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WHO: Harmful alcohol use kills 3 million globally in 2016
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Although there have been positive trends in prevalence of heavy episodic drinking and alcohol-related mortality since 2010, there have been no global reductions in total per capita consumption and the global burden of disease related to alcohol remains high, a report issued by WHO found.
With the current trends projecting a rise in total per capita alcohol consumption worldwide over the next 10 years, WHO will not meet their target of a 10% relative reduction in the harmful use of alcohol by 2025 unless effective alcohol control measures are implemented in countries with high and rising levels of alcohol intake, according to WHO’s “Global status report on alcohol and health 2018.”
“The situation with alcohol consumption level in the world continues to be very high with very significant disease burden attributable to alcohol consumption. We have 3 million deaths, which are the latest estimates for 2016 — this is 5.3% of all global deaths,” Vladimir Poznyak, MD, PhD, coordinator of the WHO Management of Substance Abuse program, said during the virtual press briefing. “The policy responses currently in place in countries are definitely not sufficient to reverse the trends which we observe in several parts of the world or to improve significantly this situation with alcohol-related harm in the world.”
The report presented information on reducing the harmful use of alcohol, global strategies for monitoring and prevention, trends on alcohol consumption at the global and regional levels, health consequences, and alcohol’s impact on public health and policy responses.
“The report presents also some positive trends, which took place from 2010, which shows the feasibility of reduction of harmful use of alcohol when effective policies are being implemented,” Poznyak added.
Global alcohol consumption
Worldwide in 2016, approximately 2.3 billion people were current drinkers, according to the report. Alcohol is consumed by more than half of the population in the Americas, Europe and the Western Pacific. Additionally, 26.5% of all adolescents aged 15 to 19 years are current drinkers, amounting to 155 million teenagers globally.
While the prevalence of heavy episodic drinking has dropped from 22.6% in 2000 to 18.2% in 2016 in the total global population, it remains high among drinkers. Worldwide, the prevalence of heavy episodic drinking peaks at age 20 to 24 years, becoming higher than in the total population overall. Although the prevalence of heavy drinking among drinkers is similar for most higher-and lower-income countries, the economic wealth of countries is linked with higher alcohol consumption and higher prevalence of current drinkers across all WHO regions, the report said.
By 2025, WHO has projected the total alcohol per capita consumption in people aged 15 years will increase in the Americas, South-East Asia and the Western Pacific unless these increasing trends in alcohol consumption are stopped and reversed.
Harmful use, health consequences
Heavy drinking is a major population health concern that impacts maternal and child health; infectious diseases, noncommunicable diseases and mental health; injuries; and poisonings, according to the report. However, global strategies and action plans have yet to sufficiently address its role on disease burden.
Alcohol was responsible for 7.2% of all mortality in 2016 globally. Worldwide, the harmful use of alcohol resulted in about 3 million deaths — more than three quarters of which were among men — and 132.6 million disability-adjusted life years in 2016, according to WHO. Mortality caused by alcohol use was higher than that caused by tuberculosis, HIV/AIDS and diabetes.
The report showed that an estimated 237 million men and 46 million women have alcohol use disorders, with the highest prevalence observed in the European Region and the American Region. An estimated 2.3 million deaths and 106.5 million disability-adjusted life years were attributable to drinking among men in 2016 while women saw 0.7 million deaths and 26.1 million disability-adjusted life years.
Further, the report stated that alcohol is often used concurrently with other psychoactive substances. WHO recommended that public health approaches should consider this connection between alcohol and other psychoactive substance use, particularly with opioids and benzodiazepines, in the prevention of overdose deaths.
Global strategies, policies and interventions
The report revealed that in 2016, 80 countries had written national alcohol policies, eight countries had subnational policies and 11 others had a total ban on alcohol. Although the percentage of countries with a written national alcohol policy steadily increased from 2008, most countries in Africa and the Americas do not have such policies.
Further, the level of treatment coverage for alcohol dependence remains unknown in most countries, according to WHO. Approximately half of countries indicated that they increased the level of screening and brief interventions for harmful drinking in primary health care settings since 2010, but most of this happened in high-income and upper-middle-income countries. Though most countries have some type of restrictions on beer advertising, almost half of countries reported no restrictions on the Internet and social media, WHO wrote in their report.
Effective alcohol policies protect the health of populations, according to the report. WHO offered recommendations to reduce the harmful use of alcohol with updated evidence on cost-effectiveness of policy options and interventions. The most cost-effective actions included raising taxes on alcoholic beverages, banning or regulating media advertising relating to alcohol, and restricting the physical availability of alcohol.
WHO also highlighted its Global Information System on Alcohol and Health, a repository for all key alcohol-related indicators (alcohol consumption, health and social consequences, and policy and program responses) included in its global monitoring frameworks for noncommunicable diseases. National monitoring systems often only collect data on alcohol consumption and related health consequences and less often monitor social consequences and alcohol policy responses. The report advises public health should monitor all three indicators, and countries should generate international comparability of data for global surveillance.
Public health response
The report highlighted the need for “whole of government” and “whole of society” approaches with collaboration between public health-oriented organizations, professional associations and civil society groups to combat the harmful use of alcohol on the global level.
WHO reported that the magnitude of health and social problems caused by alcohol requires coordinated actions by different parts of the United Nations system and intergovernmental organizations in the context of the 2030 Agenda for Sustainable Development. To effectively monitor and report on the alcohol-related indicators, future efforts need to simplify data generation, collection, validation and reporting procedures, as well as methodological advances in assessing treatment coverage for substance use disorders.
Collaborative actions are needed to address increasing trends in alcohol consumption in the South-East Asia and Western Pacific regions, support decreasing trends in the Americas and continue encouraging positive changes in European regions. While alcohol policy development and implementation have improved across the globe, they do not effectively protect populations from alcohol-related harm.
WHO reported the following opportunities for reducing the harmful use of alcohol globally:
- including alcohol-related targets in major global policy and strategic frameworks;
- growing health consciousness in populations;
- reducing youth alcohol consumption;
- recognizing the role of alcohol control policies in reducing gender inequalities; and
- gathering evidence of effectiveness and cost-effectiveness of multiple alcohol control measures.
At the end of the briefing, Poznyak provided take-home messages from the report.
“Though there are some positive trends, which we observed from some indicators, the level of alcohol consumption and alcohol-related disease burden is unacceptably high,” Poznyak said.
“Based on all trends and predictions, we can expect an increase in overall alcohol consumption and alcohol-related harm in the next 10 years. This will result in increased number of deaths and suffering around the world,” he continued. “We have clear discrepancy between the magnitude of the problem caused by harmful use of alcohol, the resources and commitment to introduce and implement cost-effective and effective measures. This means some countries will miss the target and not advance ... if the situation will continue to be stagnated at the point that we presented in our report.” – by Savannah Demko
Reference:
WHO. “Global status report on alcohol and health 2018.” http://www.who.int/substance_abuse/publications/global_alcohol_report/gsr_2018/en/. Accessed on Sept. 21, 2018.
Disclosure: Poznyak is an employee at WHO.