Alcohol is a toxic and psychoactive substance with dependence producing properties. In many of today’s societies, alcoholic beverages are a routine part of the social landscape for many in the population. This is particularly true for those in social environments with high visibility and societal influence, nationally and internationally, where alcohol frequently accompanies socializing. In this context, it is easy to overlook or discount the health and social damage caused or contributed to by drinking.
Alcohol consumption contributes to 3 million deaths each year globally as well as to the disabilities and poor health of millions of people. Overall, harmful use of alcohol is responsible for 5.1% of the global burden of disease.
Harmful use of alcohol is accountable for 7.1% and 2.2% of the global burden of disease for males and females respectively. Alcohol is the leading risk factor for premature mortality and disability among those aged 15 to 49 years, accounting for 10% of all deaths in this age group. Disadvantaged and especially vulnerable populations have higher rates of alcohol-related death and hospitalization.
Impact
Alcohol as an intoxicant affects a wide range of structures and processes in the central nervous system and increases the risk for intentional and unintentional injuries and adverse social consequences. Alcohol has considerable toxic effects on the digestive and cardiovascular systems. Alcoholic beverages are classified as carcinogenic by the International Agency for Research on Cancer and increase the risk of several cancer types. Alcohol as an immunosuppressant increases the risk of communicable diseases, including tuberculosis and HIV.
Both the volume of lifetime alcohol use and a combination of context, frequency of alcohol consumption and amount consumed per occasion increase the risk of the wide range of health and social harms. The risks increase largely in a dose-dependent manner with the volume of alcohol consumed and with frequency of drinking, and exponentially with the amount consumed on a single occasion. Surrogate and illegally produced alcohols can bring an extra health risk from toxic contaminants.
Since any alcohol use is associated with some short-term and long-term health risks, it is difficult to define universally applicable population-based thresholds for low-risk drinking.
WHO response
The World Health Organization (WHO) collaborates with Member States and partners to address the issue of harmful alcohol consumption as a public health priority. The 2010 WHO Global strategy, which is endorsed by Member States, serves as a comprehensive international policy document that guides efforts to reduce alcohol harm at all levels. WHO’s efforts in this regard are aligned with the UN Sustainable Development Goals, specifically target 3.5 on substance abuse, including harmful use of alcohol, and target 3.4 on the prevention and control of noncommunicable diseases (NCDs) and promoting mental health and well-being.
WHO has identified that the most effective ways to reduce alcohol harm are to increase taxes on alcoholic beverages, enforce restrictions on exposure to alcohol advertising, and limit physical access to alcohol sales. Additionally, implementing measures to prevent drink driving and ensuring access to screening, brief interventions, and treatment are effective and ethical interventions. These cost-effective interventions are at the forefront of the WHO-led SAFER initiative, which supports Member States in reducing the harmful use of alcohol.
WHO’s efforts also prioritize reducing harm to individuals other than the drinker, as well as populations that are at heightened risk of alcohol harm. Such groups include children, adolescents, women of child-bearing age, pregnant and breastfeeding women, indigenous peoples, and other minority groups or those with low socioeconomic status.
