Health risk distribution by socio-economic status and educational levels of Thai households: Who smokes and drinks more? BACKGROUND: Tobacco and alcohol consumption remained two major contributors to burden of disease (BOD) in Thailand in terms of Disability Adjusted Life Year (DALY) loss as indicated by the 1999 and 2004 Burden of Disease Study. These two health risk behaviors contributed approximately 37% of total DALY loss in There is no evidence on the distribution of such health risk behaviors across different socio-economic status and educational levels of Thais. OBJECTIVES: To assess the prevalence and trends in cigarette smoking and alcohol consumption among Thais of different income quintiles and educational levels from 2001 to 2006; To explore household spending on tobacco and alcohol, and health expenditure, across households of different income quintiles. METHODS: Secondary data analyses of two nationally representative household surveys conducted by the National Statistical Office of Thailand (NSO) on: Alcohol and tobacco consumption of Thais aged over 15 years in 2001, 2003 and 2006; Household expenditure on tobacco, alcohol, and health in 2002, 2004 and 2006; Household income quintiles were adjusted by adult equivalence scale, Q1 - the poorest and Q5 - the richest; Educational levels were classified as no education/primary, secondary, and university or higher education. Data sources: Six nationally representative household surveys in Thailand: the 2001, 2003 and 2006 Health and Welfare Surveys (HWS); the 2002, 2004, and 2006 Socio-economic Surveys (SES). RESULTS: Conclusions: The poor and those with lower education had higher prevalence of cigarette smoking and alcohol consumption, Those with lower education and the poor less benefited from the government campaigns against tobacco and alcohol, There is a need for urgent revisit of effective policy interventions on alcohol consumption control in Thailand including both demand and supply side interventions e.g. taxation and price policy, Other important interventions include control of accessibility to alcohol, restrict hours of sale, minimum purchasing age, and drunk-driving testing. Vichai Chokevivat, Supon Limwattananon, Kanitta Bundhamcharoen, Phusit Prakongsai, Viroj Tangcharoensathien International Health Policy Program (IHPP) – Thailand For further information, contact Dr. Phusit Prakongsai This study was financially supported by MOPH and CREHS Figure 1: Estimates of the prevalence of tobacco consumption by educational levels The prevalence of regular cigarette use in Thailand continuously decreased from 2001 to 2006 and share of the never smoking group was increasing; There is a negative correlation between cigarette smoking and educational levels (Figure 1), as well as the prevalence of cigarette smoking and income quintiles (Figure 2). Figure 2: Estimates of the prevalence of tobacco consumption by income quintiles Figure 3: Estimates of the prevalence of alcohol consumption by educational levels The prevalence of regular alcohol use tended to increase among those graduated from secondary schools, while that in higher education group tended to decrease; There is an unclear correlation between the prevalence of alcohol consumption and educational levels (Figure 3), but a negative correlation between alcohol consumption and income quintiles. Figure 4: Estimates of the prevalence of alcohol consumption by income quintiles