The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview

Rehm, Jürgen; Room, Robin; Graham, Kathryn; Monteiro, Maristela; Gmel, Gerhard; Sempos, Christopher T.

doi:10.1046/j.1360-0443.2003.00467.x

Cited by 995Alcohol Consumption and Health EffectsSubstance Abuse Treatment and OutcomesGlobal Public Health Policies and Epidemiology

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview

Rehm, Jürgen, Room, Robin, Graham, Kathryn, Monteiro, Maristela, Gmel, Gerhard, Sempos, Christopher T.·2003·Addiction

DOI 10.1046/j.1360-0443.2003.00467.x

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Abstract

Aims As part of a larger study to estimate the global burden of disease attributable to alcohol: to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and to combine exposure and risk estimates to determine regional and global alcohol‐attributable fractions (AAFs) for major disease and injury categories. Design, methods, setting Systematic literature reviews were used to select diseases related to alcohol consumption. Meta‐analyses of the relationship between alcohol consumption and disease and multi‐level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual‐level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi‐level analyses with prevalence data. Findings Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed. Conclusions Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.

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Knowledge on and estimates of risk relations between alcohol use and health outcomes have been evolving during the past 15 years.
“Knowledge on and estimates of these risk relations have been evolving during the past 15 years (compare the overview from 2003 23, and especially since 2010 when the last overview on this topic in Addiction appeared 24, which the current review will update with the latest evidence.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [23]
Alcohol use has long been identified as a major contributor to injuries of all kinds, with established causal links.
“Alcohol use has long been identified as a major contributor to injuries of all kinds, with established causal links (for details see previous reviews 23, 24).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [23]
The impact of alcohol on aggression and violence to others has been well established.
“The impact of alcohol on aggression and violence to others has been well established 23, 338, 339.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [23]

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Authors: Rehm, J., Room, R., Graham, K., Monteiro, M., Gmel, G., & Sempos, C. T.
Affiliations: Stockholm University (SE)
Centre for Addiction and Mental Health (CA)
World Health Organization (CH)
Addiction Switzerland (CH)
University at Buffalo, State University of New York (US)
Corresponding author: Rehm, Jürgen
ORCID: Rehm, Jürgen
Room, Robin
Graham, Kathryn
Monteiro, Maristela
Gmel, Gerhard
Sempos, Christopher T.
Venue: Addiction
Publisher: Wiley
Published: 2003-08-27
Volume: 98
Issue: 9
Pages: 1209-1228
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1046/j.1360-0443.2003.00467.x
OpenAlex: W2089313156
Cited by: 995
References: 130
Citations by year: 2026: 10 · 2025: 9 · 2024: 20 · 2023: 25 · 2022: 24 · 2021: 35 · 2020: 37 · 2019: 37 · 2018: 47 · 2017: 55 · 2016: 35 · 2015: 75 · 2014: 56 · 2013: 58 · 2012: 67
FWCI: 4.90
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders: Centre for Addiction and Mental Health
Bundesamt für Gesundheit
Topics: Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Keywords: alcohol consumption, drinking patterns, alcohol-attributable fraction, global burden of disease, alcohol-related disorders, alcohol-related injuries, coronary artery disease, stroke, liver cirrhosis, cancer, depression, alcoholism, hypertension, diabetes mellitus, oropharyngeal cancer, esophageal cancer, breast cancer
MeSH terms: Acute Disease, Alcohol Drinking, Chronic Disease, Female, Humans, Male, Risk Factors, Risk Assessment, Alcohol-Related Disorders, Alcohol-Induced Disorders

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The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview

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