Perspectives of community leaders/members on factors hindering alcohol regulation in Nigeria

Abstract

Background

Previous studies have examined factors impairing alcohol policy implementation in Nigeria, but none adopted a community-based approach. Given that alcohol consumption has sociocultural, economic, religious, and legal connotations, it is pertinent that a community-based study interrogates how these, and other similar factors hinder its regulation.

Methods

We conducted semi-structured interviews with 30 community leaders/members in Anambra State, exploring their perspectives on factors hindering the regulation of alcohol (mis)use in their communities. Data were analyzed thematically.

Results

Findings show complex factors affecting alcohol regulation in Anambra communities. Participants argued that alcohol consumption is symbolic and essential to their lives; therefore, regulating it is difficult. Participants further indicated that sociocultural events in many communities promote the availability of free drinks. Thus, regulating the quantities that individuals consume on such occasions is impossible. They stated that rapid urbanization and the influx of migrants, unemployment and personal business interests are among the factors affecting regulating alcohol (mis)use among adults/minors. Participants revealed they could not establish laws banning alcohol (mis)use since the government has not implemented such policies/regulations.

Conclusion

Findings indicate that to implement effective alcohol regulation, community leaders/members should be involved in its development because of the sociocultural roles of alcohol.

Keywords:

• Alcohol
• alcohol policy
• community leaders
• Nigeria

Introduction

The study’s aim was to explore the perspectives of community leaders and members on factors impairing the regulation of alcohol in communities in Anambra State. Formal and informal alcohol regulatory mechanisms are necessary due to the harmful role its (mis)use plays in morbidity and mortality rates. Alcohol (mis)use is associated with many health and social problems. For instance, heavy drinking influences aggressive behaviour, resulting in male-to-female partner violence and also negatively impacts consumers’ cognition and problem-solving abilities (Wilson et al., 2014).

Globally, abundant evidence shows that alcohol consumption contributes to the increasing burden of non-communicable diseases (NCDs) and deaths. In 2016, the harmful use of alcohol resulted in approximately 3 million deaths (5.3% of all deaths) worldwide and 132.6 million disability-adjusted life years (World Health Organization [WHO, 2018]). In terms of gender, Carver et al. (2021) reported that alcohol use disorders (AUD) affect 237 million adult men (8.6%) and 46 million adult women (1.7%) worldwide. In Europe, Berdzuli et al. (2020) reported that mortalities attributed to alcohol on the continent are currently at 9.4%, and the alcohol-attributable disease burden stands at 10.3%. They stressed that mortality and morbidity due to the consumption of alcohol stem from four major disease categories: cancer, cardiovascular diseases, injuries, and alcohol use disorders (Berdzuli et al., 2020).

In the Nigerian context, alcohol is also a leading risk factor for NCDs and deaths (Adeloye et al., 2019). Nigeria is one of the leading African countries in the consumption of alcohol. The per capita alcohol consumption was estimated at 25.5 litres of pure alcohol in 2016 (WHO, 2018). Relatedly, the 2017 United Nations Office on Drugs and Crime (UNODC, 2018) Nigerian drug survey indicated that about one-quarter of adults have used alcohol in their lifetime, while 25% and 13% of men and women, respectively, used alcohol in the last one year. Additionally, the survey reported that although 40% of those who have used alcohol stated that they drink occasionally, 48% (33% of men and 15% of women) have consumed alcohol every day or close to every day in the last one year, with men reporting ‘‘binge drinking on three occasions in the past 30 days, while women reported binge drinking on 2 occasions’’ (UNODC, 2018, p.29). In the Southeast of Nigeria, the consumption rate is reported to be the highest in the country. For instance, Anyanwu et al. (2016) reported that the prevalence rate of consumption among young people was 29%. Available evidence shows that alcohol mis(use) is the sixth leading risk factor for most deaths and disabilities in Nigeria (WHO, 2018). Some of the common alcohol-related harms in Nigeria include cancer, alcohol-induced aggressiveness, alcohol dependency, increased risky sexual behavior, and physical injuries (Ajayi et al., 2019; Dumbili, 2016; Odutola et al., 2017). Other problems include alcohol-induced accidents, truancy, and loss of personal property due to intoxication (Dumbili, 2020; Dumbili & Swahn, 2023).

In the face of the numerous challenges associated with alcohol consumption, societies vary in their cultural disposition towards its use. In Islamic societies (e.g. Northern Nigeria), there appears to be an absolute prohibition of alcohol consumption; it is forbidden outrightly (Nwosu & Obot, 2017). In other societies (e.g. most Southern Nigerian communities), regulation was gender and age based as drinking alcoholic beverages was restricted to adult males except on a few occasions where adult females were permitted to drink a little (Ikuesan, 1994). Also, excessive use by adult males attracts sanctions such as verbal condemnation or enforcement of consumption limits by group members (Olajide, 2006). Nwosu and Obot (2017) further highlights cultural practices adopted in the regulation of alcohol, such as stigmatization of those who frequently became intoxicated, restricting alcohol consumption to men alone, proscription of solitary drinking, regulating of drinking venues/periods, prescribing guided drinking by male youths, proscription of drinking from jars/containers and the beliefs that only fools get drunk. Presently, traditional practices might no longer be enough to regulate alcohol usage, especially because of the influence of the alcohol industry and the liberal economic policy of the government, which opened doors for more alcohol-related businesses (Dumbili, 2013; Morojele et al., 2021).

Despite the problems associated with harmful alcohol use in Nigeria, the consumption rate is increasing, and no serious attempt has been made to regulate or reduce its availability, accessibility, and affordability through policy implementation (Morojele et al., 2021; WHO, 2018). In 2010 and 2013 respectively, the WHO proposed a Global Strategy to reduce the harmful use of alcohol and Global Action Plans for the Prevention and Control of Non-Communicable Diseases (Chestnov, 2013). Relatedly, in 2018, WHO launched the SAFER Initiative in collaboration with its global partners. According to WHO (2023), SAFER is an acronym for five major cost-effective strategies to reduce alcohol availability, use and related harms. The initiative aims to ‘‘strengthen restrictions on alcohol availability, advance and enforce drink driving countermeasures, facilitate access to screening, brief interventions and treatment, enforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion, and raise prices on alcohol through excise taxes and pricing policies’’ (WHO, 2023). WHO introduced the initiative due to the recognition of the rising alcohol-related burdens in different parts of the world. While countries like Ghana and Uganda have aligned with these WHO-Initiatives by implementing alcohol control policies to regulate misuse and related harm in their countries, no such efforts have been made by different Nigerian governments to regulate alcohol marketing, availability/accessibility, and consumption via comprehensive national alcohol control policies (Morojele et al, 2021; Nelson, 2018; WHO, 2018). This is despite the country’s involvement in global conferences on alcohol control over the years (Abiona et al., 2019) and the fact that it was among the 193 delegates at the 2010 63rd World Health Assembly, which adopted the 2008 WHO resolution (Dumbili, 2014a). Given this lack of willingness to implement a centrally enforced regulation, alcohol production, sales, use, and misuse are largely unregulated in Nigerian communities.

Factors hindering the regulation of alcohol in Sub-Saharan Africa

Studies have shown that most Sub-Saharan African countries do not have comprehensive national alcohol control policies to regulate production, marketing, availability and (mis)use of alcohol (Ferreira‐Borges, Dias, et al., 2015; Morojele et al., 2021; WHO, 2018). Among other reasons, industry interference, vested interests, and the lack of political will from the government (due to economic interests) are the primary reasons for the non-implementation of policies (Ferreira-Borges et al., 2014; Morojele et al., 2021; Swahn et al., 2022). In countries where policies exist (e.g. Malawi), non-enforcement of existing policies caused by some of the reasons stated above is also evident (Morojele et al., 2021).

In the Nigerian context, the lack of a stand-alone, comprehensive national alcohol regulatory measure has been attributed to many factors. First, alcohol remains an integral and symbolic part of many communities in Nigeria (as it is with several other African societies). It is culturally symbolic and used for rituals during traditional festivals or ceremonies (Obot, 2000). Although there were informal control measures on misuse, especially before the introduction of commercial alcoholic beverages (Obot, 2000), researchers argue that unrestricted access to industry-produced alcoholic beverages before and immediately after Independence in 1960 weakened the informal regulatory mechanism and influenced the high consumption rates (Gureje et al., 2007).

According to Dumbili (2014b), the leading multinational alcohol producers in Nigeria are among the main reasons why regulations regarding alcohol availability and (mis)use through policies have not been implemented. This is because the multinational alcohol corporations (e.g. Heineken and Guinness Nigeria) have been campaigning for ‘responsible drinking’ while displacing policy initiatives. Dumbili (2014b) further stressed that because there are no definitions of standard drinks in Nigeria which ideally should be inscribed on alcohol product labels, the ‘Drink Responsibly’ message has been ineffective in mitigating alcohol misuse. Like in other contexts (see Baggott, 2006; Hawkins et al., 2012; Room, 2004), different Nigerian governments have accorded a prominent role to the alcohol industry due to economic interests (Dumbili, 2014b). Therefore, these companies have continued to promote their products and the competition among them has resulted in unrestricted availability of, and accessibility to cheaper beverages. Thus, more people can afford diverse brands in Nigeria. This is in line with Ferreira-Borges, Esser et al.’s (2015) analysis of the factors fuelling the increasing consumption of alcohol and related harm in Africa, which include the potential convergence of variables like rapid urbanization, economic development, increased availability, corporate targeting, and a lack of policies or the availability of lax laws.

Additionally, Abiona et al. (2019) analysed the state of alcohol regulation in Nigeria and found that there is currently no all-inclusive, health sector-led policy document to regulate alcohol marketing, availability, and accessibility. The study blamed the non-implementation of alcohol control policies on the lack of willpower of different Nigerian governments. These previous studies have provided useful insights into the reasons for the lack of comprehensive policies in Nigeria, but little is known about the perspectives of community leaders and members on the factors militating against the regulation of alcohol (mis)use in Nigerian communities. This study addresses this gap by interrogating the perspectives of community leaders/members on the factors impairing the regulation and control of alcohol use and (mis)use in their communities. The study adds to the existing knowledge on the sociocultural, economic, legal, and other aspects of alcohol. Further, it lays the ground for evolving research on implementing regulations/policies in Nigeria and beyond. While the study focuses on communities in Anambra State, it presents findings that are relevant to regional, subregional, and national alcohol regulations and beyond.

Methods

Study procedure

This article was taken from a study that examined the awareness of alcohol-related harms and regulatory mechanisms in Anambra communities, the factors that hinder regulating alcohol (mis)use, and the role community leaders may play in implementing alcohol control mechanisms. In this current paper, we focus on exploring community leaders’ and members’ views on factors that hamper the regulation of alcohol (mis)use in their communities. Previous studies (e.g. Anebonam et al., 2019; Dumbili, 2020) have shown that alcohol-related harms are common in the state, but none employed community-based approach to examine how the lack of regulations may be implicated, which informed the choice of our study site. Anambra is one of the States in the South-eastern political zones of Nigeria. It was created from the old Anambra state on 27th August 1991 and currently has 21 Local Government Areas and 117 local communities. The State’s name is the anglicised version of the original ‘Oma Mbala’, the native name of the Anambra River. The capital of the State and the seat of the government is Awka. Onitsha and Nnewi are the biggest commercial and industrial cities in the State. The State is located within the boundaries of Delta state in the West, Imo State and Rivers State in the South, Enugu state in the East, and Kogi state in the North (Britannica.com, 2013). The indigenous ethnic group in the State is the Igbo people, constituting 98% of the State’s entire population, while 2% consist of other ethnic groups found in the State. Anambra State is one of Nigeria’s top 10 most populous states (Igwenagu, 2021). The location was chosen because these communities engage in the production, consumption, and sale of different forms of alcoholic beverages, including traditional/locally made gin.

The State Ministry of Health granted ethics approval (Ref: MH/AWK/M321/405). The study adopted a cross-sectional qualitative survey. The lead-author used a snowballing method to purposively select 30 participants (9 women, 21 men, aged 31 to 75 years). Participants include 27 current leaders, 1 ex-community leader and 2 community members selected from 30 communities in Anambra state in Nigeria (see Table 1 for further details). The participants included President Generals, Secretaries of Communities, Youth Leaders, Cabinet members, Women Leaders, and other Community Members. The unequal number of men and women was because most executive positions in these communities are gendered and dominated by men. For instance, a woman is not culturally permitted to be the overall head of a community in this part of the country.

Table 1. Socio-demographic distribution of respondents.

S/N	Status of Respondent	Sex	Community	Age
1	Anambra State Association of Town Union President (ASATU)	Male	Eziowelle	53
2	President General	Male	Achina	61
3	President General	Male	Alor	62
4	Secretary General	Male	Umuuchu	65
5	President General	Male	Urualla	55
6	Youth Leader	Male	Aguleri	31
7	President General	Male	Anam	67
8	Youth Leader	Male	Ezinifite	36
9	Community Leader	Male	Ivite Aguleri	44
10	Former Community Leader	Male	Amawbia	69
11	Community Member	Male	Ebenebe	40
12	Community Leader	Male	Amawbia	75
13	Youth Leader	Male	Ekwuluobia	43
14	Youth Leader	Male	Awgbu	38
15	Youth Leader	Male	Nkpor	54
16	Youth Leader	Male	Okija	46
17	Woman Leader	Female	Isuaniocha	58
18	Woman Leader	Female	Mgbakwu	66
19	Woman Leader	Female	Igboukwu	64
20	Woman Leader	Female	Nibo	65
21	Woman Leader	Female	Mbaukwu	51
22	Woman Leader	Female	Enugu-ukwu	63
23	Woman Leader	Female	Nise	55
24	Executive Member women group	Female	Ifite, Awka.	47
25	Secretary General	Male	Umunnoke Community, Awka.	40
26	Community Member	Male	Umueri	50
27	President General	Male	Ukpo	60
28	Woman Leader	Female	Oko	48
29	Community Leader	Male	Ogidi	67
30	President General	Male	Okija	56

Source: Fieldwork.

Individual, semi-structured interviews were conducted to elicit information for the study. The data collection took place between June and September 2022. The interviews were conducted primarily in English (official Nigerian language), and virtually all of the participants spoke fluently. Some specific questions and probes used to elicit information from participants included: ‘what role does alcohol play in your community?’ ‘Can you describe how members of your community use alcohol?’ ‘On which occasion(s) do they consume (or not consume) alcohol in your community?’ ‘What role does alcohol play on such occasions?’ ‘Who provides alcohol on such occasions?’ ‘What determines who will or will not consume alcohol in your community?’ Do you have mechanisms to regulate alcohol sales, availability use/misuse in your community?’ ‘What are those mechanisms?’ ‘How would you describe community members’ perception and participation in regulating alcohol use?’ ‘Are there reasons why community members may be unwilling to participate in the regulation of harmful alcohol use?’ ‘Are there factors militating against the regulation and control of alcohol misuse in your community?’ ‘How would you describe these factors militating against regulating/controlling alcohol use?’ Are there cultural or gender issues militating against the fight against harmful alcohol use?

Analytical procedure

Following Braun and Clarke’s (2019) six steps (where the analyst familiarizes him/herself with the data, generates initial codes, searches for themes, and reviews themes that were developed, defines/names themes and then produces the report) for doing reflexive thematic analysis, the data were analyzed by the lead-author using inductive and deductive approaches. First, the audio recordings were transcribed word for word and read thoroughly, which helped the analyst to immerse in the data. The data were then manually coded deductively in line with the study’s overarching objectives stated above. The second author, who supervised the entire research process, then read the lead author’s initial thoughts about coding and made significant inputs inductively, which enhanced the coding processes. After coding was completed, the lead author searched for, generated, and named tentative themes. Following this, the second author helped to refine and (re)name the initial themes generated. This collaborative process facilitated analytical rigour (Richards & Hemphill, 2018). The findings below are the results of the systematic analytical process.

Results

The findings, which are presented under four themes, highlight the complex roles that alcohol plays for community members and the factors militating against its regulation. These factors include cultural, individual/family, socioeconomic, and legal issues.

Community members’ perception of the importance of alcohol

Our analysis shows that, culturally, alcohol is viewed positively in all of the communities. For instance, participants discussed that alcohol is used at many social and religious events, and social drinking functions as a uniting force for many young and older people, whether on formal or informal occasions. The excerpts below shed light on the usefulness of alcohol at different events:

Talking of alcohol, we did not create alcohol; alcohol has been in vogue in all communities, and most of the events people organise, they do it with alcohol; say weddings, burials, ‘Ozo’ (chieftaincy) titles, and even in meetings. We use it in many ways, so it is part of us. (Male, former Community Leader)

Alcohol is a very vital component of the religious, traditional, ritual, and symbolic presentation of the community. Alcohol is at the heart of most ceremonies in my community, and such ceremonies abound, like traditional marriage, church weddings, naming ceremonies, and the like. (Male, Community Member)

Alcohol is not only an integral element of many cultures in Nigeria, but it is also symbolic for performing libation during traditional ceremonies (Dumbili, 2013; Obot, 2000). Although there were informal control measures regarding the age and gender of those who were culturally permitted to drink in the traditional era, as well as to regulate heavy drinking, the commercialisation of alcohol production altered these informal structures (Obot, 2000). Thus, unrestricted access to alcoholic beverages has been granted to both young and old in different communities (Gureje et al., 2007). As the accounts above indicate, alcohol is an essential element of the events held in the communities we examined.

Participants further discussed that alcohol plays a huge role in establishing and fostering camaraderie among young people, especially men. To quote one participant:

Alcohol is a rallying point. It is a huge factor in rallying friendships and camaraderie among young people in our community…. Alcohol is one thing that fosters and reinforces relationships, alliances, and friendships in different ways. (Male, Youth Leader)

These accounts demonstrate the perceived roles performed by social drinking in the communities we examined and why it is used at different events. This is why regulating alcohol will be difficult for them.

Sociocultural factors militating against regulation of alcohol (mis)use

Given the symbolic role that alcohol plays, the widespread social drinking practices and the public perception of its usefulness, we probed participants to understand how its availability and consumption are regulated on different occasions and the sociocultural factors that impair regulation. Our findings reveal that alcohol is a symbolic element in all the communities, thus, regulating consumption is difficult. Some of the respondents narrated that there are no existing regulatory measures in their communities, and if there is anything of such, they are not backed by the law. In contrast, other participants revealed some of the community-based informal patterns of regulating and controlling alcohol (mis)use. They noted that a few communities have specified intervals when alcohol retailers can open and close their shops for business and when members of their communities could be tolerated if found at ‘beer parlours’ (restaurants or alcohol retail shops). The quote below captures this:

In my community, we have regulations; beer parlours don’t open in my community before 10.00 am, you don’t go out there and start drinking before 10.00 am. You must go and do your work, and then come back and relax to drink. If we get you dispensing or drinking during work hours, you will be punished. (Male, Community Leader)

As referenced above, this community has some mechanisms to regulate alcohol sales and use. Still, more effective measures are needed given that one can start drinking from 10 am. One reason is that most outlets selling alcohol in Nigerian villages and cities also sell food. Therefore, it may be challenging to identify patrons who visit for food or alcohol.

Our analysis also shows that religiously induced measures of informally regulating alcohol (mis)use are available. For instance, in order to maintain religious doctrines, some religious denominations outrightly reject the use of alcohol during their events. As such, no form of alcoholic drinks will be served or allowed on such occasions. For example, two community leaders succinctly state that:

People that profess faith will say that their faith forbids them from alcohol consumption. In that case, they normally bring the equivalent of whatever they think will be the price of non-alcoholic drinks to the ceremony. (Male, Community Secretary)

In my community, we don’t have any kind of specific programme geared towards the control of alcohol, except that there are some who say that they are "born again" [Christians]. Such people wouldn’t like anybody to bring alcohol to them when their son or daughter is getting married. They will insist they don’t want alcohol to be brought at all and even in some burial ceremonies, the acclaimed born again refuse that alcohol will be shared or consumed. (Male, Community Secretary)

The study also highlighted other regulatory patterns, such as the one done by the age-grade members. This is similar to the one enforced by the family members. The difference, however, is that it is executed by the age-grade group to which the alcohol user belongs. The age grade is a self-help organ for social control and improving inter-group relations in each community. The age grade could go as far as warning retailers to stop supplying alcohol to heavy drinkers. In extreme cases, the heavy drinker pays a fine or is deprived of certain benefits or rights. For example, one of the participants reveals that:

In such cases of excess intake, talking to them is just a waste of time; sometimes, we punish them using traditional groups. Sometimes we ostracize them to bring them back to normalcy. The ostracization is not permanent; sometimes, we use people of their age who will tell them that they have nothing to do with them except they change their ways. (Male, Community Leader)

The implication is that in communities where modernisation has not altered their communal lifestyle, the relatives and kinsmen have a certain level of control over individuals, including their drinking lifestyle.

These regulations are however impaired by some cultural events that promote the availability of free drinks. For instance, at traditional marriage and burial ceremonies, large quantities of both locally and industry-produced alcoholic beverages are served free by the hosts. Alcohol is considered an essential requirement and such occasions are considered poor/incomplete if people are not offered large amounts of different alcoholic beverages. Thus, during such occasions, many people drink heavily. It is also difficult to regulate the consumption volume because not offering people drinks will be regarded as not being hospitable to the guests, especially when they know that alcoholic beverages are available. There are similar annual/biennial events like the New Yam festivals New Yam, Chieftaincy enthronements, and masquerade festivals are perfect grounds where people celebrate and enjoy free alcoholic drinks that are provided by the celebrants. In the account below, one of the participants discussed how they consumed large quantities of alcohol at cultural events:

There are cultural events [where alcohol is inevitable]; it could be people celebrating their cultural deities. In our town, despite the prominence of Christianity, every village/community has a deity they worship. These old gods are celebrated, and when they are celebrating it, the primary thing they do is to drink. It is a kind of cultural thing because they want to be happy, and these are gods, so during those periods, excess intake of alcohol is also engendered. (Male, Community Secretary)

In many communities, different socio-religious events that require drinking are held, and one such occasion is masquerade events. In the communities we studied, masquerades are regarded as ‘gods or spirits’, and it is taboo to call them humans. Relatedly, it is popularly believed that a spirit does not get drunk. Thus, events like masquerade festivals promote excessive drinking practices among men, who are culturally permitted to attend (it is taboo for women to come close to a masquerade).

The analysis further shows a significant relationship between masculinity and the capacity to consume alcohol. For example, in some situations, participants revealed that whenever men sit together or are having a meeting (whether formal or informal), the occasion is not complete without alcohol. One of the participants described this as follows:

In my area, alcohol is accepted as a way to re-enforce male virility. For example, if, as a young man, you do not take alcohol or you prefer to take very little for fear of getting drunk, people look at you as though you are not man enough. (Male, Youth Leader)

The above account reinforces the popular heterosexual masculinity norms in Nigeria, where alcohol has been gendered and dominated by men (Heap, 1998).

Relatedly, our data highlighted another aspect of the gender-based issue impairing alcohol control and regulation. Female participants discussed that men see themselves as superior and will never take advice from them on how to reduce their heavy drinking practices. One of the women community leaders opined:

No matter the level of our education, men still look at us as people from the village. Whenever you tell a man not to drink, he begins to say who are you to tell me what to do? If you go to the village or the community and say, stop drinking [large amount of alcohol], they will say, "who is this woman," and they could also insult you with a vulgar statement. (Chairperson, Women’s group)

Nigeria is a patriarchal society where women are socialised to be passive (Dumbili, 2022). As the above account demonstrates, men do not like women to advise them to regulate their drinking, and this is one of the socio-cultural factors that make the regulation of alcohol (mis)use difficult.

Participants also stressed issues related to the loss of family values and moral decadence, stressing that youths no longer listen to, or take advice from, their elders. Thus, it is difficult to regulate their lifestyle, including their drinking behaviours. The analysis shows how alterations to the traditional value systems impair the regulation of alcohol misuse. For instance, participants shared accounts showing that traditional values have been altered, and stated that some parents defend their children who engage in antisocial behaviours, which affects the maintenance of societal values:

There are parents who do not care whether their children are given this substance or not. In fact, for them, they even see it as exclusion or discrimination if their child is not given alcohol, and they will use parlance like "nye nya oke ruru ya" (give him his own share") to argue for sharing alcohol to their wards. (Male, Community Member).

The study also revealed urbanisation as a factor impairing the control of alcohol misuse and how that relates to sociocultural traditional norms. For example, one participant argued that, with the influx of migrants, people no longer act as a community, and the traditional practices, including regulations, mores, and taboos, are altered in one way or another. Thus, drinking by minors cannot be regulated because families have lost their unionism and communalistic values to urbanisation. The quote below succinctly illustrates this:

Before now, at certain ages, some consumable goods like alcohol and cigarettes could never be sold to younger people. Then, the local seller knows everybody around, so when they see you, they know you are the child of this person or the child of that person and will go and talk to your parents, asking them; are you the one sending these children to come and buy cigarette or alcohol? Those checks used to be in the community, and then, with the development and influx of some people and the quest for people to make money, they do not care whose ox is gored. (Male Community Member)

Before the commercialization of alcohol production in Nigeria in the 1940s, drinking among young people was taboo (Heap, 1998). In this era, a communal lifestyle was normative. According to Dumbili (2013), community members could apply a punishment to an erring adolescent on behalf of their parents and, in turn, receive a commendation. Following the socio-political and economic development in Nigeria, these values have changed. Participants’ accounts showed that they were aware of how this breakdown in traditional values hinders the regulation of alcohol use and misuse among young people in their communities.

Lack of awareness and economic factors hindering alcohol regulation

Additional accounts show that participants believed that some of the principal factors (in)directly working against regulating alcohol misuse are ignorance of the effects of harmful alcohol use and resistance to changing one’s drinking behaviour. For example, one participant indicated that there are people who or for whom any advice against taking alcohol is taken as an insult or that you are trying to teach them how to really lead their own lives. Although they discussed that some alcohol users are aware that alcohol misuse can affect them, they believed that there is a group of consumers who are not well informed about the harm that alcohol misuse can cause. Others had different opinions. Many of the participants revealed that while some people are fully aware that alcohol can be harmful, they do not consider it a social problem because of the role they believe it plays for them:

Sure! They are aware; why do I say so? I have seen situations where somebody who works for me, he is actually in the site now. He said that all his friends are gone (dead). These are his friends that, by 5:30 am, they are already gulping some shots of locally made alcohol; of course, they die; they do not live that long because the liver is destroyed in the process. I believe they know, and he knows too because he makes fun of it, but he sees it as a necessary evil because, over time, they become so used to it. (Male, former Community Head)

Economically, participants believed that it is difficult to control or regulate alcohol consumption, including excessive use, because many people earn their living from producing and selling alcoholic drinks. To quote one participant: "I hope you know that people who earn their living from the production and sale of alcohol will not stop at anything to ensure that laws against alcohol use are not implemented." (Male, community leader)

To further buttress this point, another participant asked:

How can it be regulated when some folks are doing business with it? Will you stop a vendor from selling? Or will you tell a woman not to give one crate [12 bottles] of beer to the person who wants to buy from her? Then you are encroaching into the business of that person. (Former Community Leader)

Other participants argued that alcohol contributes a large chunk of their gross domestic product. Therefore, regulating the drinking/sale of alcohol will meet with stiff resistance from community members and higher authorities. Again, the research revealed that poverty is a factor that promotes drinking behaviour. The study showed that hunger is a factor that hinders the regulation of excessive consumption because people usually cannot resist free drinks when they are hungry. One participant noted that:

I think it is hunger; people are hungry, so whenever they see anything, especially free things that will enter their mouth, be it food or alcohol, they will take it. So, if someone does not see anything to eat, a drink will be an option. (Female Community Leader)

The data also show that alcohol is cheap and easily accessible to people of all ages. Participants argued that availability promotes access, and sometimes drinks are free, so people take them at will, virtually all the time. One female participant argued: "Another thing I feel that promotes drinking is the availability [of alcohol]; whenever they see the drinks available for free, they start taking free drinks." (Female community leader)

In a related development, another participant noted that:

It cannot be controlled because even breweries put up their stand in the form of marketing; they will come, display their stand/station and give people free drinks. How can you stop people from taking what has been given to them for free? (Male, Community Member)

Participants also discussed that unemployment is impairing the regulation of alcohol mis(use), in that many youths are idle. Since they do not have anything to do, most of the time, they resort to substance use, including excessive drinking. For instance, one female community leader noted that:

The youths are idle! You know that an idle mind is the devil’s workshop. The youths do not have anything doing so they can only relax with alcohol. (Chairperson, Women’s group)

As discussed earlier, relaxing with alcohol is made possible, given that alcohol is often served for free on almost all social occasions in Nigeria. Thus, people who cannot afford to buy alcohol use such events to consume large quantities of alcohol.

Legal/human right considerations

From a legal perspective, participants noted that since there are no official policies/laws regulating alcohol consumption in the State, communities cannot make or enforce such laws. They noted that imposing ‘rules’ regarding how people should consume alcohol would be regarded as an abuse of fundamental human rights. Indeed, community leaders believed that they could be sued if they overstepped their boundaries.

Participants’ accounts highlighted some interesting nuances. For example, some of them stressed that the government is complicit in the lack of alcohol regulation because it has failed to implement or enforce any serious regulations either in the State or nationwide. They emphasized that the government even contradicts itself by allowing the alcohol industry to promote Drink Responsibly Messages while receiving tax from alcohol-related businesses. One former youth leader argued:

Look, the only group that has the right to regulate alcohol is the government. Let there be a policy from the government, then you can make a [community-based] policy based on that, but the government is receiving tax from alcohol companies. Can you see the problem? It is conflicting; so, whatever we are doing to regulate alcohol misuse is just on compromise. (Male, former Youth Leader)

The study further revealed that even if a policy/law against harmful alcohol consumption is enacted, implementation is a problem in Nigeria. One of the participants stressed the dynamic nature of human beings, which influences their perception of harm. In his words:

It is difficult to regulate because there is no way you can tell people not to eat what they want to eat. Even for some people with health challenges, doctors have always warned them not to take alcohol, and their argument will always be that "something will kill a man." That is what you will hear from alcohol users, even when they have been told not to take it. Will you follow a man to his house to know whether he is taking alcohol in his room? So, it is [regulating alcohol] a complex issue, you know. (Male, Community Secretary)

Together, participants discussed the role that alcohol plays for members of their communities and noted diverse sociocultural, economic, and legal factors that constrain the regulation alcohol use and misuse.

Discussion

Our study explored the perspectives of members and leaders of some Anambra communities on the factors that hinder the regulation of alcohol (mis)use in their communities. The findings have shown that alcohol is considered an essential part of the culture of the communities we studied. Alcohol is used for different sociocultural and religious events; as such, these communities view drinking mainly in a positive light. Given the roles drinking plays in sociocultural and religious ceremonies and the availability of large quantities of free drinks at some events, regulating excessive drinking becomes challenging. Furthermore, we found that rapid urbanisation and influx of migrants that facilitated the alteration of traditional norms, unemployment, quests for profit by private businesses, and the government’s lack of interest and willpower are other factors hindering alcohol regulation in Anambra communities.

In these communities, alcohol is viewed in a positive light given the complex roles it performs for them, which is in line with previous research in Nigeria. For instance, Gureje and Olley (1992) found that alcohol is culturally tolerated during festivities and ceremonies in Nigeria and other African communities, especially in places where drinking is not restricted by the Islamic religion. Obot (2000) also reported that drinking alcohol is culturally tolerated, and it constitutes a part of the ceremonial lives of many ethnic groups in Nigeria. Thus, in a society that believes in the symbolic nature of alcohol, regulating its availability and how it is consumed may be challenging.

We found that there are annual/biennial cultural events/celebrations in many communities that promote the availability of free drinks. This finding supports Ibanga et al. (2005), who reported that alcohol consumption is used in religious rituals, marriage ceremonies, and cultural festivals. Also, Odediran (2017) stated that alcohol is tied up with many areas of our lives, and we use it to celebrate life events. Unfortunately, while moderate drinking was normative in the traditional era, we found that heavy drinking may have become common and even tolerated in the contemporary era (Dumbili & Swahn, 2023). Given the large quantities of free drinks that are often provided by event hosts, some attendees may consume it heavily because it is free. Again, because Nigeria does not have standard drink measurements (Dumbili et al. 2022), it becomes more difficult to know how to consume it sensibly. Relatedly, the study found that the loss of cultural/family values has engendered moral decadence among youths who no longer listen to elders or take advice from them. Thus, it is difficult to regulate their drinking behaviours. These complex factors make it very challenging to regulate the drinking behaviours of community members to avoid alcohol misuse.

We also found that some gender-based factors encourage the non-regulation of how alcohol is used among men. Nigeria is essentially a patriarchal society where men dominate (Heap, 1998). Thus, as our findings indicate, men often refuse advice to cut down their heavy drinking, especially if such advice is offered by a woman. As previous research shows (e.g. Dumbili, 2015; Oshodin, 1995), different societies have specific behavioural patterns that are categorised as either masculine or feminine, and one of these is alcohol consumption. In a patriarchal society like Nigeria, alcohol intake is usually reserved for men, and as stated above, it plays a vital role at socioeconomic and religious gatherings (Odediran, 2017). From the participants’ perspectives, it is clear that alcohol consumption is one way of reinforcing masculinity. As such, taking less alcohol or not drinking at all is seen as a weakness or as not being manly enough. The implication of this finding is that regulating alcohol consumption in such a society would be difficult due to such societal constructs because as people get older, they tend to prove their masculinity through drinking and other activities that involve risk-taking (Dumbili, 2022; Thurnell-Read, 2011).

Additionally, the findings show that urbanisation is a factor impairing the control or regulation of alcohol. With urbanisation, development, and the influx of migrants, people no longer act as a community; family and communal values have been altered and monitoring or regulating young people’s behaviours has become difficult. As Dumbili (2013) noted, some striking changes in the patterns of consumption were brought about by the development of the socio-political and economic structures of the country. As societies become more developed and people become individualistic, they are hardly their ‘brother’s keeper’ as in the past, when adults in the community applied disciplinary measures to wayward teenagers on behalf of their parents. As we found in this study, the traditional values of the society have been altered to the extent that some parents will defend their children’s antisocial behaviours such as alcohol mis/use. Our study supports Eguvbe et al. (2020), who assessed the impact of alcohol use among youths and linked it to family background and parental values.

Economically, the findings indicate that it is difficult to control or regulate alcohol consumption, including excessive use because many people earn their living from producing and selling alcoholic drinks. More so, alcohol is cheap, available, and easily accessible for people of all ages because of the lack of a legal drinking age and the lack of means of proving one’s age in Nigeria. These factors affect the control and regulation of drinking behaviour in the communities we examined. This finding is consistent with an earlier report by Gureje et al. (2007), which showed that one of the principal reasons why there is no comprehensive national alcohol policy in Nigeria is because alcohol is the most common drug consumed in the country and its spread and availability is unchecked. The study further reveals that brewers also advertise easily and present a positive view of alcohol; the advertisements by the industry influence people to consume new products and also affect their brand preference. This view connects with Dumbili’s (2014b) critical analysis of the politics of alcohol policy in Nigeria, where it was shown that the leading alcohol producers in Nigeria are the core reason why alcohol policies have not been formulated.

Unemployment is also a factor that hinders the regulation of alcohol (mis)use. Many youths are idle and, since they do not have jobs, they often resort to free drinks, which are available at most events, which often facilitates excessive use. This finding is consistent with Eguvbe et al. (2020), who reported that unemployment predisposes young people to alcohol use and misuse.

Interestingly, participants stressed that their communities cannot make laws or enforce regulations among their members since there are no policies that are backed by the State. Thus, imposing rules regarding how people can sell or consume alcohol would be regarded as an abuse of their fundamental human rights. In fact, we found that community leaders could be sued if they imposed such regulations without the backing of the State. Relatedly, the findings show that the enactment of alcohol control policies has not been possible because of the government’s vested interests, given the tax it receives from alcohol-related businesses. Given the economic interests and the lack of willpower among policymakers, they have failed to enact policies to control and regulate the sale and consumption of alcohol in Nigeria. Therefore, there is no framework for communities to emulate. Unfortunately, Nigeria has participated in global meetings on alcohol control over the years (Abiona et al., 2019). However, this has not translated into comprehensive policies on alcohol control, despite the resounding evidence regarding the harm that excessive alcohol consumption causes in the country (Adeloye et al., 2019; Morojele et al., 2021).

The study has some limitations. First, it was difficult to access participants because some people were unwilling to participate due to the seemingly sensitive nature of the topic. Second, we included fewer female participants than males given that most communities had more males than females in leadership positions. Also, some communities have become urbanised, and this affected the study’s outcome, as identifying community indigenes posed some challenges. Given that our study only focused on community leaders and a few adult members, it is necessary to further investigate the views of other population segments, such as adolescents and young adults, primarily because of their drinking behaviours in contemporary Nigeria. Also, the current study only covered one out of 36 states in Nigeria, necessitating a nationwide survey on the topic to generate data that will facilitate policy implementation to regulate alcohol mis/use.

Conclusion

Our study explored perspectives of community leaders and other members on the factors that hinder alcohol regulation in Anambra communities and showed that sociocultural, economic, and legal factors are interconnectedly responsible. These factors have persisted because of the central role that alcohol plays in the communities we examined, the lack of willpower by the government to implement regulations that community leaders can adopt in their communities and the choices those who use alcohol in these communities make about drinking.

Considering the harm associated with alcohol (mis)use, establishing, and enforcing alcohol formal and informal regulatory rules has become a pressing need that could help reduce the mortality and social vices associated with harmful use. However, establishing rules regarding alcohol (mis)use appears difficult because virtually all of the communities in the research location have a favourable view of alcohol. There is a need to consistently sensitize community members regarding the dangers associated with heavy drinking. In simpler terms, the health and social benefits of abstention or drinking moderately should be focused on. To achieve this, community leaders and other influential members should be trained and equipped to champion this. Importantly, cultural practices should be considered before alcohol control/policies are enacted. That is, the implementation of effective regulations could start with revisiting sociocultural practices promoting excessive consumption or introducing regulatory patterns that communities will not see as a threat to their sociocultural values.

Acknowledgements

The authors wish to thank the participants for their time and for speaking freely about alcohol regulations in their communities. The authors also thank the two anonymous Reviewers for their helpful comments and suggestions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study received funding through the Scientific Research and Writing Mentorship Initiative grant, a collaboration between the World Health Organization, the Alcohol Research Group, and Alliance for Health Policy and Systems Research.