Alcohol use

• Alcohol is a toxic, psychoactive, dependence-producing substance, the consumption of which is causally linked to over 200 health conditions, including liver diseases, road injuries, violence, cancers, cardiovascular diseases, suicides, tuberculosis, and HIV/AIDS.
• For these conditions, there's a direct link between the amount of alcohol consumed and the risk of developing the disease or dying from it - the more alcohol you drink, the higher the risk.
• There are at least 30 health conditions that would not exist without alcohol consumption, such as alcoholic liver disease, fetal alcohol spectrum disorders, alcoholic pancreatitis or alcohol poisoning.
• Alcohol use can cause or exacerbate social, legal, medical, domestic, school, work, and financial problems.
• Alcohol use can impact mental health by increasing the risk of disorders like depression and anxiety, and worsening existing conditions. It can lead to mood swings, impulsive behaviour, and elevate the risk of self-harm and suicide. Additionally, alcohol can disrupt sleep patterns and affect social and occupational functioning, which can aggravate mental health issues and create a cycle of deterioration.
• The economic costs of alcohol to societies are significant and include health-care expenses for treating alcohol-related conditions, including costs from accidents and injuries, losses in workplace productivity due to absenteeism, presenteeism and premature death, legal and crime-related expenses of the judicial system, as well as increased expenditures for social services. In all countries of the Region, these costs are estimated to far exceed the revenue governments gain from alcohol taxes.
• The total per-capita alcohol consumption of a country is closely related to the prevalence of alcohol-related harm found in the country, including the prevalence of alcohol use disorders (AUDs).
• AUDs are a range of conditions where drinking causes harm to physical or mental health, or leads to serious problems in daily life. Alcohol dependence is the most severe form, sometimes referred to by the outdated term "alcoholism". AUDs have significant effects on people's health and well-being. In the WHO European Region, more than 1 in every 11 adults experiences alcohol use disorders.
• One in every 11 deaths in the WHO European Region is due to alcohol consumption. About 800 000 deaths a year result from alcohol use in the Region, almost a third of the global total of 2.6 million deaths. This means that death resulting from alcohol consumption is almost 3 times as common in the WHO Europe Region as it is globally.
• Cardiovascular diseases are the leading cause of death resulting from alcohol in the WHO European Region, followed by cancers, digestive diseases and injuries.
• The European Union (EU), comprising around half of the WHO European Region by population, is the heaviest-drinking area in the world. Seven of the 10 countries with the highest per-capita alcohol consumption are in the EU.
• Alcohol harms individuals, families, and communities, including those who are affected by other people's alcohol consumption.
• Cancer is the leading cause of deaths due to alcohol consumption in the EU, making up a third of the bloc's alcohol-attributable deaths.
• Drinking even small amounts of alcohol increases the risk of cancer, and the more alcohol you drink, the higher the risk becomes.
• Alcohol is classified as a Group 1 carcinogen by the International Agency for Research on Cancer, meaning it is known to cause cancer in humans. The risk is cumulative, so the more alcohol a person drinks over time, the higher their likelihood of developing alcohol-related cancers, such as those of the breast, liver, mouth, throat, oesophagus, and colon.
• Any alcoholic beverage can cause cancer because the ethanol in alcoholic beverages and the acetaldehyde it produces in the body are carcinogenic (can cause or promote the development of cancer).
• Alcohol consumption directly affects the developing brain, particularly areas involved in decision-making ability, impulse regulation and self-control. The human brain continues to develop until around the age of 25, and during this period, it is particularly vulnerable to the effects of alcohol. For example, early onset of alcohol use is strongly associated with an increased risk of alcohol use disorders later in life.
• Alcohol consumption is responsible for 1 in 4 deaths of 19-24-year-olds in the WHO European Region, mainly due to injuries.
• Low-income populations experience disproportionate harms from alcohol consumption, compared to other societal groups. Reducing alcohol consumption across populations benefits low-income populations and reduces health inequalities.
• Public health strategies that aim to reduce overall alcohol consumption, such as increasing alcohol taxes, regulating availability, and limiting alcohol marketing, can be particularly effective in mitigating disparities and improving health outcomes for low-income groups.
• Alcohol consumption undermines commitments to achieve at least 13 of the 17 Sustainable Development Goals, impacting a range of health-related indicators, such as child health, infectious diseases, and road injuries, as well as a much broader range of indicators related to economic and social development, environment and equality.

Overview

The WHO European Region has the highest levels of alcohol consumption and the highest burden of alcohol-related harm in the world. Alcohol is a toxic, psychoactive substance linked to over 200 diseases and conditions, including 7 types of cancer. The Region experiences almost one third of the global deaths attributable to alcohol, with approximately 800 000 deaths annually. Every day, around 2191 people die from alcohol-related causes in the Region. A relatively high proportion of alcohol harm occurs early in the life course. The negative effects of alcohol consumption disproportionately affect younger and vulnerable populations, and contribute significantly to the burden of noncommunicable diseases in the Region. Around 1 in every 3 deaths in men and 1 in every 5 deaths in women between 30 and 40 years of age were due to alcohol.

The EU is the heaviest-drinking area globally, with 7 of the 10 countries with the highest per-capita alcohol consumption located within the EU. Despite progress in reducing alcohol consumption and related harms, the Region continues to face significant challenges, including high rates of alcohol-related deaths, particularly from cancer.

WHO response in the WHO European Region

The WHO European Region has been proactive in addressing the harm caused by alcohol through several key initiatives and frameworks. The European framework for action on alcohol, 2022-2025, adopted by all 53 Member States, uses the latest evidence to address alcohol-related harms through comprehensive, evidence-based policies and collaborative efforts. It includes 6 priority areas where action should be taken: pricing, health information with a focus on alcohol labelling, health services' response, availability, marketing, and community action.

The SAFER initiative, launched globally in 2018, supports the implementation of high-impact strategies across the European Region.  

SAFER stands for:

• strengthening restrictions on alcohol availability;
• advancing and enforcing drink-driving countermeasures;
• facilitating access to screening, brief interventions, and treatment;
• enforcing bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion; and
• raising prices on alcohol through excise taxes and pricing policies.

This initiative includes policies that reduce the affordability, availability, and acceptability of alcohol, particularly in the heaviest-drinking countries, mitigating the effects of alcohol consumption on public health.

In 2022, the WHO Regional Office for Europe, with support from the European Commission, initiated the Evidence into Action Alcohol Project (EVID-ACTION), which is contributing to delivering on the objectives of Europe's Beating Cancer Plan. Among other things, the project is working to increase awareness among the public and policy-makers in the EU about the links between alcohol consumption and cancer risks, and to support evidence-based alcohol policy measures to reduce these risks.

A critical aspect of the Region's approach is addressing the commercial determinants of health, particularly the influence of the alcohol industry on public health policy. This emphasizes the importance of protecting policy-making processes from industry interference that aims to delay or weaken public health measures that would reduce alcohol consumption. To combat this, WHO advocates for transparency in policy development, the exclusion of the alcohol industry from policy discussions, and the implementation of regulations to limit the industry's influence on public health.

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