Associations between alcohol control law enforcement and online purchasing on regular alcohol consumption among Thai men: a nationwide cross-sectional study.

BACKGROUND: Alcohol consumption is a major public health concern, accounting for 5.1% of the global disease burden. Regular drinking, especially in large quantities can elevate the risk of developing an alcohol use disorder (AUD), resulting in negative social, occupational or health outcomes. Cultural norms surrounding masculinity, common in many countries, often shape drinking behaviours among men. Despite various alcohol control measures, factors such as enforcement and digital technology can inadvertently increase consumption. This study aimed to examine the associations between alcohol control measures, enforcement practices, digital technology use and regular alcohol consumption among Thai men. METHODS: This cross-sectional study analysed data from the 2021 National Statistical Office Survey, examining Thai men aged 15 years and older across all 77 provinces. The study included 102,886 participants selected through stratified random sampling to ensure representativeness. Generalized Linear Mixed Models (GLMM) were employed to assess the association between alcohol control measures, enforcement, digital technology factors and regular alcohol consumption while controlling covariate socioeconomic factors and clustering effects across provinces. p-values < 0.05 were considered statistically significant. RESULTS: Among 102,886 Thai men with a mean age of 40.45 years, approximately half (49.56%) regularly consumed alcohol. Significant associated factors included: age ≤ 18 years (AOR: 11.58, 95% CI: 10.49-12.78), single marital status (AOR: 4.95, 95% CI: 4.70-5.21), monthly income ≥ 15,000 baht (AOR: 7.48, 95% CI: 7.14-7.83), regular tobacco use (AOR: 3.02, 95% CI: 2.88-3.16), illicit alcohol consumption (AOR: 7.89, 95% CI: 6.99-8.92), smuggled liquor use (AOR: 1.66, 95% CI: 1.40-1.96), presence of alcohol-related health problems (AOR: 3.16, 95% CI: 3.01-3.33), exposure to alcohol advertising/festivals (AOR: 1.38, 95% CI: 1.26-1.51), social media exposure (AOR: 1.26, 95% CI: 1.15-1.37), online alcohol purchases (AOR: 4.03, 95% CI: 3.86-4.21), and elevated BMI (> 25 kg/m²) (AOR: 1.87, 95% CI: 1.76-1.96). CONCLUSION: This study identified the important roles of alcohol control law enforcement and on-line alcohol access on regular alcohol consumption among Thai men with multiple significant socioeconomic factors. These findings highlight the need for targeted public health interventions focused on law enforcement, and digital health literacy especially among vulnerable populations, to reduce alcohol consumption.