Alcohol use and burden for 195 countries and territories, 1990–2016

a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 Alcohol Collaborators

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1015-1035
Number of pages21
JournalThe Lancet
Volume392
Issue number10152
DOIs
StatePublished - Sep 22 2018

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Alcohols
Quality-Adjusted Life Years
Uncertainty
Alcohol Drinking
Health
Population
Global Burden of Disease
Age Groups
Information Storage and Retrieval
Wounds and Injuries
Drinking
Meta-Analysis
Cause of Death
Neoplasms
Tuberculosis
Ethanol
Retrospective Studies
Prospective Studies
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Alcohol use and burden for 195 countries and territories, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016. / GBD 2016 Alcohol Collaborators.

In: The Lancet, Vol. 392, No. 10152, 22.09.2018, p. 1015-1035.

Research output: Contribution to journalArticle

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title = "Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016",
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.",
author = "{GBD 2016 Alcohol Collaborators} and Griswold, {Max G.} and Nancy Fullman and Caitlin Hawley and Nicholas Arian and Zimsen, {Stephanie R.M.} and Tymeson, {Hayley D.} and Vidhya Venkateswaran and Tapp, {Austin Douglas} and Forouzanfar, {Mohammad H.} and Salama, {Joseph S.} and Abate, {Kalkidan Hassen} and Degu Abate and Abay, {Solomon M.} and Cristiana Abbafati and Abdulkader, {Rizwan Suliankatchi} and Zegeye Abebe and Victor Aboyans and Abrar, {Mohammed Mehdi} and Pawan Acharya and Adetokunboh, {Olatunji O.} and Adhikari, {Tara Ballav} and Adsuar, {Jose C.} and Mohsen Afarideh and Agardh, {Emilie Elisabet} and Gina Agarwal and Aghayan, {Sargis Aghasi} and Sutapa Agrawal and Ahmed, {Muktar Beshir} and Mohammed Akibu and Tomi Akinyemiju and Nadia Akseer and Asfoor, {Deena H.Al} and Ziyad Al-Aly and Fares Alahdab and Khurshid Alam and Ammar Albujeer and Alene, {Kefyalew Addis} and Raghib Ali and Ali, {Syed Danish} and Mehran Alijanzadeh and Aljunid, {Syed Mohamed} and Ala'a Alkerwi and Peter Allebeck and Nelson Alvis-Guzman and Amare, {Azmeraw T.} and Aminde, {Leopold N.} and Walid Ammar and Amoako, {Yaw Ampem} and Amul, {Gianna Gayle Herrera} and {Des Jarlais}, Don",
year = "2018",
month = "9",
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doi = "10.1016/S0140-6736(18)31310-2",
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TY - JOUR

T1 - Alcohol use and burden for 195 countries and territories, 1990–2016

T2 - a systematic analysis for the Global Burden of Disease Study 2016

AU - GBD 2016 Alcohol Collaborators

AU - Griswold, Max G.

AU - Fullman, Nancy

AU - Hawley, Caitlin

AU - Arian, Nicholas

AU - Zimsen, Stephanie R.M.

AU - Tymeson, Hayley D.

AU - Venkateswaran, Vidhya

AU - Tapp, Austin Douglas

AU - Forouzanfar, Mohammad H.

AU - Salama, Joseph S.

AU - Abate, Kalkidan Hassen

AU - Abate, Degu

AU - Abay, Solomon M.

AU - Abbafati, Cristiana

AU - Abdulkader, Rizwan Suliankatchi

AU - Abebe, Zegeye

AU - Aboyans, Victor

AU - Abrar, Mohammed Mehdi

AU - Acharya, Pawan

AU - Adetokunboh, Olatunji O.

AU - Adhikari, Tara Ballav

AU - Adsuar, Jose C.

AU - Afarideh, Mohsen

AU - Agardh, Emilie Elisabet

AU - Agarwal, Gina

AU - Aghayan, Sargis Aghasi

AU - Agrawal, Sutapa

AU - Ahmed, Muktar Beshir

AU - Akibu, Mohammed

AU - Akinyemiju, Tomi

AU - Akseer, Nadia

AU - Asfoor, Deena H.Al

AU - Al-Aly, Ziyad

AU - Alahdab, Fares

AU - Alam, Khurshid

AU - Albujeer, Ammar

AU - Alene, Kefyalew Addis

AU - Ali, Raghib

AU - Ali, Syed Danish

AU - Alijanzadeh, Mehran

AU - Aljunid, Syed Mohamed

AU - Alkerwi, Ala'a

AU - Allebeck, Peter

AU - Alvis-Guzman, Nelson

AU - Amare, Azmeraw T.

AU - Aminde, Leopold N.

AU - Ammar, Walid

AU - Amoako, Yaw Ampem

AU - Amul, Gianna Gayle Herrera

AU - Des Jarlais, Don

PY - 2018/9/22

Y1 - 2018/9/22

N2 - 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.

AB - 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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