1. Alcohol, a tricky liquid
Harmful use of alcohol
Alcohol, a tricky liquid

2. WHO Gobal Status Report 2014
Chapter 1: Alcohol and public health
Chapter 2: Alcohol consumption
Chapter 3: Health consequences
Chapter 4: Alcohol policy and interventions
Appendices:
Country profiles
Additional indicators
Data sources and methods
References

3. Harmful use of alcohol
Harmful use of alcohol is broad and encompasses the drinking that causes detrimental health and social consequences for:
the drinker (de-merit good);
the people around the drinker (externalities) and
society at large,
as well as the patterns of drinking that are associated with increased risk of adverse health outcomes.

4. Impact on the drinker Alcohol can harm the drinker by its:
toxic effects on organs and tissues;
intoxication, leading to impairment of physical coordination, consciousness, cognition, perception, affect or behaviour;
Dependence producing propensities, whereby the drinker’s self-control over his or her drinking behaviour is impaired. 4 4

5. Impact on people other than the drinker
Alcohol can harm other people than the drinker by:
Intentional or unintentional injury to other individuals
Neglect or abuse
Default on social role a family member, as a friend and/or as a worker
Property damage
Toxic effects on other individuals
Loss of amenity or peace of mind 5 5

6. Conceptual causal model of alcohol consumption and health outcomes
Societal
Vulnerability
factors
Individual
Vulnerability
factors
Volume
Pattern
Level of development
Age
Culture
Health outcomes
Gender
Chronic
Acute
Drinking context
Family factors
Alcohol production, distribution, regulation
Socio-economic status
Mortality by cause
Socio-economic consequences
Harm to others

7. Total adult per capita (APC) consumption

8. Total, unrecorded and recorded APC (WHO regions)

9. Prevalence of heavy episodic drinking among drinkers

10. Alcohol-attributable burden of disease, 2012
Net total = 139 million DALYs
Neonatal conditions
Intentional
injuries
Cancer
NNNNNNNNNNN
Unintentional
injuries
Cardiovascular diseases
and diabetes
Infectious
diseases
Neuropsychiatric disorders
Gastrointestinal diseases

11. alcohol-attributable fraction of different causes

12. Disease burden attributable to different risk factors in 2010 (Lim et al, Lancet, 2012; 380: )

14. What actions are needed to reduce the harmful use of alcohol?
Global, regional and national actions on:
levels of alcohol consumption;
patterns of alcohol consumption;
contexts of alcohol consumption;
wider social determinants of health.
Special attention needs to be given to reducing harm to people other than the drinker and to populations that are at particular risk from harmful use of alcohol.

15. Global strategy to reduce the harmful use of alcohol (GAS)
Represents a unique consensus among all WHO Member States on ways to tackle harmful use of alcohol at all levels.
Developed through a long and intense collaboration between the WHO Secretariat and Member States.
Complements and supports public health policies in Member States.

16. Recommended ten target areas for policy measures and interventions
Leadership, awareness and commitment.
Health services' response.
Community action.
Drink-driving policies and countermeasures.
Availability of alcohol.
Marketing of alcoholic beverages.
Pricing policies.
Reducing the negative consequences of drinking and alcohol intoxication.
Reducing the public health impact of illicit alcohol and informally produced alcohol.
Monitoring and surveillance.

17. Developments in other psychoactive substances
Nicotine (tobacco)
E-cigarettes
Beneficial effects
THC (Cannabis)
Medical marijuana
Legalization
“food stuff”
Prescription opioids
prescription painkiller overuse
Unmet need for palliative care

18. Population growth (thousands)
Source: United Nations (2014). Probabilistic Population Projections based on the World Population Prospects: The 2012 Revision. Population Division, DESA. ST/ESA/SER.A/353.

19. Population growth 16 to 64 years old (thousands)
Source: United Nations (2014). Probabilistic Population Projections based on the World Population Prospects: The 2012 Revision. Population Division, DESA. ST/ESA/SER.A/353.

20. Population growth 65+ years old (thousands)

21. Global prevalence of drinking 15+

22. Food for thought
Population growth will continue at least for 30 more years
Most people in the world do not drink alcohol and especially so in areas with high population growth
Thus the future looks bright for the global beverage alcohol industry
This potential growth is most likely already reflected in their market value
Does this imply that the total burden from harmful use of alcohol has to go up to preserve the wealth of the alcohol industry`s shareholders?

23. Alcohol industry involvement
Alcohol industry social involvement can be due to:
Social corporate responsibility, including correcting market failures
Rewarded by consumers in the marketplace
Internal feel –good tool
Generic or brand specific marketing
Hedging against government regulation

24. Discussion on barriers, bottlenecks, challenges and opportunities
Alcohol consumption
Societal
Vulnerability
factors
Individual
Vulnerability
factors
Volume
Pattern
Level of development
Age
Culture
Health outcomes
Gender
Chronic
Acute
Drinking context
Family factors
Alcohol production, distribution, regulation
Socio-economic status
Mortality by cause
Socio-economic consequences
Harm to others

25. Key messages
Alcohol is a toxic and psychoactive substance with dependence producing propensities
Harmful use of alcohol is a global health issues ranking among the top five risk factors for the global burden of disease.
Most people in the world do not drink alcohol and this paired with a continued population growth can constitute a considerable challenge for the health system in the future.
Harmful use of alcohol has considerable detrimental effects on other people than the drinker
The burden from harmful use of alcohol can and should be effectively reduced and governments have an obligation to intervene in the marketplace