A tale of two cities: Drinking practices and problems in two metropolitan cities in China, Beijing and Shanghai

Alcohol consumption has been common in China. Nonetheless, drinking and drinking-related problems have not been sufficiently described. In this dissertation project, data collected from two metropolitan cities in China, Beijing and Shanghai, have been used to describe drinking behavior and drinking-related problems in these two cities.;Previous studies have provided some basis for speculating that childhood physical punishment (CPA) might be a causal influence on drinking problems, but more research is needed before any causal inference is drawn. In this dissertation project, this possible causal relationship is also inspected in a Chinese context.;Multi-stage probability sampling was used to collect information from 5201 household-dwelling adults in Beijing (n=2633) and Shanghai (n=2568). A version of the World Health Organization Composite International Diagnostic Interview was used to assess drinking behavior and problems, childhood experiences, as well as other relevant variables.;It was found that alcohol is highly accessible in these two metropolitan cities; alcohol consumption is common; heavier drinking is not rare (occurrence ≥ 7%); drinking problems (socially maladaptive drinking and alcohol dependence) exist at a fairly low occurrence (occurrence <7%). Males and younger people were more likely to be involved with drinking; they are also more likely to have a history of drinking problems.;A positive association was found between CPA and drinking-related problems after taking family history of drinking problems into account. The assumption of exogeneity of covariates was tested using the recursive probit regression method. Estimates from generalized linear models were corrected when there was evidence of endogeneity. Good internal validity and model stability was found by the bootstrap resampling approach. The strengths of associations were stronger for "early onset drinking problem" variables as compared to some other variables.;This dissertation project provided the first epidemiological description of drinking behavior and drinking-related problems in the two biggest cities in China, Beijing and Shanghai. Result implied that the priority of prevention and intervention should be placed on males and young adults. A possible causal relationship between CPA and riskier drinking and drinking problems were found. Limitations of the study were discussed. Directions for future research have been suggested.