A Global Look at Alcohol Burden and Policies

The Marin Institute

August 25, 2009

A three-part series recently published in The Lancet (the British equivalent of the Journal of the American Medical Association) brings attention to the substantial harm that alcohol causes around the world, most of which could be prevented or reduced.

The first article in the series quantifies the burden of mortality and disease attributable to alcohol, both globally and for ten large countries, including the United States. Social costs of alcohol in selected countries were also compared. An estimated 3.8 percent of all global deaths and 4.6 percent of global disability-adjusted life-years are attributable to alcohol. The authors concluded that alcohol consumption is one of the largest avoidable risk factors globally and that action to reduce the harm and costs is urgently needed.

The second article of the series reviewed evidence for the effectiveness of policies and programs to reduce the harm caused by alcohol. Researchers examined education, community action, availability, marketing, and pricing, among other strategies.

Enforced legislative measures to reduce drink-driving and individually-directed interventions to at-risk drinkers were found to be cost effective. However, educational and informational type strategies such as school-based programs do not reduce alcohol-related harm.

After thorough examination of numerous systematic reviews and meta-analyses, the authors confirmed that increasing alcohol prices, decreasing alcohol availability, and banning alcohol advertising were the most cost-effective strategies to reduce harm.

The last article of the series is a call to action to address the global harm that alcohol causes. The authors reported that although there are currently cost-effective and affordable interventions to restrict alcohol-related harm, most countries do not have these interventions or adequate policies in place. Some factors that hinder this progress include a failure of political will, undermining of policy by the alcohol industry, and increasing challenges from free-trade polices.

An effective national and international response will need not only governments, but also non-governmental organizations to support and hold government agencies accountable. International health policy, in the form of Framework Convention on Alcohol Control (similar to tobacco) is needed to achieve a forum of cooperation and negotiation to support and encourage national action.

For more information, visit The Lancet.