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Alcohol in the European Union

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Alcohol in the European Union Alcohol in the European Union Consumption, harm and policy approaches Edited by: Peter Anderson, Lars Møller and Gauden Galea ABSTRACT Alcohol is one of the world’s top three priority areas in public health. Even though only half the global population drinks alcohol, it is the world’s third leading cause of ill health and premature death, after low birth weight and unsafe sex, and greater than tobacco. In Europe, alcohol is also the third leading risk factor for disease and mortality after tobacco and high blood pressure. This report presents the latest literature overview of effective alcohol policies, and includes data from the European Union, Norway and Switzerland in the areas of alcohol consumption, harm and policy approaches. The data presented were collected from a survey in 2011. Keywords ALCOHOL DRINKING – adverse effects ALCOHOL-RELATED DISORDERS – prevention and control ALCOHOLISM – prevention and control DATA COLLECTION HARM REDUCTION HEALTH POLICY ISBN 978 92 890 0264 6 Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 DK–2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2012 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. The responsibility for the content of this report lies with the authors and the content does not represent the views of the European Commission, nor is the Commission responsible for any use that may be made of the information contained herein. CONTENTS Page Acknowledgements ............................................................................................................ vi About the authors ............................................................................................................. vii Foreword ......................................................................................................................... ix Introduction ....................................................................................................................... 1 Alcohol as a health issue ............................................................................................ 1 Policy responses ........................................................................................................ 2 References ................................................................................................................ 3 The impact of alcohol on health ........................................................................................... 5 Introduction .............................................................................................................. 5 Alcohol as a carcinogen .............................................................................................. 5 Cardiovascular disease ............................................................................................... 6 Death ....................................................................................................................... 6 Social circumstances .................................................................................................. 8 Conclusions for policy and practice .............................................................................. 8 References ................................................................................................................ 8 Societal burden of alcohol ................................................................................................. 10 Introduction ............................................................................................................ 10 Alcohol consumption in Europe ................................................................................. 10 Alcohol-attributable burden of disease in Europe ........................................................ 16 Conclusions ............................................................................................................. 26 References .............................................................................................................. 26 Unrecorded and illicit alcohol ............................................................................................. 29 Introduction ............................................................................................................ 29 Updated evidence .................................................................................................... 30 Influence of price policies on the informal market ....................................................... 32 Conclusions for practice and policy ............................................................................ 32 Research gaps ......................................................................................................... 32 Conclusions ............................................................................................................. 33 References .............................................................................................................. 33 Information and education ................................................................................................ 35 Introduction ............................................................................................................ 35 School-based information and education .................................................................... 35 Public education campaigns ...................................................................................... 36 Campaigns based on drinking guidelines .................................................................... 36 Social responsibility messages ................................................................................... 37 Consumer labelling and warning messages ................................................................ 37 What to do about education and information .............................................................. 37 Conclusions ............................................................................................................. 38 References .............................................................................................................. 38 Health sector responses .................................................................................................... 40 Introduction ............................................................................................................ 40 Recent evidence ...................................................................................................... 41 Conclusions for policy and practice ............................................................................ 44 References .............................................................................................................. 45 Reducing injuries and death from alcohol-related road crashes ............................................. 49 Introduction ............................................................................................................ 49 Summary of current evidence ................................................................................... 49 Deaths and injuries from road traffic crashes with alcohol a risk factor ......................... 50 Conclusions for policy and practice ............................................................................ 51 References .............................................................................................................. 53 Community action ............................................................................................................ 55 Preventive intervention at the community level ........................................................... 55 Conclusions ............................................................................................................
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