Changes in alcoholic beverage preference and consumption in Taiwan following accession to the World Trade Organization

Cheng-Che Chen; Kai-Wen Cheng; Hsin-Yi Chang; Shu-Sen Chang

doi:10.1111/add.15184

Changes in alcoholic beverage preference and consumption in Taiwan following accession to the World Trade Organization

Addiction. 2021 Mar;116(3):497-505. doi: 10.1111/add.15184. Epub 2020 Jul 24.

Authors

Cheng-Che Chen¹, Kai-Wen Cheng^{2

3}, Hsin-Yi Chang⁴, Shu-Sen Chang^{5

6}

Affiliations

¹ Division of Psychiatry and Center of Medical Education and Research, National Taiwan University Hospital Chu-Tung Branch, Hsinchu, Taiwan.
² Department of Health Administration, Governors State University, University Park, IL, USA.
³ Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA.
⁴ Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
⁵ Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁶ Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

PMID: 32621300
DOI: 10.1111/add.15184

Abstract

Background and aims: Given the growing concerns that international trade agreements may increase the supply of health-harming commodities, including alcohol, this study aimed to investigate the changes in alcoholic beverage preference and consumption after Taiwan's accession to the World Trade Organization (WTO).

Design: A before-and-after comparison analysis using data from two waves (1993-1996 and 2005-2008) of the Nutrition and Health Survey in Taiwan (NAHSIT), before and after Taiwan's accession to the WTO in 2002.

Setting: Taiwan.

Participants: A total of 5031 and 2910 participants aged 19 years or older in NAHSIT 1993-1996 and 2005-2008, respectively.

Measurements: Alcohol measures included beverage-specific preference, mean daily ethanol consumption, and heavy drinking. Logistic regression was used to estimate the prevalence rate ratios and rate differences of beverage preferences between the two waves and the risk ratios of heavy drinking associated with different beverage preferences.

Findings: A reduced prevalence rate of drinkers who preferred rice spirits (prevalence rate ratio [PRR] = 0.47; 95% confidence interval [CI] = 0.24, 0.91) and Asian wine (PRR = 0.11; 95% CI = 0.04, 0.29) was found in contrast to an increase in the preference for fruit wine (PRR = 2.90; 95% CI = 1.75, 4.79); the preference for Asian spirits showed a non-significant increase (PRR = 1.63; 95% CI = 0.88, 3.02). Similarly, the mean daily ethanol consumption decreased for Asian wine and increased for Asian spirits. Compared with beer, an increased risk of heavy drinking was associated with rice spirits (adjusted risk ratio [aRR] = 3.30; 95% CI = 1.68, 6.47) and Asian spirits (aRR = 2.64; 95% CI = 1.38, 5.01).

Conclusions: After Taiwan became a member of the World Trade Organization and abolished its alcohol monopoly in 2002, the pattern of alcoholic beverage preference changed markedly, including a decrease in drinkers who preferred rice spirits and Asian wine (53% and 89% decrease, respectively) and an increase in drinkers who preferred fruit wine and Asian spirits (2.9-fold and 1.6-fold increase, respectively).

Keywords: Alcohol; Taiwan; beverage preference; heavy drinking; trade agreements; world trade organization.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alcohol Drinking / epidemiology
Alcoholic Beverages
Beer
Commerce*
Humans
Internationality
Taiwan / epidemiology
Wine*