Alcohol and Public Health

Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.
The Lancet (Impact Factor: 45.22). 02/2005; 365(9458):519-30. DOI: 10.1016/S0140-6736(05)17870-2
Source: PubMed


Alcoholic beverages, and the problems they engender, have been familiar fixtures in human societies since the beginning of recorded history. We review advances in alcohol science in terms of three topics: the epidemiology of alcohol's role in health and illness; the treatment of alcohol use disorders in a public health perspective; and policy research and options. Research has contributed substantially to our understanding of the relation of drinking to specific disorders, and has shown that the relation between alcohol consumption and health outcomes is complex and multidimensional. Alcohol is causally related to more than 60 different medical conditions. Overall, 4% of the global burden of disease is attributable to alcohol, which accounts for about as much death and disability globally as tobacco and hypertension. Treatment research shows that early intervention in primary care is feasible and effective, and a variety of behavioural and pharmacological interventions are available to treat alcohol dependence. This evidence suggests that treatment of alcohol-related problems should be incorporated into a public health response to alcohol problems. Additionally, evidence-based preventive measures are available at both the individual and population levels, with alcohol taxes, restrictions on alcohol availability, and drinking-driving countermeasures among the most effective policy options. Despite the scientific advances, alcohol problems continue to present a major challenge to medicine and public health, in part because population-based public health approaches have been neglected in favour of approaches oriented to the individual that tend to be more palliative than preventative.

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    • "The changing alcohol environment in Africa suggests the need for stronger alcohol control policies to reduce alcohol-related harm among drinkers, as well as to protect those who abstain from alcohol. Alcohol and Alcoholism, 2015, 1–7 doi: 10.1093/alcalc/agv036 Article Numerous alcohol control policy options have been found to reduce alcohol consumption and related health and social problems (Room et al., 2005; Anderson et al., 2009a; Babor et al., 2010). Evidence-based policy options include regulating alcohol's availability (e.g. "
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    ABSTRACT: There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.
    Alcohol and Alcoholism 04/2015; 50(4). DOI:10.1093/alcalc/agv036 · 2.89 Impact Factor
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    • "First, there has been a consistent positive association between income and increased alcohol consumption at the population level. Adult per capita consumption rises rapidly between zero gross domestic product (GDP) and $10,000 to $15,000, after which the growth decelerates but remains positive (Room et al., 2005; Schmidt et al., 2010; Sornpaisarn et al., 2013; World Health Organization [WHO], 2011a). The shape of this curve is partly due to the fact that in low-and middle-income countries, there is a higher proportion of abstainers compared to high-income nations (WHO, 2011a). "
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    ABSTRACT: To examine the association between increases in income and self-reported alcohol consumption, binge drinking, and alcohol problems in 2006 and 2012 in Brazil. Participants were interviewed as part of 2 multistage representative cluster samples of the Brazilian household population between November 2005 and April 2006 and between November 2011 and March 2012. The number of current drinkers during these 2 intervals (n = 1,379 and n = 1,907, respectively) comprised the sample analyzed. Four past-year outcome variables-standard drinks per week, binge drinking, presence of alcohol-related social/health problems, and DSM-5 alcohol use disorder (AUD)-were estimated across income, age, and gender groups. Regression models were estimated to evaluate these and other sociodemographic effects on drinking and problem outcomes and to test for possible wave by income interactions. Response rates were 66.4% in 2006 and 77% in 2012. Income increases were seen in virtually all age-gender subgroups and were particularly pronounced for younger age groups and older women. Both genders reported increased drinks per week (men: 12.82, 2006; 15.78, 2012; p < 0.01; women: 4.89, 2006; 7.66, 2012; p < 0.001) and proportion binge drinking (men: 57%, 2006; 66%, 2012; p < 0.05; women: 39%, 2006; 48%, 2012; p < 0.05), although this was not seen in all gender and age groups. Social/health problem prevalence decreased among men (37%, 2006; 26%, 2012; p < 0.001) and remained the same among women (13%, 2006; 14%, 2012). DSM-5 AUD decreased among men (34%, 2006; 24%, 2012; p < 0.01) and remained stable among women (14%, 2006; 16%, 2012). Brazilian economic development between 2006 and 2012 led to a rise in income in several gender and age groups. Although not always directly associated with an observed increase in alcohol consumption, the rise in income may have created a sense of optimism that inhibited a rise in alcohol-related problems. Copyright © 2015 by the Research Society on Alcoholism.
    Alcoholism Clinical and Experimental Research 04/2015; 39(5). DOI:10.1111/acer.12692 · 3.21 Impact Factor
    • "Alcohol consumption is a widespread, culturally accepted practice in most Western countries; according to World Health Organization data (WHO, 2014), worldwide consumption in 2010 was equal to 6.2 L of pure alcohol consumed per person aged 15 years or older. Alcohol abuse is related to at least 60 different health conditions (Room et al., 2005), and 5.9% of global deaths are attributable to alcohol consumption (WHO, 2014). As a result, there is a major concern about the economic (Room and Jernigan, 2000) and social (Wells and Graham, 2003) impacts of drinking behaviors. "
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    ABSTRACT: Objective: To evaluate the effectiveness of brief interventions in the primary health care setting to decrease alcohol consumption in non-alcoholic adult drinkers. Method: Systematic review of systematic reviews and meta-analyses of randomized clinical trials published in English and Spanish and indexed in EMBASE, MEDLINE (PubMed), Web of Science, Scopus, and The Cochrane Library, from their inception to January 2014. The quality of the studies was evaluated with the AMSTAR instrument. Results: Seven studies, published from 1999 to 2011, were included in the review (six meta-analyses, one systematic review). These studies were heterogeneous in terms of design, type and length of interventions analyzed, participants, responsible professionals, and results. Five studies reported a moderate decrease in alcohol consumption and four showed a decrease in the number of participants who consumed alcohol above the established risk level. Conclusion: Brief interventions have a moderate effect on reducing alcohol consumption among excessive drinkers or people who consume excessive amounts of alcohol and as a consequence these interventions increased the number of people drinking alcohol below established limits of risk. Brief interventions with multiple contacts or follow-up sessions are the most effective.
    Preventive Medicine 12/2014; 76. DOI:10.1016/j.ypmed.2014.12.010 · 3.09 Impact Factor
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