Alcohol

Fact sheet
February 2011

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Key facts

• The harmful use of alcohol results in 2.5 million deaths each year.
• 320 000 young people between the age of 15 and 29 die from alcohol-related causes, resulting in 9% of all deaths in that age group.
• Alcohol is the world’s third largest risk factor for disease burden; it is the leading risk factor in the Western Pacific and the Americas and the second largest in Europe.
• Alcohol is associated with many serious social and developmental issues, including violence, child neglect and abuse, and absenteeism in the workplace.

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The harmful use of alcohol is a global problem which compromises both individual and social development. It results in 2.5 million deaths each year. It also causes harm far beyond the physical and psychological health of the drinker. It harms the well-being and health of people around the drinker. An intoxicated person can harm others or put them at risk of traffic accidents or violent behaviour, or negatively affect co-workers, relatives, friends or strangers. Thus, the impact of the harmful use of alcohol reaches deep into society.
Harmful drinking is a major determinant for neuropsychiatric disorders, such as alcohol use disorders and epilepsy and other noncommunicable diseases such as cardiovascular diseases, cirrhosis of the liver and various cancers. The harmful use of alcohol is also associated with several infectious diseases like HIV/AIDS, tuberculosis and sexually transmitted infections (STIs). This is because alcohol consumption weakens the immune system and has a negative effect on patients’ adherence to antiretroviral treatment.
A significant proportion of the disease burden attributable to harmful drinking arises from unintentional and intentional injuries, including those due to road traffic accidents, violence, and suicides. Fatal injuries attributable to alcohol consumption tend to occur in relatively younger age groups.

Who is at risk for harmful use of alcohol?

The degree of risk for harmful use of alcohol varies with age, sex and other biological characteristics of the consumer. In addition the level of exposure to alcoholic beverages and the setting and context in which the drinking takes place also play a role. For example, alcohol is the world’s third largest risk factor for disease burden; it is the leading risk factor in the Western Pacific and the Americas and the second largest in Europe. Furthermore, 320 000 young people between the age of 15 and 29 die from alcohol-related causes, resulting in 9% of all deaths in that age group. Alcohol consumption by an expectant mother may cause fetal alcohol syndrome and pre-term birth complications, which are detrimental to the health and development of neonates.

 

Figure: Global percentages of DALYs¹ attributed to 19 leading risk factors by income group.
Source: Global Health Risks (2009)
The impact of alcohol consumption on disease and injury is largely determined by two separate but related dimensions of drinking:

• the total volume of alcohol consumed, and
• the pattern of drinking.

A broad range of alcohol consumption patterns, from occasional hazardous drinking to daily heavy drinking, creates significant public health and safety problems in nearly all countries. One of the key characteristics of the hazardous pattern of drinking is the presence of heavy drinking occasions, defined as consumptions of 60 or more grams of pure alcohol.

Ways to reduce the burden from harmful use of alcohol

The health, safety and socioeconomic problems attributable to alcohol can be effectively reduced and requires actions on the levels, patterns and contexts of alcohol consumption and the wider social determinants of health.
Countries have a primary responsibility for formulating, implementing, monitoring and evaluating public policies to reduce the harmful use of alcohol. A substantial scientific knowledge base exists for policy-makers on the effectiveness and cost–effectiveness of the following strategies:

• regulating the marketing of alcoholic beverages, (in particular to younger people);
• regulating and restricting availability of alcohol;
• enacting appropriate drink-driving policies;
• reducing demand through taxation and pricing mechanisms;
• raising awareness and support for policies;
• providing accessible and affordable treatment for people with alcohol-use disorders; and
• implementing screening programmes and brief interventions for hazardous and harmful use of alcohol.

WHO response

WHO aims is to reduce the health burden caused by the harmful use of alcohol and, thereby, to save lives, prevent injuries and diseases and improve the well-being of individuals, communities and society at large.
WHO emphasizes the development, testing and evaluation of cost-effective interventions for harmful use of alcohol as well as creating, compiling and disseminating scientific information on alcohol use and dependence, and related health and social consequences.
In 2010, the World Health Assembly approved a resolution to endorse a global strategy to reduce the harmful use of alcohol. The resolution urged countries to strengthen national responses to public health problems caused by the harmful use of alcohol.
The global strategy to reduce the harmful use of alcohol represents a collective commitment by WHO Member States to sustained action to reduce the global burden of disease caused by harmful use of alcohol. The strategy includes evidence-based policies and interventions that can protect health and save lives if adopted, implemented and enforced. The strategy also contains a set of principles that should guide the development and implementation of policies; it sets priority areas for global action, recommends target areas for national action and gives a strong mandate to WHO to strengthen action at all levels.
The policy options and interventions available for national action can be grouped into 10 recommended target areas, which are mutually supportive and complementary. These 10 areas are:

• leadership, awareness and commitment;
• health services’ response;
• community action;
• drink–driving policies and countermeasures;
• availability of alcohol;
• marketing of alcoholic beverages;
• pricing policies;
• reducing the negative consequences of drinking and alcohol intoxication;
• reducing the public health impact of illicit alcohol and informally produced alcohol;
• monitoring and surveillance.

The Global Information System on Alcohol and Health (GISAH) has been developed by WHO to dynamically present data on levels and patterns of alcohol consumption, alcohol-attributable health and social consequences and policy responses at all levels.
Successful implementation of the strategy will require concerted action by countries, effective global governance and appropriate engagement of all relevant stakeholders. By effectively working together, the negative health and social consequences of alcohol can be reduced.

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¹ The disability-adjusted life year (DALY) extends the concept of potential years of life lost due to premature death to include equivalent years of "healthy" life lost by virtue of being in states of poor health or disability.
Antar M.A. Al-Omani(FIBMLS,MSc,CB,Leeds,UK)