Factors affecting alcohol consumption and alcohol-related harm

Alcohol consumption is a causal factor in more than 200 diseases, injuries and other health conditions. Drinking alcohol is associated with a risk of developing health problems such as mental and behavioural disorders, including alcohol dependence, and major noncommunicable diseases such as liver cirrhosis, some cancers and cardiovascular diseases.

A significant proportion of the disease burden attributable to alcohol consumption arises from unintentional and intentional injuries, including those due to road traffic crashes, violence, and suicide. Fatal alcohol-related injuries tend to occur in relatively younger age groups.

A  causal relationship has been established between harmful drinking and incidence or outcomes of infectious diseases such as tuberculosis and HIV.

Alcohol consumption by an expectant mother may cause fetal alcohol syndrome (FAS) and pre-term birth complications.

Factors affecting alcohol consumption and alcohol-related harm

A variety of factors which affect the levels and patterns of alcohol consumption and the magnitude of alcohol-related problems in populations have been identified at individual and societal levels.

Societal factors include level of economic development, culture, social norms, availability of alcohol, and implementation and enforcement of alcohol policies. Adverse health impacts and social harm from a given level and pattern of drinking are greater for poorer societies.

Individual factors include age, gender, family circumstances and socio-economic status. Although there is no single risk factor that is dominant, the more vulnerabilities a person has, the more likely the person is to develop alcohol-related problems as a result of alcohol consumption. Poorer individuals experience greater health and social harms from alcohol consumption than more affluent individuals.

The impact of alcohol consumption on chronic and acute health outcomes is largely determined by the total volume of alcohol consumed and the pattern of drinking, particularly those patterns which are associated with episodes of heavy drinking.

The context of drinking plays an important role in the occurrence of alcohol-related harm, particularly as a result of alcohol intoxication. Alcohol consumption can have an impact not only on the incidence of diseases, injuries and other health conditions, but also on their outcomes and how these evolve over time.

There are gender differences in alcohol-related mortality and morbidity, as well as levels and patterns of alcohol consumption. The percentage of alcohol-attributable deaths among men amounts to 7.7 % of all global deaths compared to 2.6 % of all deaths among women. Total alcohol per capita consumption in 2016 among male and female drinkers worldwide was on average 19.4 litres of pure alcohol for males and 7.0 litres for females.

Reducing the burden from harmful use of alcohol

Health, safety and socioeconomic problems attributable to alcohol can be reduced when governments formulate and implement appropriate policies.

Policy-makers are encouraged to take action on strategies that have shown to be effective and cost-effective. These include:

• regulating the marketing of alcoholic beverages (in particular to younger people);
• regulating and restricting the availability of alcohol;
• enacting appropriate drink-driving policies;
• reducing demand through taxation and pricing mechanisms;
• raising awareness of the health and social problems for individuals and society at large caused by the harmful use of alcohol;
• ensuring support for effective alcohol policies;
• providing accessible and affordable treatment for people with alcohol-use disorders; and
• implementing screening and brief intervention programmes in health services for hazardous and harmful drinking.

WHO response

WHO emphasizes the development, implementation and evaluation of cost-effective interventions for harmful use of alcohol as well as creating, compiling and disseminating scientific information on alcohol use and dependence, and related health and social consequences.

The Global strategy to reduce the harmful use of alcohol, agreed by WHO Member States in 2010, represents international consensus that reducing the harmful use of alcohol and its associated health and social burden is a public health priority.

The Strategy provides guidance for action at all levels, including 10 recommended target areas for policy options and interventions for national action to reduce the harmful use of alcohol and the main components for global action to support and complement activities at country level.

The update of the evidence on cost-effectiveness of policy options and interventions undertaken in the context of the Global action plan for the prevention and control of noncommunicable diseases 2013–2020 provides a new set of enabling and focused recommended actions to reduce the harmful use of alcohol. The most cost-effective actions, or so-called best buys, include increasing taxes on alcoholic beverages, enacting and enforcing bans or comprehensive restrictions on exposure to alcohol advertising across multiple types of media, and enacting and enforcing restrictions on the availability of retailed alcohol.

With growing awareness of the impact of alcohol consumption on global health and an increase in international frameworks for action, the demand for global information on alcohol consumption and alcohol-attributable and alcohol-related harm, as well as related policy responses, has increased significantly. The Global Information System on Alcohol and Health (GISAH) has been developed by WHO to dynamically present data on levels and patterns of alcohol consumption, alcohol-attributable health and social consequences and policy responses at all levels.

Achieving a reduction in the harmful use of alcohol in line with the targets included in the SDG 2030 agenda and the WHO Global Monitoring Framework for Noncommunicable Diseases requires concerted action by countries, effective global governance and appropriate engagement of all relevant stakeholders. By working together effectively, the negative health and social consequences of alcohol can be reduced.