Abstract

Background: Reports of unrecorded alcohol consumption have relied on aggregated and regional information rather than empirical research on national characteristics. This study aims to inform about the Chilean unrecorded alcohol market and the magnitude of unrecorded consumption. Methods: We employed a multi-methods approach with four components: a Delphi panel among experts (n = 21), a survey of people at increased risk of problematic alcohol consumption (n = 138), semi-structured interviews with key stakeholders and alcohol industry informants (n = 12), and chemical analysis of 10 unrecorded alcohol samples. Results: After two rounds of consultations, experts challenged prior estimates of unrecorded alcohol consumption and set per capita levels between 0.05 and 0.5 liters of pure alcohol (0.7 %-8 % of total per capita alcohol consumption), with homemade alcohol as the primary source (31 %). Homemade alcohol consumption was prevalent among individuals at high risk of problematic alcohol use, where clandestine or unlicensed establishments and artisanal producers were primary sources. Informants identified regulatory controls, production traceability, and the affordability of recorded alcohol as factors that limit the unrecorded alcohol market in Chile. Conversely, the availability of raw materials and alcohol taxation were seen as potential threats. Finally, while chemical analyses revealed that some unrecorded alcohol samples exceeded regulatory parameters (e.g., acidity, impurities), all 10 samples were safe for human consumption. Conclusions: Unrecorded alcohol consumption in Chile appears to be lower than previous estimates. A robust surveillance system of the alcohol market will strengthen the institutional capacity to monitor and take actions to prevent harm from recorded and unrecorded alcohol use.