{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T07:51:47Z","timestamp":1773388307784,"version":"3.50.1"},"reference-count":49,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"unspecified","delay-in-days":114,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,9,26]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Problematic alcohol use negatively impacts individuals, families and communities. While perceptions regarding alcohol use are likely vital to mitigating problematic alcohol use at the population level, little is known. Perceptions that demarcate normative versus problematic use may be relevant for interventions in communities with normative alcohol use. Our study explores ethnocentric perceptions of alcohol use in a community where alcohol use is historically integrated into its social fabric.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mixed-methods study design using a culturally curated online survey with closed and open-ended responses assessed perceptions regarding alcohol use. Participants were members of the Kodava community: an affluent ethno-linguistic community in Southern India with an international presence. For Kodavas, alcohol consumption is normative and socially sanctioned. We studied perceptions of alcohol use among family members, including factors influencing its use and the impact of problematic alcohol drinking on immediate and extended family in three domains: health, finances and relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 711 total respondents, a\n                      <jats:italic>small<\/jats:italic>\n                      minority of 11.4% (n=81) stated that at least one immediate family member experienced negative impacts of alcohol use. Among respondents who reported on their extended family (n=639), 52.1% (n=333) endorsed at least one member experienced negative impacts. The integration of quantitative and qualitative data elucidates negative impacts of alcohol use within and at the intersections of health, relationships and finances.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>First study to employ social media (WhatsApp) to survey a globally dispersed ethnic community on alcohol use impacts among family members. Interventions tailored to these perceptions, in culturally embedded communities, may improve outcomes. The framework and approach of this study can be replicated globally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-002385","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:25:48Z","timestamp":1761290748000},"page":"e002385","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Ethnocentric perceptions, impacts and influences of problematic alcohol use in a global community sample: a mixed-methods study"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-0863","authenticated-orcid":false,"given":"Harini","family":"Chakkera","sequence":"first","affiliation":[{"name":"Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Butterfield","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srishti","family":"Sardana","sequence":"additional","affiliation":[{"name":"University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA"},{"name":"Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrit","family":"Mukkatira","sequence":"additional","affiliation":[{"name":"Lopamudra Medical Center, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Unnikrishnan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kasturba Medical College Mangalore, MAHE, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharada","family":"Rai","sequence":"additional","affiliation":[{"name":"Manipal Academy of Higher Education, Kasturba Medical College Mangalore, Mangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kariappa","family":"Appachu","sequence":"additional","affiliation":[{"name":"Banner Health, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshni","family":"Kundranda","sequence":"additional","affiliation":[{"name":"Banner Health, Phoenix, Arizona, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia J","family":"Michlig","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Public Health, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2026010703071887000_3.2.e002385.1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.35946\/arcr.v38.1.05","article-title":"Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework","volume":"38","author":"Sudhinaraset","year":"2016","journal-title":"Alcohol Res"},{"key":"2026010703071887000_3.2.e002385.2","unstructured":"World Health Organization . 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