Background: Unrecorded traditional distilled spirits (bai jiu, 白酒) are made and used throughout rural China for everyday use and special occasions. Nearly every town or village has a distiller to supply the demand. In rural China, distilling bai jiu is legal and regulated lightly or not at all. The World Health Organization estimates that as much as 25% of all alcohol consumed in China is unrecorded alcohol, of which an unknown portion is unrecorded bai jiu. Little is known about the composition of unrecorded Chinese spirits from rural parts of the country. This study focused on white spirits because the high ethanol (EtOH) concentration makes them more likely to contribute to health risks compared to other types of lower alcohol by volume (ABV) Chinese unrecorded alcohol.Methods: Researchers purchased samples of Chinese white spirits from small-factory distillers in central China. An independent laboratory conducted the analysis. Alcohol strength (ABV) was determined by hydrometer. Gas chromatography was used to determine the concentration of volatile organic compounds: EtOH, methanol, acetaldehyde, ethyl acetate, and higher alcohols. Samples were tested for 3 heavy metals-arsenic, cadmium, and lead. We used the guidelines developed by the Alcohol Measures for Public Health Research Alliance (AMPHORA) of the European Commission to assess risk.Results: ABV ranged from 35.7 to 61.4%, and 58 of the 61 samples exceeded 40% ABV. The concentration of methanol, ethyl acetate, lead, arsenic, and cadmium was below AMPHORA guideline. The sum of higher alcohols exceeded the AMPHORA maximum in just 1 sample. Forty of the 61 samples had acetaldehyde levels beyond the AMPHORA guideline.Conclusions: The unrecorded Chinese alcohols we analyzed had a high EtOH concentration-a public health concern that is also presented by recorded alcohols. The high percentage of samples (65.5%) that had elevated acetaldehyde suggests the need to investigate the causes for this result and the need for steps to reduce acetaldehyde levels. The cumulative long-term risks of using high EtOH and high acetaldehyde Chinese spirits are heightened by the percentage of people in China who have a genetic trait for impaired acetaldehyde metabolism.

of tobacco product retailers have led to a decrease in the prevalence of youth buying cigarettes in a store [3][4][5] . However, social access to cigarettes has been increasing, with strong evidence indicating that youth aged <18 years can obtain their cigarettes from friends and young adults aged 18-20 years [6][7][8] .In 2015, the Institute of Medicine (IOM) examined existing literature on tobacco use initiation and ABSTRACT INTRODUCTION Tobacco control laws that raise the minimum age of tobacco sales to 21 years (T21) play a pivotal role in youth tobacco prevention, yet empirical data are sorely needed to inform enforcement, compliance efforts, and future legislation. METHODS Spatial analysis was conducted at the zip code level by geocoding the states and localities that adopted T21 ordinances from 2015 to 2019. A multi-level logistic regression model was conducted to examine disparities in neighborhood socioeconomic status (SES), FDA retail inspection, and state-level tobacco control policies associated with T21 adoption. RESULTS T21 adoption at the state and local level increased considerably from 1.4% of zip codes in 2015 to 40.2% in 2019. However, the T21 ordinances were disproportionally adopted in New England (82.6%) and Pacific (73.6%) regions with scarce coverage in East South Central (<0.1%), Mountain (1.6%), and West North Central regions (6.1%). The T21 policies were more likely to be adopted in areas with stronger tobacco control policies, urban areas (vs rural, adjusted odds ratio, AOR=1.25, p=0.005), areas with a larger Hispanic (AOR=1.19, p<0.0001) or Asian population (AOR=1.12, p<0.0001), and in areas where the population had higher levels of education (AOR=1.05, p<0.0001). It was less likely to be adopted in areas with larger proportions of American Indians, youths, and young adults. Nearly 40% of zip codes with tobacco retailers did not receive annual FDA tobacco retail inspections for underage sales in 2019. The average retail violation rate of underage sales of tobacco products in T21 regions was lower than in non-T21 regions. CONCLUSIONS Disparities in T21 adoption, retail inspections, and retail compliance may limit the policy impact. Unified enforcement of youth tobacco access restrictions with resources and interventions in vulnerable communities is needed to reduce tobacco-related health disparities.

Newman, I., Qian, L., Tamrakar, N., Feng, Y., & Xu, G. (2017). Chemical content of unrecorded distilled alcohol (bai jiu) from rural central China: Analysis and public health risk. The International Journal Of Alcohol And Drug Research, 6(1), 59-67. doi:http://dx.doi.org/10.7895/ijadr.v6i1.236Aims: To test 47 samples of locally distilled unrecorded beverage alcohol (bai jiu) obtained in rural central China.Methods: Alcohol samples purchased from home-based makers or from small village shops were analyzed for ethanol, methanol, acetaldehyde, ethyl acetate, six higher alcohols, arsenic, cadmium, and lead. Results were judged against the standards for these compounds set by the AMPHORA Project.Findings: Ethanol concentrations ranged from 38.7% to 63.7% (mean 50.4%). Methanol and methyl acetate detected in all samples did not exceed the Alcohol Measures for Public Health Research Alliance (AMPHORA) limits. Acetaldehyde was present in all samples, with three samples exceeding the AMPHORA limit by a small amount. Lead was found in 57.4% of the samples with one sample exceeding the AMPHORA limit; cadmium was found in 89.4% of the samples with two exceeding the AMPHORA limit. Arsenic was found in 46.8% of the samples with none exceeding the AMPHORA limit.Conclusions: The three samples that exceeded AMPHORA limits for cadmium or lead are of concern in terms of the potential of long-term exposure for local people who regularly consume locally made bai jiu. The main health concern from bai jiu appears to be the risk associated with high ethanol concentration—the same health concern as for recorded, commercially produced spirits.

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About 20% of spirits consumed in China are “unrecorded”, where these spirits are produced in small-scale distilleries and sold outside the systems of taxation and quality control. Researchers visited small distilleries in rural Yunnan, Hubei and Anhui and purchased 56 samples of unrecorded bai jiu. Seven samples of the recorded bai jiu were purchased as reference samples. An independent laboratory conducted a blind analysis of the samples. Results were compared to the standards for unrecorded alcohol adopted by the European Commission’s Alcohol Measures for Public Health Research Alliance (AMPHORA). No samples exceeded the AMPHORA guidelines for methanol, ethyl acetate, lead and cadmium; one sample exceeded 1000 g/hL of combined higher alcohols; one sample exceeded 100 mg/L of arsenic; and three samples exceeded 50g/hL of acetaldehyde, but only by relatively small amounts. Low-priced unrecorded bai jiu averaged 9.8 RMB/jin (500 mL), compared to 10.7 RMB/jin for inexpensive recorded bai jiu. The low-priced unrecorded bai jiu samples had a mean alcohol-by-volume of 51.8%, compared to 50.1% for the recorded bai jiu samples. The results did not raise any critical safety issues with unrecorded bai jiu, but there may be long-term health risks related to ethanol, acetaldehyde and arsenic. The social ties between the bai jiu makers and the people who consume their product are a deterrent to adulteration; but when bai jiu is sold outside of the social circle, the deterrent disappears.