alcohol

overview

Alcohol and alcoholic beverages contain ethanol, a psychoactive and toxic substance with addictive properties. Alcohol has been widely consumed in many cultures for centuries, but is associated with significant health risks and harm.

Worldwide, 2.6 million deaths were attributable to alcohol consumption in 2019, of which 2 million were among men and 0.6 million were among women. The highest numbers of alcohol-related deaths per 100,000 people were recorded in the WHO European and African regions, with 52.9 and 52.2 deaths per 100,000 people respectively.

Younger people (20-39 years) are disproportionately affected by alcohol consumption; this age group accounted for the highest proportion (13%) of alcohol-related deaths in 2019.

Global alcohol consumption data in 2019 show that an estimated 400 million people aged 15 and over are living with alcohol use disorders and an estimated 209 million are living with alcohol dependence.

Some progress has been made; between 2010 and 2019, the number of alcohol-related deaths per 100,000 population worldwide fell by 20.2%.

The number of countries developing national alcohol policies is steadily increasing. Almost all countries impose alcohol taxes. However, some countries report continued interference by the alcohol industry in policy-making.

Based on 2019 data, approximately 54% of the 145 reporting countries had national guidelines/standards for specialized treatment services for alcohol use disorders, but only 46% of countries had legal provisions to protect the confidentiality of people in treatment.

Access to screening, brief intervention and treatment for people with hazardous drinking and alcohol use disorders remains very low, as does access to medications for the treatment of alcohol use disorders. Overall, the proportion of people with alcohol use disorders in contact with treatment services varies from less than 1% to a maximum of 14% across all countries where such data are available.

Health risks of alcohol consumption

Alcohol consumption has been shown to play a causal role in more than 200 diseases, injuries and other health conditions. However, the global burden of alcohol-related diseases and injuries can only be quantified for 31 health conditions based on the available scientific evidence on the role of alcohol consumption in their development, occurrence and consequences.

Alcohol consumption is associated with the risk of developing non-communicable diseases such as liver disease, heart disease and various types of cancer, as well as mental and behavioral disorders such as depression, anxiety and alcohol abuse.

An estimated 474,000 deaths from cardiovascular disease were caused by alcohol consumption in 2019.

Alcohol is a recognized carcinogen and alcohol consumption increases the risk of several types of cancer, including breast, liver, head and neck, esophageal and colon cancer. In 2019, 4.4% of cancers diagnosed worldwide and 401,000 cancer deaths were attributable to alcohol consumption.

Alcohol consumption also causes significant harm to others, not just the person who consumes alcohol. A significant proportion of the alcohol-related disease burden comes from injuries such as road traffic accidents. In 2019, of a total of 298,000 deaths from alcohol-related road traffic accidents, 156,000 were due to others drinking.

Other injuries, whether intentional or unintentional, include falls, drowning, burns, sexual assault, intimate partner violence, and suicide.

A causal relationship has been established between alcohol consumption and the incidence and consequences of infectious diseases such as tuberculosis and HIV.

Drinking alcohol during pregnancy increases the risk of having a baby with fetal alcohol spectrum disorders (FASDs). The most serious form of this is fetal alcohol syndrome (FAS), which is associated with developmental delays and birth defects. Drinking alcohol during pregnancy can also increase the risk of complications of preterm birth, including miscarriage, stillbirth, and premature birth.

Younger people are disproportionately affected by alcohol consumption. The highest proportion (13%) of alcohol-related deaths in 2019 affected the age group between 20 and 39 years.

In the long term, harmful and dangerous alcohol use can lead to social problems, including family problems, workplace problems, financial problems and unemployment.

Factors influencing alcohol consumption and alcohol-related harm

There is no form of alcohol consumption that is without risk. Even small amounts of alcohol consumption carry risks and can cause harm.

The level of risk depends on several factors, including the amount consumed, the frequency of drinking, the person’s health status, age, gender and other personal characteristics, and the context in which alcohol consumption occurs.

Some groups and individuals who are vulnerable or at risk may be more susceptible to the toxic, psychoactive and addictive properties of alcohol. On the other hand, individuals who adopt less risky consumption patterns may not necessarily face a significantly higher likelihood of negative health and social outcomes.

Societal factors that influence levels and patterns of alcohol consumption and related problems include cultural and social norms, the availability of alcohol, the level of economic development, and the implementation and enforcement of alcohol policies.

The impact of alcohol consumption on chronic and acute health outcomes is largely determined by the total amount of alcohol consumed and drinking behavior, particularly drinking patterns associated with frequency of drinking and episodes of heavy drinking. Most alcohol-related harm results from heavy episodic or sustained alcohol consumption.

Context plays an important role in the development of alcohol-related harm, particularly as a result of alcohol intoxication. Alcohol consumption can affect not only the occurrence of diseases, injuries and other health problems, but also their consequences and their development over time.

There are gender differences in both alcohol consumption and alcohol-related mortality and morbidity. In 2019, 52% of men were current drinkers, while only 35% of women had drunk alcohol in the previous 12 months. Alcohol consumption per capita averaged 8.2 litres for men and 2.2 litres for women. In 2019, alcohol consumption accounted for 6.7% of all deaths among men and 2.4% of all deaths among women.

WHO response

The Global Alcohol Action Plan 2022–2030, supported by WHO Member States, aims to reduce harmful alcohol use through effective, evidence-based strategies at national, regional and global levels. The plan outlines six key areas for action: effective policies and interventions, advocacy and awareness-raising, partnership and coordination, technical support and capacity building, knowledge production and information systems, and resource mobilization.

Implementation of the Global Strategy and Action Plan will accelerate global progress towards achieving the alcohol-related targets under Sustainable Development Goal 3.5 on strengthening the prevention and treatment of substance abuse, including drug abuse and the harmful use of alcohol.

To achieve this, global, regional and national action is needed that addresses the levels, patterns and relationships of alcohol consumption and the broader social determinants of health, with particular attention to implementing cost-effective, high-impact interventions.

It is crucial to address the factors that determine the acceptability, availability and affordability of alcohol consumption through multisectoral, comprehensive and integrated policy actions. It is also crucial to achieve universal health coverage for people with alcohol use disorders and other alcohol-related health problems by strengthening health systems responses and developing comprehensive and accessible treatment and care systems for those in need.

The SAFER initiative, launched in 2018 by WHO and its partners, supports countries in implementing highly effective and cost-effective interventions that have been proven to reduce the harm caused by alcohol consumption.

The WHO Global Information System on Alcohol and Health (GISAH) provides data on the levels and patterns of alcohol consumption, alcohol-related health and social outcomes, and policy responses around the world.

Achieving reductions in harmful alcohol use in line with the targets of the Global Action Plan on Alcohol, the SDG 2030 Agenda and the WHO Global Monitoring Framework for Noncommunicable Diseases requires concerted action by countries and effective global governance.

Public policies and measures to prevent and reduce alcohol-related harm should be guided by public health interests and based on clear public health objectives and the best available evidence.

The involvement of all relevant stakeholders is essential, but potential conflicts of interest, particularly with the alcohol industry, must be carefully assessed before any involvement takes place. Economic operators should refrain from activities that could prevent, delay or stop the development, adoption, implementation and enforcement of effective policies and measures to reduce the harmful use of alcohol.

Through cooperation, due diligence and protection against conflicts of interest, the negative health and social consequences of alcohol can be effectively reduced.