Alcoholic beverages contain ethanol, a psychoactive and toxic substance capable of causing dependence. While widely consumed across various cultures for centuries, it poses significant health risks and contributes to numerous adverse outcomes globally. In 2019, its consumption was responsible for approximately 2.6 million deaths worldwide. These fatalities included 1.6 million deaths due to non-communicable diseases, 700,000 deaths from injuries, and 300,000 deaths from communicable diseases. Men were disproportionately affected, with two million alcohol-attributable deaths compared to 600,000 among women.
Younger individuals, particularly those aged 20-39 years, are notably impacted, with 13% of alcohol-attributable deaths occurring in this age group in 2019. The substance plays a causal role in over 200 diseases, injuries, and other health conditions, though the global burden can only be quantified for 31 conditions based on existing scientific evidence. In 2019, an estimated 400 million people, or 7% of the global population aged 15 years and older, lived with drinking and drug use disorders. Of these, 209 million people (3.7% of the adult population) were dependent on alcohol.
Disorders, dependence and health risks of alcohol consumption.
Despite these high numbers, access to treatment and intervention services remains low, with less than 1% to no more than 14% of people with alcohol use disorders engaging with treatment services in countries where such data is available. Its consumption is linked to numerous noncommunicable diseases, including liver disease, heart disease, and various cancers (breast, liver, head and neck, esophageal, and colorectal). In 2019, alcohol consumption accounted for 474,000 cardiovascular disease deaths and 401,000 Cancer deaths, representing 4.4% of global cancer diagnoses.
Also, the impact extends beyond individual health, as alcohol consumption contributes to significant harm to others. In 2019, 298,000 deaths from road traffic accidents were alcohol-related, with 156,000 of these deaths caused by another person’s drinking. Additionally, alcohol is implicated in injuries from falls, drownings, burns, sexual assaults, intimate partner violence, and suicides. A causal relationship exists between alcohol use and the incidence or outcomes of infectious diseases like Tuberculosis and HIV. Alcohol consumption during pregnancy also increases the risk of Fetal Alcohol Spectrum Disorders (FASDs), which can lead to developmental disabilities and birth defects, as well as complications such as miscarriage, stillbirth, and premature delivery.
Societal and contextual factors determining the level of risk.
The level of risk from alcohol consumption depends on several factors, including the amount consumed, drinking frequency, individual health status, age, sex, and other personal characteristics. Cultural and social norms, economic development, and the implementation and enforcement of alcohol policies also influence alcohol consumption patterns and related problems. In 2019, 52% of men were current drinkers compared to 35% of women. The average per capita alcohol consumption was 8.2 litres for men and 2.2 litres for women. Alcohol use was responsible for 6.7% of all male deaths and 2.4% of all female deaths that year.
Efforts to reduce the harmful use of alcohol are guided by the Global Alcohol Action Plan 2022-2030, endorsed by WHO Member States. This plan outlines six key areas for action: high-impact strategies and interventions, advocacy and awareness, partnership and coordination, technical support and capacity-building, knowledge production and information systems, and resource mobilization. The SAFER Initiative, launched in 2018 by WHO and partners, supports countries in implementing proven, cost-effective interventions to reduce alcohol-related harm. The WHO Global Information System on Alcohol and Health (GISAH) provides data on consumption levels, alcohol-attributable health and social consequences, and policy responses worldwide.
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Achieving a reduction in harmful alcohol use requires comprehensive, cross-sectoral policy measures that address the acceptability, availability, and affordability. Strengthening health system responses and ensuring universal health coverage for those with alcohol use disorders are critical. Public policies and interventions should prioritize Public Health interests, be guided by clear health goals, and be based on the best available evidence. Engaging all relevant stakeholders is essential, but potential conflicts of interest, particularly with the alcohol industry, must be carefully managed.