Action needed to reduce health impact of harmful alcohol use

The latest edition of the Global status report on alcohol and health has been published by the World Health Organization (WHO). It analyses available evidence on alcohol consumption and provides data in over 100 individual country profiles.

The WHO says that wider implementation of policies is needed to save lives and reduce the health impact of harmful alcohol drinking. The Global status report explains that, worldwide, harmful use of alcohol results in the death of 2.5 million people annually, causes illness and injury to many more, and increasingly affects younger generations and drinkers in developing countries.

Harmful use of alcohol is defined as excessive use to the point that it causes damage to health and often includes adverse social consequences.

“Many countries recognize the serious public health problems caused by the harmful use of alcohol and have taken steps to prevent the health and social burdens and treat those in need of care. But clearly much more needs to be done to reduce the loss of life and suffering associated with harmful alcohol use,” says Dr Ala Alwan, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health.

The report also recognises that there is a broad range of people adversely affected by the drinking of others. It presents Australian data to show that around 1% of the population was hospitalized due to another person’s drinking in the course of a year, and about the same proportion suffered a domestic assault related to alcohol, according to police records. But much larger numbers report being negatively impacted by somebody else’s drinking in the workplace, household or public place, and by a family member, friend, stranger or someone not well known to the victim. More than two thirds of the survey respondents were adversely affected by someone else’s drinking in the last year. The drinking of a stranger negatively impacted a total of 10.5 million people.

Range and magnitude of alcohol’s harm to others in Australia in 2008

The report presents evidence that, measured in terms of Disability Adjusted Life Years (DALYs), alcohol is the leading global risk factor for 15-59 year olds.

Health implications

Harmful use of alcohol has many implications on public health.

• Nearly 4% of all deaths are related to alcohol. Most alcoholrelated deaths are caused by problems resulting from injuries, cancer, cardiovascular diseases and liver cirrhosis.

• Globally, 6.2% of all male deaths are related to alcohol, compared to 1.1% of female deaths. One in five men in the Russian Federation and neighbouring countries dies due to alcohol-related causes.

• Globally, 320,000 young people aged 15-29 years die annually, from alcohol-related causes, resulting in 9% of all deaths in that age group.

DALYs lost attributable to 10 leading risk factors for the age group
15-59 years in the world, 2004

The WHO complains that too few countries use effective policy options to prevent death, disease and injury from alcohol use. From 1999, when WHO first began to report on alcohol policies, at least 34 countries have adopted some type of formal policies to reduce harmful use of alcohol. Restrictions on alcohol marketing and on drink–driving have increased, but there are no clear trends on most preventive measures. Many countries have weak alcohol policies and prevention programmes.

Effective strategies

The Global Strategy to reduce the harmful use of alcohol, endorsed by WHO’s Member States in May 2010, promotes a range of proven effective measures for reducing alcohol-related harm. These include taxation on alcohol to reduce harmful drinking, reducing availability through allowing fewer outlets to sell alcohol, raising age limits for those buying alcohol and using effective drink-driving measures.

The Global Strategy also promotes screening and brief interventions in healthcare settings to change hazardous patterns of drinking, and treatment of alcohol use disorders, regulating or banning marketing of alcoholic beverages and conducting information and educational campaigns in support of effective policy measures.

Consumption

Worldwide consumption in 2005 was equal to 6.13 litres of pure alcohol consumed per person aged 15 years or older, according to the report. Analysis from 2001-2005 showed countries in the WHO Americas, European, Eastern Mediterranean and Western Pacific regions had relatively stable consumption levels during that time; but marked increases were seen in Africa and South-East Asia during the five-year period.

Despite widespread consumption, most people do not drink. Almost half of all men and two-thirds of women did not consume alcohol in 2005, according to the latest information made available in the report. Abstention rates are low in high-income, high consumption countries, and higher in North African and South Asian countries. But those who do drink in countries with high abstention rates consume alcohol at high levels.

Reducing harmful use of alcohol worldwide

The launch of the Global Alcohol Report coincided with the end of a four-day meeting of officials from over 100 countries working with WHO to reduce harmful use of alcohol worldwide. This first such meeting, hosted by WHO in Geneva, was held to initiate implementation of the Global Strategy to Reduce the Harmful Use of Alcohol. The strategy aims to raise awareness of the problems of harmful alcohol use and help countries to better prevent and reduce such harm.