Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries
Abstract
To estimate the effects of changes in per capita alcohol consumption on liver cirrhosis mortality rates in various demographic groups across 14 western European countries.Yearly changes in gender- and age-specific mortality rates from 1950 to 1995 were analysed in relation to corresponding yearly changes in per capita alcohol consumption, employing the Box-Jenkins technique for time series analysis. Country-specific estimates were pooled into three regions: northern, central and southern Europe.Cirrhosis mortality data for 5-year age groups were converted into gender-specific mortality rates in the age groups 15+, 15-44, 45-64 and 65+ and expressed as the number of deaths per 100,000 inhabitants. Alcohol sales were used to measure aggregate consumption, which were calculated into consumption (litres 100% alcohol) per year per inhabitant over 14 years of age and weighted with a 10-year distributed lag model.The country-specific analyses demonstrated a positive and statistically significant effect of changes in per capita consumption on changes in cirrhosis mortality in 13 countries for males and in nine countries for females. The strongest alcohol effect was found in northern Europe, due mainly to a large effect in Sweden. Moreover, when different age groups were analysed significant estimates were obtained in 29 of 42 cases for males and in 20 of 42 cases for females. Most of the non-significant estimates were found in older age groups.The results suggest clearly that a change in the overall level of drinking as a general rule affect cirrhosis mortality in different drinking cultures as well as among different demographic groups. Moreover, the findings correspond with what is expected from the collectivity theory of drinking cultures.
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Since the 1970s, improvements in alcohol quality and a reduction in alcohol consumption have been the major determinants of the steady decline in cirrhosis mortality in Western European countries.
“Since the 1970s, improvements in alcohol quality and a reduction in alcohol consumption have been the major determinants of the steady decline in cirrhosis mortality in these countries [5,36–39].”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [38]
The comparatively short lag between national alcohol consumption levels and changes in cirrhosis mortality is probably related to the effects of alcohol on patients with subclinical compensated liver cirrhosis.
“While alcohol generally requires several years to induce fibrosis in the liver, the comparatively short lag between national alcohol consumption levels and changes in cirrhosis mortality is probably related to the effects of alcohol on patients with subclinical compensated liver cirrhosis [4,38,51].”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [38]
The high liver cirrhosis death rates in Moldova and Hungary may be largely attributable to widespread consumption of highly hepatotoxic home-brewed fruit-based alcoholic beverages in these countries.
“This may be largely attributable to widespread consumption of highly hepatotoxic home-brewed fruit-based alcoholic beverages in these countries [5,36–39,52–54].”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [38]
The decline in liver cirrhosis mortality in Western Europe, particularly Spain, France and Italy, is due to a steady decrease in alcohol consumption, accompanied by improvement in wine quality and restrictions on home-brewed alcoholic beverage making.
“The decline in liver cirrhosis mortality in Western Europe, particularly in Spain, France and Italy, is undoubtedly due to a steady decrease in alcohol consumption, accompanied by an improvement in the quality of wine and restrictions on home-brewed alcoholic beverage making [5,36–39].”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [38]
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Cited by 96
- Authors
- Ramstedt, M.
- Affiliations
- Stockholm University (SE)
- Corresponding author
- Ramstedt, Mats
- ORCID
- Ramstedt, Mats
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2001-02-15
- Volume
- 96
- Issue
- 1
- Pages
- 19-33
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W4243292280
- Cited by
- 96
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 7 · 2013: 5 · 2012: 2
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- Funders
- European Commission
- 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
- per capita alcohol consumption, cirrhosis mortality, alcohol sales, age-specific mortality, sex differences, drinking culture, Sweden, European countries
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