Understanding the alcohol harm in Nepal requires an exploration of the alcohol norm in the country and its cultural connotations for the Nepalese people. Any alcohol policy and law to prevent and reduce alcohol harm has to start from changing these norms and people’s ideologies and attitudes towards alcohol.
Alcohol is available everywhere in Nepal. From little corner shops to dazzling liquor stores, there are plenty of options to suit all kinds of wants and wallets,” said Sanjeev Kumar Shah, program coordinator at Sober Recovery and Rehabilitation Center (SRRC), as per The Annapurna Express.Sanjeev Kumar Shah, program coordinator, Sober Recovery and Rehabilitation Center (SRRC)
But most people in Nepal live free from alcohol.
According to one study reported by The Annapurna Express, 21% males and 1.5% females in Nepal consumed alcohol.
According to the World Health Organization, 72.9% of Nepalese people (61.6% male, 82.9% female) live alcohol-free. This means it is only a minority of Nepalese who consume alcohol. This is reflected in total per capita alcohol use: population-level alcohol consumption is very low at 2% and well below the average for the WHO South-East Asia Region.
Rising alcohol harms
Despite the majority of Nepalese people living alcohol-free, alcohol causes a heavy burden to communities and society in Nepal. This is common to many low- and middle-income countries.
According to a study published in the Lancet under the Global Burden of Diseases Study in 2020, the amount of people in Nepal who use alcohol above the “non drinker equivalent (NDE)” has increased since 1990 in all age groups. The highest increase has been among males aged 15 to 39 years and males aged 40 to 64 years – both age groups saw an increase of 9.75% each since 1990. This is followed by the 7.17% increase seen among males aged over 65 years. For females the increase in NDE has been below 5% for all age groups.
The study cited by The Annapurna Express found:
- Alcohol deaths increased by 376% between 1990 and 2016 in Nepal,
- According to WHO in 2016 alcohol caused,
- 1229 deaths due to liver cirrhosis,
- 897 deaths due to road traffic injuries, and
- 295 deaths due to cancer.
These figures are only deaths directly linked to alcohol. The number of people killed due to alcohol is likely much higher, when other harms are considered, including alcohol violence.
Apart from causing deaths, alcohol fuels rampant social harms, such as domestic and sexual violence, accidents, and many other crimes according to the Nepalese Police.
So, if most people live free from alcohol in Nepal, how does it cause this much harm?
Alcohol norms in Nepal
One main reason is the easy and wide availability of alcohol in Nepal. This did not happen overnight. The entrenched alcohol norms among several communities in the country led to high alcohol availability, which is driven and exploited by the alcohol industry.
The minority of people who do use alcohol use it for both celebrations as well as mourning. The pressure to use alcohol in social settings where others use is high. Not using alcohol can make a person an outsider amongst their own people.
In Nepal the cultural and social norms of alcohol use can be divided into two:
- Tagadhari, those who wear a janai on their shoulder, live alcohol-free, and
- Matawalis, those who have cultural alcohol norms and therefore, use alcohol products.
Different cultures have different occasions where they use alcohol, but there are some commonalities. Most of the alcohol using communities have alcohol norms related to marriages or weddings, deaths and funerals and certain other cultural and religious rituals. These alcohol using communities also have home-made alcohol types specific to their community.
Alcohol norms related to marriage
In the Kirat, Gurung and Tamang communities a groom is expected to send alcohol to a bride’s family for the bride’s family to accept the marriage proposal.
The Kirat community home-brews a beer called “Tonga”. The Gurungs home-brew “Marpha” or apple brandy and make “Jhaikhatte” – a home-made liquor coffee.
Both Sherpa and Tharu communities use alcohol during wedding ceremonies.
The Sherpa community home-brews a beer called “Chhyang”. The Tharu community has a home-made alcohol called “Madh”.
In the Magar community the newlywed couple is expected to perform a ritual called “Duran” where they must go to the bride’s home with a bottle of wine and a leg of goat.
Rituals and alcohol norms
The Kirat community exchanges alcohol during rituals such as sodhani, multheki and bhakah. The Kirat community also uses alcohol for various rituals and to worship gods and goddesses.
The Newa community has a particularly strong alcohol norm where alcohol plays a role during various pujas or rituals and festivals like during Indra Jatra. The Newa community is also known for home-brewing “Aila” – a type of alcohol that is served to bless the achievements of community members and is served by women during social gatherings or feasts. Newas also home-brew the beer called “Thon”.
The Sherpa community uses alcohol extensively during festivals. Alcohol is even given to new mothers. Alcohol is also used in business settlements by Sherpas.
The Tharu community offers alcohol to deities as deuryar. They also have a ritual for the haircutting of a boy where alcohol is offered to deities to begin the ceremony.
Alcohol norms and funerals
The Gurung and Tamang communities offer alcohol to their deceased.
The alcohol-free communities of Nepal
As explained above, those who wear a “Janai” in Nepal live alcohol-free. Janai is a sacred thread in Hindu culture. It has a high religious and cultural significance among Hindu men.
Wearing the Janai serves as a reminder to the wearer to adhere to certain vows and rules and to always follow the conduct and lessons taught by their gurus. The Janai is also believed to grant the wearer knowledge, power, prosperity, and wisdom. In turn the person who wears it is expected to be dutiful, loyal, respectful, truthful and disciplined.
In the past, the Janai was gold or silver. Today it is made of cotton. At present, only men from Bramhin, Kshetriya and Vaishya varna groups which are higher castes wear the Janai.
While today, only the higher castes wear the Janai experts in religion say it is the right of every person, man or woman to wear the Janai. An expert on religion and culture, Basudev Krishna Shastri says in the past both men and women of all castes probably wore the Janai. He points out how the same thread is offered to both gods and goddesses indicating women also wore the Janai. Certain religious texts also indicated women wore the Janai in the past as well.
It is understood that people gradually stopped wearing the Janai due to the vows one has to keep when wearing it. Even certain Brahmin and Kshetriya men do not wear the Janai.
Considering the history of the Janai and the abstention from alcohol among those who wear it, it is possible that all Hindu people of the past lived alcohol-free and that the alcohol norms related to rituals only developed later on.
The current state of alcohol laws in Nepal
Nepal currently has some laws in place to protect people from alcohol harm. These include the following:
- Restricted opening hours for licensed alcohol outlets between 10:00 AM to 10:00 PM.
- Minimum age for alcohol use of 18 years.
- Licensing required for outlets to sell alcohol.
- Quality control.
- Enforcing a card system.
- Restrictions on alcohol advertising.
- A cap on the production of alcohol in a year.
- Prohibition of home-made alcohol products such as “Aila”.
However, implementation of even these existing laws are low.
Although some of the local governments have brought these laws into force, there is no such legal provision maintained by the provincial governments as of now,” said Jyoti Baniya, president of the Consumer Welfare Protection Forum, as per my República.Jyoti Baniya, president, Consumer Welfare Protection Forum
Meanwhile, Tek Prasad Rai, spokesperson of the Nepal Police, believes that the current alcohol laws are not enough and there is an urgent need for proper provisions regarding the manufacture and sales of alcohol products.
The Police spokesperson says that the alcohol norms of certain communities make it hard for the police to enforce even the existing laws regarding alcohol production and sale.
Those who see the rampant harm caused by alcohol first hand are the people working in Nepalese Rehabilitation Centers. They also agree that improved alcohol policy solutions and laws are a necessity in Nepal.
Shishir Thapa, founder of Cripa Nepal, highlights that alcohol use disorders are increasing in Nepal. Despite their best efforts, most of their patients relapse once they leave the rehabilitation center. He adds that men develop alcohol use disorders more often in Nepal due to harmful patriarchal norms which excuse men for any behaviors.
According to the World Health Organization, 3.1% of Nepalese men suffer from alcohol use disorders with 2.1% dependent on alcohol.
Communities, civil society, the Nepal Police, addiction treatment providers, and many more have been calling on the Nepalese government to pass the bill to transform improved alcohol policy solutions into law and better protect people and communities from alcohol harm.
Community members say the main cause for rising alcohol use and harm is easy and wide alcohol availability. The increasingly pervasive alcohol norm and high availability propagated by the alcohol industry are putting Nepali youth in alcohol harm’s way.
Apart from the alcohol norms in various cultures, the alcohol industry works to establish an alcohol norm that conditions people to associate alcohol with being “cool”. Increasingly, young people are engaging in alcohol use just to fit in.
Nepalis are at a high risk of alcohol harm as alcohol is available everywhere and anyone can access it,” said Shisir Thapa, founder of Cripa Nepal, an alcohol rehabilitation center, as per, The Annapurna Express.
There is no oversight on who is selling alcohol and who is buying it. This has been creating many problems in our society but the government remains oblivious.”Shisir Thapa, founder, Cripa Nepal
Police takes action against driving of school buses under the influence of alcohol
Since July 24, 2022, Nepal’s traffic police has been conducting a campaign to prevent school vehicle drivers from driving under the influence of alcohol. The police is working to better enforce the rules of the School Bus Directory 2074. On July 31, 2022 alone, traffic police apprehended five drivers who were driving school buses under the influence of alcohol.
Improved alcohol policy still not implemented
The government of the Federal Democratic Republic of Nepal, planned to adopt a new policy in 2017 to coherently and effectively regulate the alcohol industry in the country.
The core features of the policy included the following:
- Total ban of alcohol advertisement, promotion and sponsorship.
- Decreasing availability: in the future alcohol will only be sold by especially licensed shops for certain hours.
- Decreasing alcohol availability: the minimum age for alcohol purchases is increased from 18 to 21 years.
- All alcohol containers will have at least a 75% health warning. Nepal will be the first country in the world to introduce 75% pictorial warnings.
- Alcohol will no longer be used in Government-sponsored programs and events.
- Alcohol is no longer allowed to be sold in public places including heritage sites, educational institutions, and sports complexes.
However, alcohol industry interference in the last minute stopped the Council of Ministers from adopting the policy. It was never revived since 2017 and many lives have been lost that could have been saved with better alcohol policy solutions.
Failure to implement the alcohol policy in the last five years has led to rising alcohol use and harm.
You [the government] can’t allow something to thrive like the way it has allowed the liquor industry to and then tell people to be responsible adults,” said Bishnu Sharma, CEO of Recovery Nepal, the umbrella organization of rehabilitation centers in Nepal, as per The Annapurna Express.Bishnu Sharma, CEO, Recovery Nepal
It was expected that following the alcohol policy a new and evidence-based “Alcohol Control and Regulation Bill” would also be developed to implement the policy. However, the policy never was adopted. And so the bill never materialized either.
The Nepal Advertisement Board is said to have issued a statement to stop advertising alcohol and alcoholic products, citing Article 45 under the Public Health Service Act 2018. However, the level of implementation of this is unclear.
Cross border trade issues with Bihar, India
The lack of policy protections on the production and sale of alcohol in Nepal has become a problem beyond Nepal as well. In the Indian State of Bihar women campaigned against alcohol-fueled violence and were able to make the state alcohol-free. This resulted in decreased crime and violence in the state. But, cross-border trade happening with nearby Nepal is now threatening these gains achieved in Bihar.
Nepal is also suffering under the cross-border trade with India. Outlets selling alcohol have cropped up in border towns on the Nepali side looking to make a profit off of the Indian customers from the Bihar side. The increase in alcohol outlets has inevitably brought with it a rise in alcohol-fueled violence.
There are many scientific studies showing the link between alcohol outlet density and violence. This is why reducing alcohol availability, such as by reducing outlet density and limiting hours of sale is one of the alcohol policy Best Buys recommended by the World Health Organization.
Urgent action to improve alcohol policies needed in Nepal
If action is not taken to implement comprehensive alcohol policy solutions, the alcohol harm in Nepal will continue to rise and burden Nepalese people and communities immensely.
When member states endorsed the WHO Global Alcohol Strategy at the 63rd World Health Assembly in May 2010 Nepal also committed to the strategy.
But now WHO projections show that Nepal is still a long way from reaching the targets enshrined in the Agenda 2030, the NCDs Global Action Plan, and the new WHO Global Alcohol Action Plan that were all endorsed by the government. Alcohol use remains one of the few health risk factors that are projected to increase in Nepal until 2023.
[This article was updated on October 24, 2022]
The Annapurna Express: “Nepal’s drinking problem“
Online Khabar: “Janai: The story of ‘the sacred thread’ of some Hindu men“