Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
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Abstract
BACKGROUND: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. METHODS: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. FINDINGS: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. INTERPRETATION: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. FUNDING: Bill & Melinda Gates Foundation.
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The record
- Venue
- The Lancet
- Topic
- Substance Abuse Treatment and Outcomes
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Science and Engineering Faculty, Queensland University of TechnologyCenter for International HealthRussian Academy of SciencesInstitute for Physical Activity and NutritionUniversity of California, IrvineHeller School for Social Policy and ManagementNational Institutes of HealthUniversidad de Ciencias Aplicadas y AmbientalesDebre Markos UniversityWestern Sydney UniversityUniversidade Federal de SergipeHáskólinn í ReykjavíkNational Human Genome Research InstituteFrankfurt University of Applied SciencesPontificia Universidad JaverianaMekelle UniversityInternational Medical UniversityMansoura UniversityNational Health and Medical Research CouncilStockholms UniversitetNanjing UniversityLee Kuan Yew School of Public Policy, National University of SingaporeUniversitatea de Medicină şi Farmacie "Carol Davila" BucureştiUniversity of South AfricaUniversity of the PhilippinesPomorski Uniwersytet Medyczny W SzczecinieUniversidade Federal de Minas GeraisAll-India Institute of Medical SciencesUniversidad del ValleNational Research University Higher School of EconomicsCentro de Investigación Biomédica en Red de Salud MentalNational Taiwan UniversityAristotle University of ThessalonikiI.M. Sechenov First Moscow State Medical UniversityHospital for Sick ChildrenDebre Tabor UniversityUniversità di BolognaUniversidad de ChileDirectorate for Biological SciencesKarnatak University DharwadGöteborgs UniversitetNorwegian Institute of Public HealthBabol University of Medical SciencesUniwersytet ŁódzkiGeorge Institute for Global HealthFoundation for Education and European CultureUniversidad de Costa RicaDilla UniversityUniversity of NamibiaInstitute of Nuclear Energy ResearchQazvin University of Medical SciencesUniversitair Medisch Centrum GroningenUniversidade Federal do Rio Grande do SulShanghai Jiao Tong UniversityTaipei Medical UniversityInyuvesi Yakwazulu-NataliUniversité de BourgogneUniversiti Kebangsaan MalaysiaKuwait UniversityChinese Center for Disease Control and PreventionTampereen YliopistoVetenskapsrådetTsinghua UniversityFudan UniversityUniversity of EmbuLoma Linda UniversityGBS/CIDP Foundation InternationalChalmers Tekniska HögskolaAlborz University of Medical SciencesUniversidad Nacional de ColombiaNorth-West UniversityUniversitetet i BergenChest Research FoundationMinisterio de Educación, Cultura y DeporteIslamic Azad UniversityKorea UniversityQueensland University of TechnologyCurtin University of TechnologyUniversity of South AustraliaKermanshah University of Medical SciencesRMIT UniversityInstituto Nacional de Psiquiatría Ramón de la Fuente MuñizInternational Centre for Diarrhoeal Disease Research, BangladeshWashington University in St. LouisMonash UniversityHögskolan DalarnaRijksuniversiteit GroningenPublic Health Foundation of IndiaKosin UniversityUniversity of California, Los AngelesNHS Health ScotlandDepartment of Science and Technology, Ministry of Science and Technology, IndiaBundesministerium für GesundheitSouth African Medical Research CouncilGeorg-August-Universität GöttingenNational University of SingaporeLa Trobe UniversityMazandaran University of Medical SciencesHigh Blood Pressure Research Council of AustraliaChandigarh UniversityUniversity of OxfordUniversitat de ValènciaIndian Council of Medical ResearchUniwersytet Jagielloński Collegium MedicumUniversity College LondonServierAcademy of FinlandImperial College LondonKing's College LondonAstellas Pharma USUniversity of TorontoGeneralitat ValencianaMinisterio de Economía y CompetitividadNational Center for Advancing Translational SciencesBrandeis UniversityBundesministerium für Bildung und ForschungBritish Heart FoundationGolestan University of Medical SciencesAmerican University of BeirutNational Research FoundationUniversity of QueenslandNational Institute for Health and Care ResearchUniversidade de São PauloUniversity of Health Sciences LahoreUniversitas Negeri SemarangEuropean CommissionAhmadu Bello UniversityIstituto di Ricerche Farmacologiche Mario Negri - IRCCSBirmingham City UniversityMinistério da Educação e CiênciaVital StrategiesNational Institute on AgingJackson State UniversityMurdoch Children's Research InstituteTrường Đại học Duy TânBill and Melinda Gates FoundationInstituto de Salud Carlos IIIUniversità degli Studi di MilanoApplied Molecular Biosciences UnitIran University of Medical SciencesCase Western Reserve UniversityResearch Institute, Nationwide Children's HospitalSouth Australian Health and Medical Research InstituteSykehuset Innlandet HFU.S. Department of Veterans AffairsJazan UniversityNew York University Abu DhabiEmory UniversityChildren’s Hospital of Wisconsin Research InstituteYork UniversityStudent Research Committee, Tabriz University of Medical SciencesBahir Dar UniversityBayerUniversity of the PunjabInvasive Fungi Research Center, Mazandaran University of Medical SciencesDeutsches KrebsforschungszentrumMinistério da EducaçãoPublic Health AgencyMcGill UniversityMedical Research CouncilHjärt-LungfondenDurban University of TechnologyAuckland University of Technology, New ZealandUniversity of New South WalesUniversity of LeicesterUniversity of PeradeniyaWashington State UniversityUniversity of OttawaFundação para a Ciência e a TecnologiaAksum UniversityUniversidade do PortoAustralian GovernmentNancy R. Gelman FoundationDeakin UniversityNationwide Children's HospitalKyung Hee UniversityEuropean Regional Development FundBurnet InstituteUniversità degli Studi di GenovaIsfahan University of Medical SciencesSan Diego State UniversityUniversity of California, San DiegoUniversidade Federal de Santa CatarinaConselho Nacional de Desenvolvimento Científico e TecnológicoUniversity of West FloridaUniversity of South FloridaMashhad University of Medical SciencesAlexander von Humboldt-StiftungPublic Health Agency of CanadaNational Drug and Alcohol Research CentreYonsei UniversityCharles R. Drew University of Medicine and ScienceNational Rosacea SocietyClinical and Translational Science Institute, University of California, Los AngelesUnited Nations Population FundNational Heart, Lung, and Blood InstituteOhio State University
- Keywords
- Burden of diseaseDisease burdenMedicineDiseaseEnvironmental healthMEDLINEPolitical scienceInternal medicine
- Has abstract in OpenAlex
- yes