Alcohol linked to 2.8 million deaths each year worldwide

24 Aug 2018 --- Alcohol is a leading risk factor for death and disease worldwide, and is associated with nearly one in 10 deaths in people aged 15-49 years old, according to a Global Burden of Disease study published in The Lancet. Based on estimates of levels of alcohol use and health effects in 195 countries between 1990 to 2016, the authors suggest that there is no safe level of alcohol as any health benefits of alcohol are outweighed by its adverse effects on other aspects of health, particularly cancers.

They estimate that, for one year, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of the 23 alcohol-related health problems by 0.5 percent, compared with not drinking at all (from 914 people in 100,000 for one year for non-drinkers aged 15-95 years, to 918 in 100,000 people a year for 15-95 year olds who consume one alcoholic drink a day).

Alcohol has a complex association with health, affecting it in multiple ways. Regular consumption has adverse effects on organs and tissues, acute intoxication can lead to injuries or poisoning, and alcohol dependence may lead to frequent intoxication, self-harm or violence.

Globally, one in three people (32.5 percent) drink alcohol – equivalent to 2.4 billion people – including 25 percent of women (0.9 billion women) and 39 percent of men (1.5 billion men). On average, each day women consumed 0.73 alcoholic drinks, and men drank 1.7 drinks.

Risks associated with alcohol
Globally, drinking alcohol was the seventh leading risk factor for premature death and disease in 2016, accounting for 2.2 percent of deaths in women and 6.8 percent of deaths in men. However, in people aged 15-49 years old, alcohol was the leading risk factor in 2016, with 3.8 percent of deaths in women and 12.2 percent of deaths in men attributable to alcohol.

The main causes of alcohol-related deaths in this age group were tuberculosis (1.4 percent of deaths), road injuries (1.2 percent) and self-harm (1.1 percent). For people aged 50 years and older, cancers were a leading cause of alcohol-related death, constituting 27.1 percent of deaths in women and 18.9 percent of deaths in men.

The health problems associated with alcohol at age 50 or older varied depending on region. In high-income countries, cancers were the most common alcohol-related premature death and disease, while in low-income countries tuberculosis was the leading cause, followed by cirrhosis and chronic liver diseases. In middle- and high-to-middle income countries stroke was the main alcohol-related burden.

The authors found that there was only a protective effect between alcohol and ischemic heart disease, and there were possible protective effects for diabetes and ischemic stroke but these were not statistically significant. The risk of developing all other health problems increased with the number of alcoholic drinks consumed each day.

Combining these findings, the protective effect of alcohol was offset by the risks and overall the health risks associated with alcohol rose in line with the amount consumed each day. Therefore, the authors conclude that there is no safe level of alcohol.

Professor Emmanuela Gakidou from the US Institute for Health Metrics and Evaluation, University of Washington, says: “Alcohol poses dire ramifications for future population health in the absence of policy action today. Our results indicate that alcohol use and its harmful effects on health could become a growing challenge as countries become more developed, and enacting or maintaining strong alcohol control policies will be vital.”

“Worldwide we need to revisit alcohol control policies and health programs, and to consider recommendations for abstaining from alcohol. These include excise taxes on alcohol, controlling the physical availability of alcohol and the hours of sale, and controlling alcohol advertising. Any of these policy actions would contribute to reductions in population-level consumption, a vital step toward decreasing the health loss associated with alcohol use,” she notes.