Harmful Alcohol Use Increases Health Risks in All Countries

Harmful alcohol use is linked with increased risk of alcohol-related cancers, injury and death in many countries, but the threat appears worst in lower income countries, where harmful alcohol use is more common, a study published in The Lancet today has found.

“Our data support the call to increase global awareness of the harmful use of alcohol and the need to further identify and target the modifiable determinants of harmful alcohol use,” said Dr. Andrew Smyth, lead author and a research fellow of the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences. He is also a clinical lecturer and researcher at the National University of Ireland Galway, Galway (Ireland).

The Hamilton-based research team looked at information from 12 countries divided into four income groups: high, high middle, low middle and low. Among the 115,000 adults followed for an average of about four years, just more than three in 10, or 36,000 people, reported drinking alcohol.

Although current drinking was associated with a 24 per cent lower risk of heart attack, there was no reduction in risk of mortality or stroke and a 51 per cent increase in risk of alcohol-related cancers (such as mouth, esophagus, stomach, liver, colorectal, breast, ovary and head and neck) and a 29 per cent increase in risk of injury. An increased risk of death was seen in those with high alcohol intake (31 per cent increase) and heavy episodic drinking (54 per cent increase).

The authors also identified differences between countries of different levels of prosperity. For higher income countries, current drinking (regular alcohol consumption during the previous year) was associated with a 16 per cent reduction in the risk of a combination of all outcomes (death, cardiovascular disease, heart attack, stroke, cancer, injury and admission to hospital), but in lower income countries there was a 38 per cent increase in risk. Harmful alcohol use was most common in lower income countries, where one in eight current drinkers had high levels of intake of alcohol and one in three had a heavy episodic drinking pattern.

“Because alcohol consumption is increasing in many countries, especially low middle and low income countries, the importance of alcohol as a risk factor for disease might be underestimated. Therefore, global strategies to reduce harmful use of alcohol are essential,” Dr. Salim Yusuf, senior author, said.

In a related comment published in the same issue of The Lancet, two professors of the University of Queensland in Brisbane, Australia, said governments have the evidence they need to give the issue priority. Jason P. Connor and Wayne Hall, both of the Centre for Youth Substance Abuse Research, said increasing the price of alcohol, reducing its availability, especially to younger drinkers, and preventing promotion of high alcohol consumption are the most effective policies to discourage drinking.

The paper was developed from the PHRI’s Prospective Urban Epidemiological (PURE) study. The study was funded by the Population Health Research Institute; the Canadian Institutes for Health Research; Heart and Stroke Foundation; several pharmaceutical companies including Astra Zeneca, Sanofi-Aventis, Boehringer Ingelheim, Servier, GlaxoSmithKline, Novartis, King Pharma, and the national or local organizations in participating countries.

McMaster University