Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Issue 10152 (22nd September 2018)

• Record Type: Journal Article
• Authors: Griswold, Max G; Fullman, Nancy; Hawley, Caitlin; Arian, Nicholas; Zimsen, Stephanie R M; Tymeson, Hayley D; Venkateswaran, Vidhya; Tapp, Austin Douglas; Forouzanfar, Mohammad H; Salama, Joseph S; Abate, Kalkidan Hassen; Abate, Degu; Abay, Solomon M; Abbafati, Cristiana; Abdulkader, Rizwan Suliankatchi; Abebe, Zegeye; Aboyans, Victor; Abrar, Mohammed Mehdi; Acharya, Pawan; Adetokunboh, Olatunji O; Adhikari, Tara Ballav; Adsuar, Jose C; Afarideh, Mohsen; Agardh, Emilie Elisabet; Agarwal, Gina; Aghayan, Sargis Aghasi; Agrawal, Sutapa; Ahmed, Muktar Beshir; Akibu, Mohammed; Akinyemiju, Tomi; Akseer, Nadia; Asfoor, Deena H Al; Al-Aly, Ziyad; Alahdab, Fares; Alam, Khurshid; Albujeer, Ammar; Alene, Kefyalew Addis; Ali, Raghib; Ali, Syed Danish; Alijanzadeh, Mehran; Aljunid, Syed Mohamed; Alkerwi, Ala'a; Allebeck, Peter; Alvis-Guzman, Nelson; Amare, Azmeraw T; Aminde, Leopold N; Ammar, Walid; Amoako, Yaw Ampem; Amul, Gianna Gayle Herrera; Andrei, Catalina Liliana; Angus, Colin; Ansha, Mustafa Geleto; Antonio, Carl Abelardo T; Aremu, Olatunde; Ärnlöv, Johan; Artaman, Al; Aryal, Krishna K; Assadi, Reza; Ausloos, Marcel; Avila-Burgos, Leticia; Avokpaho, Euripide F; Awasthi, Ashish; Ayele, Henok Tadesse; Ayer, Rakesh; Ayuk, Tambe B; Azzopardi, Peter S; Badali, Hamid; Badawi, Alaa; Banach, Maciej; Barker-Collo, Suzanne Lyn; Barrero, Lope H; Basaleem, Huda; Baye, Estifanos; Bazargan-Hejazi, Shahrzad; Bedi, Neeraj; Béjot, Yannick; Belachew, Abate Bekele; Belay, Saba Abraham; Bennett, Derrick A; Bensenor, Isabela M; Bernabe, Eduardo; Bernstein, Robert S; Beyene, Addisu Shunu; Beyranvand, Tina; Bhaumik, Soumyadeeep; Bhutta, Zulfiqar A; Biadgo, Belete; Bijani, Ali; Bililign, Nigus; Birlik, Sait Mentes; Birungi, Charles; Bizuneh, Hailemichael; Bjerregaard, Peter; Bjørge, Tone; Borges, Guilherme; Bosetti, Cristina; Boufous, Soufiane; Bragazzi, Nicola Luigi; Brenner, Hermann; Butt, Zahid A; Cahuana-Hurtado, Lucero; Calabria, Bianca; Campos-Nonato, Ismael R; Campuzano, Julio Cesar; Carreras, Giulia; Carrero, Juan J; Carvalho, Félix; Castañeda-Orjuela, Carlos A; Castillo Rivas, Jacqueline; Catalá-López, Ferrán; Chang, Jung-Chen; Charlson, Fiona J; Chattopadhyay, Aparajita; Chaturvedi, Pankaj; Chowdhury, Rajiv; Christopher, Devasahayam J; Chung, Sheng-Chia; Ciobanu, Liliana G; Claro, Rafael M; Conti, Sara; Cousin, Ewerton; Criqui, Michael H; Dachew, Berihun Assefa; Dargan, Paul I; Daryani, Ahmad; Das Neves, José; Davletov, Kairat; De Castro, Filipa; De Courten, Barbora; De Neve, Jan-Walter; Degenhardt, Louisa; Demoz, Gebre Teklemariam; Des Jarlais, Don C; Dey, Subhojit; Dhaliwal, Rupinder Singh; Dharmaratne, Samath Dhamminda; Dhimal, Meghnath; Doku, David Teye; Doyle, Kerrie E; Dubey, Manisha; Dubljanin, Eleonora; Duncan, Bruce B; Ebrahimi, Hedyeh; Edessa, Dumessa; El Sayed Zaki, Maysaa; Ermakov, Sergei Petrovich; Erskine, Holly E; Esteghamati, Alireza; Faramarzi, Mahbobeh; Farioli, Andrea; Faro, Andre; Farvid, Maryam S; Farzadfar, Farshad; Feigin, Valery L; Felisbino-Mendes, Mariana Santos; Fernandes, Eduarda; Ferrari, Alize J; Ferri, Cleusa P; Fijabi, Daniel Obadare; Filip, Irina; Finger, Jonas David; Fischer, Florian; Flaxman, Abraham D; Franklin, Richard Charles; Futran, Neal D; Gallus, Silvano; Ganji, Morsaleh; Gankpe, Fortune Gbetoho; Gebregergs, Gebremedhin Berhe; Gebrehiwot, Tsegaye Tewelde; Geleijnse, Johanna M; Ghadimi, Reza; Ghandour, Lilian A; Ghimire, Mamata; Gill, Paramjit Singh; Ginawi, Ibrahim Abdelmageed; Giref, Ababi Zergaw Z; Gona, Philimon N; Gopalani, Sameer Vali; Gotay, Carolyn C; Goulart, Alessandra C; Greaves, Felix; Grosso, Giuseppe; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gutiérrez, Reyna Alma; GVS, Murthy; Hafezi-Nejad, Nima; Hagos, Tekleberhan Beyene; Hailu, Gessessew Bugssa; Hamadeh, Randah R; Hamidi, Samer; Hankey, Graeme J; Harb, Hilda L; Harikrishnan, Sivadasanpillai; Haro, Josep Maria; Hassen, Hamid Yimam; Havmoeller, Rasmus; Hay, Simon I; Heibati, Behzad; Henok, Andualem; Heredia-Pi, Ileana; Hernández-Llanes, Norberto Francisco; Herteliu, Claudiu; Hibstu, Desalegn Ts Tsegaw; Hoogar, Praveen; Horita, Nobuyuki; Hosgood, H Dean; Hosseini, Mostafa; Hostiuc, Mihaela; Hu, Guoqing; Huang, Hsiang; Husseini, Abdullatif; Idrisov, Bulat; Ileanu, Bogdan Vasile; Ilesanmi, Olayinka Stephen; Irvani, Seyed Sina Naghibi; Islam, Sheikh Mohammed Shariful; Jackson, Maria D; Jakovljevic, Mihajlo; Jalu, Moti Tolera; Jayatilleke, Achala Upendra; Jha, Ravi Prakash; Jonas, Jost B; Jozwiak, Jacek Jerzy; Kabir, Zubair; Kadel, Rajendra; Kahsay, Amaha; Kapil, Umesh; Kasaeian, Amir; Kassa, Tesfaye D Dessale; Katikireddi, Srinivasa Vittal; Kawakami, Norito; Kebede, Seifu; Kefale, Adane Teshome; Keiyoro, Peter Njenga; Kengne, Andre Pascal; Khader, Yousef; Khafaie, Morteza Abdullatif; Khalil, Ibrahim A; Khan, Md Nuruzzaman; Khang, Young-Ho; Khater, Mona M; Khubchandani, Jagdish; Kim, Cho-Il; Kim, Daniel; Kim, Yun Jin; Kimokoti, Ruth W; Kisa, Adnan; Kivimäki, Mika; Kochhar, Sonali; Kosen, Soewarta; Koul, Parvaiz A; Koyanagi, Ai; Krishan, Kewal; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kulkarni, Veena S; Kumar, Pushpendra; Lafranconi, Alessandra; Lakshmana Balaji, Arjun; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lami, Faris Hasan; Lan, Qing; Lang, Justin J; Lansky, Sonia; Larsson, Anders O; Latifi, Arman; Leasher, Janet L; Lee, Paul H; Leigh, James; Leinsalu, Mall; Leung, Janni; Levi, Miriam; Li, Yichong; Lim, Lee-Ling; Linn, Shai; Liu, Shiwei; Lobato-Cordero, Andrea; Lopez, Alan D; Lorkowski, Stefan; Lotufo, Paulo A; Macarayan, Erlyn Rachelle King; Machado, Isis Eloah; Madotto, Fabiana; Magdy Abd El Razek, Hassan; Magdy Abd El Razek, Muhammed; Majdan, Marek; Majdzadeh, Reza; Majeed, Azeem; Malekzadeh, Reza; Malta, Deborah Carvalho; Mapoma, Chabila Christopher; Martinez-Raga, Jose; Maulik, Pallab K; Mazidi, Mohsen; Mckee, Martin; Mehta, Varshil; Meier, Toni; Mekonen, Tesfa; Meles, Kidanu Gebremariam; Melese, Addisu; Memiah, Peter T N; Mendoza, Walter; Mengistu, Desalegn Tadese; Mensah, George A; Meretoja, Tuomo J; Mezgebe, Haftay Berhane; Miazgowski, Tomasz; Miller, Ted R; Mini, Gk; Mirica, Andreea; Mirrakhimov, Erkin M; Moazen, Babak; Mohammad, Karzan Abdulmuhsin; Mohammadifard, Noushin; Mohammed, Shafiu; Monasta, Lorenzo; Moraga, Paula; Morawska, Lidia; Mousavi, Seyyed Meysam; Mukhopadhyay, Satinath; Musa, Kamarul Imran; Naheed, Aliya; Naik, Gurudatta; Najafi, Farid; Nangia, Vinay; Nansseu, Jobert Richie; Nayak, Mudavath Siva Durga Prasad; Nejjari, Chakib; Neupane, Subas; Neupane, Sudan Prasad; Ngunjiri, Josephine W; Nguyen, Cuong Tat; Nguyen, Long Hoang; Nguyen, Trang Huyen; Ningrum, Dina Nur Anggraini; Nirayo, Yirga Legesse; Noubiap, Jean Jacques; Ofori-Asenso, Richard; Ogbo, Felix Akpojene; Oh, In-Hwan; Oladimeji, Olanrewaju; Olagunju, Andrew T; Olivares, Pedro R; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oommen, Anu Mary; Oren, Eyal; Orpana, Heather M; Ortega-Altamirano, Doris D V; Ortiz, Justin R; Ota, Erika; Owolabi, Mayowa Ojo; Oyekale, Abayomi Samuel; P A, Mahesh; Pana, Adrian; Park, Eun-Kee; Parry, Charles D H; Parsian, Hadi; Patle, Ajay; Patton, George C; Paudel, Deepak; Petzold, Max; Phillips, Michael R; Pillay, Julian David; Postma, Maarten J; Pourmalek, Farshad; Prabhakaran, Dorairaj; Qorbani, Mostafa; Radfar, Amir; Rafay, Anwar; Rafiei, Alireza; Rahim, Fakher; Rahimi-Movaghar, Afarin; Rahman, Mahfuzar; Rahman, Muhammad Aziz; Rai, Rajesh Kumar; Rajsic, Sasa; Raju, Sree Bhushan; Ram, Usha; Rana, Saleem M; Ranabhat, Chhabi Lal; Rawaf, David Laith; Rawaf, Salman; Reiner, Robert C; Reis, Cesar; Renzaho, Andre M N; Rezai, Mohammad Sadegh; Roever, Leonardo; Ronfani, Luca; Room, Robin; Roshandel, Gholamreza; Rostami, Ali; Roth, Gregory A; Roy, Ambuj; Sabde, Yogesh Damodar; Saddik, Basema; Safiri, Saeid; Sahebkar, Amirhossein; Salama, Joseph S; Saleem, Zikria; Salomon, Joshua A; Salvi, Sundeep Santosh; Sanabria, Juan; Sanchez-Niño, Maria Dolores; Santomauro, Damian Francesco; Santos, Itamar S; Santric Milicevic, Milena M M; Sarker, Abdur Razzaque; Sarmiento-Suárez, Rodrigo; Sarrafzadegan, Nizal; Sartorius, Benn; Satpathy, Maheswar; Sawhney, Monika; Saxena, Sonia; Saylan, Mete; Schaub, Michael P; Schmidt, Maria Inês; Schneider, Ione J C; Schöttker, Ben; Schutte, Aletta Elisabeth; Schwendicke, Falk; Sepanlou, Sadaf G; Shaikh, Masood Ali; Sharif, Mehdi; She, Jun; Sheikh, Aziz; Shen, Jiabin; Shiferaw, Mekonnen Sisay; Shigematsu, Mika; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Shukla, Sharvari Rahul; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Silva, Natacha Torres Da; Silveira, Dayane Gabriele Alves; Sinha, Dhirendra Narain; Sitas, Freddy; Soares Filho, Adauto Martins; Soofi, Moslem; Sorensen, Reed J D; Soriano, Joan B; Sreeramareddy, Chandrashekhar T; Steckling, Nadine; Stein, Dan J; Sufiyan, Mu'awiyyah Babale; Sur, Patrick J; Sykes, Bryan L; Tabarés-Seisdedos, Rafael; Tabuchi, Takahiro; Tavakkoli, Mohammad; Tehrani-Banihashemi, Arash; Tekle, Merhawi Gebremedhin; Thapa, Subash; Thomas, Nihal; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Troeger, Christopher E; Truelsen, Thomas Clement; Tsilimparis, Nikolaos; Tyrovolas, Stefanos; Ukwaja, Kingsley Nnanna; Ullah, Irfan; Uthman, Olalekan A; Valdez, Pascual R; Van Boven, Job F M; Vasankari, Tommi Juhani; Venketasubramanian, Narayanaswamy; Violante, Francesco S; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Vollset, Stein Emil; Vos, Theo; Wagnew, Fasil Wagnew Shiferaw; Waheed, Yasir; Wang, Yuan-Pang; Weiderpass, Elisabete; Weldegebreal, Fitsum; Weldegwergs, Kidu Gidey; Werdecker, Andrea; Westerman, Ronny; Whiteford, Harvey A; Widecka, Justyna; Wijeratne, Tissa; Wyper, Grant M A; Xu, Gelin; Yamada, Tomohide; Yano, Yuichiro; Ye, Pengpeng; Yimer, Ebrahim M; Yip, Paul; Yirsaw, Biruck Desalegn; Yisma, Engida; Yonemoto, Naohiro; Yoon, Seok-Jun; Yotebieng, Marcel; Younis, Mustafa Z; Zachariah, Geevar; Zaidi, Zoubida; Zamani, Mohammad; Zhang, Xueying; Zodpey, Sanjay; Mokdad, Ali H; Naghavi, Mohsen; Murray, Christopher J L; Gakidou, Emmanuela;
• Is Part Of: Lancet. Volume 392:Issue 10152(2018)
• Page Start: 1015
• Page End: 1035
• Publication Date: 2018-09-22
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(18)31310-2
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: 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.