HEAVY EPISODIC DRINKING AMONG CURRENT ALCOHOL CONSUMERS IN KAZAKHSTAN: URBAN-RURAL DIFFERENCES AND RISK CLUSTERING

Introduction. Heavy episodic drinking is a harmful pattern of alcohol use that may differ from the overall prevalence of alcohol consumption. In Kazakhstan, national survey data allow separate assessment of current alcohol use and riskier drinking patterns among those who drink. Aim. To examine heavy episodic drinking among current alcohol consumers in Kazakhstan, with emphasis on urban-rural differences and clustering of behavioural and metabolic risk indicators. Materials and Methods. This cross-sectional secondary analysis used data from a national World Health Organization STEPwise survey among adults aged 18–69 years. Of 6712 records available after verification, 1737 respondents reported alcohol use during the previous 30 days. The primary analytical sample included 1591 current drinkers with valid information on heavy episodic drinking. Heavy episodic drinking was defined as consumption of six or more standard drinks on at least one occasion during the previous 30 days. Associations were examined using chi-square tests and multivariable logistic regression. Results. Among current drinkers, 642 of 1591 participants reported heavy episodic drinking (40.4%). Urban adults were more likely than rural adults to report alcohol use during the previous 30 days (31.2% vs 17.1%; p<0.001). In contrast, heavy episodic drinking among current drinkers was more frequent in rural than urban areas (56.6% vs 35.1%; p<0.001). In the fully adjusted model, rural residence (adjusted odds ratio 2.42; 95% CI 1.88–3.11), male sex (1.58; 1.25–1.99), and current smoking (1.77; 1.41–2.22) were independently associated with heavy episodic drinking. A graded association was observed for risk-factor clustering, with adjusted odds ratio 2.93 (95% CI 1.94–4.43) among participants with three or more risk indicators compared with those with none. Conclusion. In Kazakhstan, urban adults reported alcohol use more often, but rural current drinkers had a substantially higher probability of heavy episodic drinking. These findings support the need to distinguish overall alcohol use from harmful drinking patterns in public health surveillance and prevention.