu villagers stated that commercial adverts did not have an influence on their choice of alcohol as the advertised brands were usually more expensive and not easily accessible amongst the northern tribal communities.

Discussion

Most alcohol drinkers among the Lahu people are males. This coincides with the study of Dvorak et al.[4] that concluded that males were more likely to drink alcohol than females. Stephens et al.[5] also agreed that males had more opportunities to consume alcohol compared to females. Similarly, the report of the Center for Disease Control and Prevention (CDC) found that males tend to consume alcohol more than females[6]. Apidechkul et al.[7] also reported that alcohol drinking behavior depended on the social consideration that men had more frequent exposure than women.

This study found that the Lahu generally start drinking alcohol at 15 years. This finding is similar to that reported by Delker et al.[8] where a high proportion of American youth started drinking before 20 years of age. It is an interesting finding that young Lahu males stated that they started drinking due to social expectations between the sexes. Drinking is perceived as a sign of adulthood and to start drinking is a sign of having reached maturity. Upon reaching adulthood, Lahu males are perceived as family leaders and need the acceptance of all members of the family. This is similar to the study of Paveena et al.[10] who found that university students started drinking alcohol because they wanted to present themselves as adults.

The Lahu people prefer to work and earn a wage rather than continue to study beyond primary school. One significant finding from the study is that having an income is one of the reasons to start drinking alcohol. Furthermore, the consumption of alcohol at a young age was more acceptable for males than for females. Additionally, the price of alcohol plays a significant part in the reason to drink; a Lahu man’s daily wage is 350 Baht on average while a bottle of beer at the nearby grocery store costs 35 Baht, and so does not greatly impact the household income. This agrees with the study of KingKaew et al.[11] which reported that an increase in income had a correlation to the increased use of alcohol amongst the Thai adult population. A similar study conducted by Magdalena et al.[12] found that whenever income reduced, the consumption of alcohol reduced amongst adults in the USA. A study by Holmes et al.[13] also found that when the price changes, there was a decrease in consumption of alcohol, especially amongst low income groups.

Among the Lahu people, stress and religion do not determine whether a person will start drinking alcohol or not. This may be because the Lahu do not work in stressful conditions and most Lahu people live in a big group but not a complicated community relationship. The Lahu people are also inherently friendly and funny, therefore stress levels are low among the Lahu. Stress is therefore not a contributing factor for alcohol consumption.

In a community, there are many kinds of religions such as Christian, Buddhism, and local rituals and beliefs. A Lahu man said they live in in great relationship with people in the same village who are adherents of other religions. Most of them were happy to live and stay with their friends. Almost all of them said that all residents in the community, regardless of religion preferred to drink alcohol in the community. They were happy to drink alcohol socially whenever the occasion arose. This suggests that that religion was not related to drinking alcohol amongst the Lahu people. This agrees with the study of Nicole et al.[3] which found no association between religion and alcohol consumption.

Regarding starting alcohol consumption in the family, experience is an important factor that contributes to alcohol consumption. This coincides with the study of Orrathai et al.[14] which reported that families that have parents that drink alcohol have children that end up drinking alcohol later. Banducci et al.[15] found that mother’s drinking habits affects drinking among youths. Asking a child to buy alcohol beverage was associated with starting alcohol drinking among the youth, and this presented the chance to drink alcohol, unlike those families that prohibit drinking or those families that have a rule of no drinking for their children. This agrees with the study of Chartier et al.[16] which found that those people who were alcohol addicts had a family member with alcoholism. Furthermore, the behavior modeling of Bandura et al.[17] confirmed that young children learn behavior from their parents. The study of Sarintip et al.[18] reported that drinking alcohol behavior patterns among vocational students were not associated with the behavior of their parents. But, in our study, parents’ behavior of alcohol drinking was associated with the drinking behavior of their child.

Our study found that peer pressure was the greatest influence for drinking alcohol in the Lahu community. This coincides with the study of Teunissen et al.[19] which reported that peers impact the decision to drink amongst young people. Franken et al.[20] and Teunissen et al.[21] also reported that youths changed alcohol consumption behaviors according to their peer group.

The new alcohol drinkers among the Lahu are mostly persuaded by their peers, particularly in modern ceremony parties such as birthdays and new-year parties. The study also found that the integration of income and peer motivation leads to commencing alcohol consumption. The Lahu villagers have several occasions such as weddings and celebrating the move to a new home or building of a new house that involves the consumption of alcohol as part of the celebration. The Lahu custom of drinking socially links with the WHO report that social and communal gatherings are the basic contributing factor for the consumption of alcohol[2]. Seaman et al.[22] reported that alcohol was a sign of celebrating friendship and was a normal aspect of adulthood. Similarly, the study of Mark et al. reported that the prevalence of heavy drinking was found in urban areas more than rural areas because of societal and cultural determinants including geographical conditions. In terms of the adaptation pattern of drinking alcohol, our study found that Lahu people started drinking after work as a practice picked up from working with Thai employers. This coincides with the study of Wakabayashi, et al.[23] which reported that alcohol consumption was associated with urban migration.

The only perceivable effect of alcohol advertisements on television on the Lahu community is that adverts present alcohol drinking in social settings such as parties which may explain why Lahu villagers also provide alcohol to their guests at parties and celebrations. The study of Kingkaew et al.[11, 24] reported that alcohol use and smoking were factors for getting acceptance from peers.

Taste and price played a crucial part in the decision for Lahu people to consume alcohol at a young age. Lahu people prefer low cost alcohol which is confirmed by the study of Scott et al.[25] who reported that the price of alcohols was the influencing factor for starting alcohol consumption in young people. Similarly Lintonen et al.[26] reported in Finland that alcohol consumption of adolescents correlated with its taste. Bruijing et al.[27] reported that the frequency of exposure to advertising was associated with alcohol drinking behavior. However, in our study, alcohol advertisements did not influence the commencement of alcohol consumption among the young Lahu people. Stautz et al.[28] also reported that advertising was not related to alcohol drinking.

Conclusion

The pattern and perception of alcohol drinking among Lahu people varies according to sex and age. Several factors contribute to drinking alcohol among the Lahu people including age, income, occupation, knowledge, attitude, taste, and experience. Family and parenting styles are also found as contributing factors either in a positive or negative way for young Lahu people to start drinking alcohol. Additionally, some Lahu people use drinking as an opportunity to take drugs too. Peer pressure was found to be the most crucial factor in starting and continuing to consume alcohol, particularly amongst the Lahu males. The consumption of alcohol is associated with celebrations and is also a means of defining social levels within the Lahu community and is also used in the treatment of illness. The practice of consuming alcohol after work is seen as a cultural adaptation following the practice of neighboring Thai communities who serve alcohol to their employees after work.

Figures

Figure 1

Five key components related to alcohol drinking behaviors among Lahu people