Risks, Influences, and Health Impacts

Alcohol and alcoholic beverages contain ethanol, a psychoactive and toxic substance with addictive properties. While alcohol has been consumed across various cultures for centuries, it poses significant health risks. In 2019, alcohol consumption was responsible for 2.6 million deaths worldwide, with men accounting for 2 million and women 0.6 million. The WHO European and African Regions had the highest alcohol-related death rates, with 52.9 and 52.2 deaths per 100,000 people, respectively. Young adults aged 20–39 are particularly affected by alcohol consumption, with this age group experiencing 13% of alcohol-attributable deaths in 2019.

In 2019, it was estimated that 400 million people aged 15 and older had alcohol use disorders, with 209 million of them living with alcohol dependence. Despite these challenges, some progress has been made. From 2010 to 2019, the global rate of alcohol-attributable deaths per 100,000 people decreased by 20.2%. Additionally, more countries have developed national alcohol policies, and nearly all implement alcohol excise taxes. However, the alcohol industry continues to interfere in policy development. As of 2019, about 54% of 145 reporting countries had national guidelines or standards for specialized treatment services for alcohol use disorders, but only 46% had legal protections for the confidentiality of individuals in treatment.

Access to screening, brief interventions, and treatment for hazardous alcohol use and alcohol use disorders remains limited, as does access to medications for treatment. The proportion of individuals with alcohol use disorders who engage with treatment services is low, ranging from less than 1% to no more than 14% in all countries with available data.

Health Risks of Alcohol Use

Alcohol consumption contributes to more than 200 diseases, injuries, and other health conditions, but its global impact can be specifically quantified for only 31 conditions based on existing scientific evidence. Alcohol consumption is linked to the development of noncommunicable diseases like liver diseases, heart diseases, and various cancers, as well as mental health issues such as depression, anxiety, and alcohol use disorders. In 2019, an estimated 474,000 deaths from cardiovascular diseases were attributed to alcohol consumption. Alcohol is also a recognized carcinogen, increasing the risk of cancers such as breast, liver, head and neck, oesophageal, and colorectal cancers. That year, 4.4% of globally diagnosed cancers and 401,000 cancer deaths were linked to alcohol use.

Alcohol consumption causes significant harm beyond the drinker, notably through injuries from road traffic accidents. In 2019, out of 298,000 deaths from alcohol-related road crashes, 156,000 were caused by someone else’s drinking. Other alcohol-related injuries include falls, drowning, burns, sexual assault, intimate partner violence, and suicide. There is also a causal link between alcohol use and the incidence or outcomes of infectious diseases like tuberculosis and HIV. Drinking alcohol during pregnancy increases the risk of fetal alcohol spectrum disorders (FASDs), the most severe form being fetal alcohol syndrome (FAS), associated with developmental disabilities and birth defects. It also raises the risk of pre-term birth complications, including miscarriage, stillbirth, and premature delivery. Young people, particularly those aged 20 to 39, are disproportionately affected by alcohol, with 13% of alcohol-attributable deaths in 2019 occurring in this age group. Long-term harmful alcohol consumption can lead to social problems, including family issues, workplace difficulties, financial troubles, and unemployment.

Factors Affecting Alcohol Consumption and Alcohol-Related Harm

No level of alcohol consumption is entirely risk-free; even minimal consumption carries some risk and potential for harm. The risk associated with alcohol consumption depends on several factors, including the amount and frequency of drinking, individual health status, age, sex, and other personal characteristics, as well as the context in which alcohol is consumed. Certain groups and individuals may be more susceptible to the toxic, psychoactive, and addictive properties of alcohol. Conversely, those who drink in lower-risk patterns may not necessarily experience a significantly higher likelihood of adverse health and social consequences.

Societal factors influencing alcohol consumption levels and related problems include cultural and social norms, alcohol availability, economic development, and the implementation and enforcement of alcohol policies. The impact of alcohol on chronic and acute health outcomes is primarily determined by the total volume of alcohol consumed and drinking patterns, particularly those involving frequent drinking and episodes of heavy drinking. Most alcohol-related harms stem from heavy episodic or continuous alcohol consumption.The context of drinking significantly influences alcohol-related harm, especially from intoxication. Alcohol affects not only the incidence of diseases, injuries, and other health conditions but also their outcomes and progression over time.

There are gender differences in alcohol consumption and related mortality and morbidity. In 2019, 52% of men were current drinkers, compared to 35% of women. The average alcohol consumption per capita was 8.2 liters for men and 2.2 liters for women. That year, alcohol use accounted for 6.7% of all deaths among men and 2.4% among women.