The relation between different dimensions of alcohol consumption and burden of disease: an overview
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Aims As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta‐analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. Methods Systematic literature reviews were used to identify alcohol‐related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta‐analyses. Results Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose–response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. Conclusions Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol–disease relationships.
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The high alcohol burden in eastern Europe was identified in the 2000 comparative risk assessment, but data for consumption patterns and effects were weaker then; now they are supported by more surveys and epidemiological studies.
“The high burden in eastern Europe was also identified in the 2000 comparative risk assessment but the data for patterns of alcohol consumption and their effects were weaker, whereas now they are supported by more surveys and epidemiological studies.182”
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 [24]
The review updated all estimates of alcohol use-disease or injury relationships for partially attributable outcomes from the most recent preceding publication, following PRISMA guidelines.
“updated all estimates of alcohol use–disease or injury relationships for partially attributable outcomes from the estimates in the most recent preceding publication 24, following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines 26, 27.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [24]
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 [24]
Since the last review, many new reviews and meta-analyses have appeared.
“Since the last review 24, many new reviews and meta‐analyses have appeared (see Table 4 and Supporting information, Appendix S1 for a complete listing)”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [24]
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A DNA methylation biomarker of alcohol consumption
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Alcohol use disorders and mortality: a systematic review and meta-analysis
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Self-citationPathophysiological Aspects of Alcohol Metabolism in the Liver
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Alcohol consumption and non‐communicable diseases: epidemiology and policy implications
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Self-citationAlcohol consumption as a risk factor for tuberculosis: meta-analyses and burden of disease
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Alcohol Use and Breast Cancer: A Critical Review
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Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis
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Burden of Disease Associated with Alcohol Use Disorders in the United States
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Risky single‐occasion drinking: bingeing is not bingeing
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A narrative review of alcohol consumption as a risk factor for global burden of disease
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Epidemiology and alcohol policy in Europe
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A review of the relationship between alcohol and oral cancer
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Self-citationFatores de risco relacionados à carga global de doença do Brasil e Unidades Federadas, 2015
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The burden of disease attributable to cannabis use in Canada in 2012
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Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?
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- Authors
- Rehm, J., Baliunas, D., Borges, G. L. G., Graham, K., Irving, H., Kehoe, T., Parry, C. D., Patra, J., Popova, S., Poznyak, V., Roerecke, M., Room, R., Samokhvalov, A. V., & Taylor, B.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- Western University (CA)
- South African Medical Research Council (ZA)
- World Health Organization (CH)
- The University of Melbourne (AU)
- Corresponding author
- Rehm, Jürgen
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2010-04-08
- Volume
- 105
- Issue
- 5
- Pages
- 817-843
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC3306013
- OpenAlex
- W2128842312
- Cited by
- 1,174
- References
- 292
- Citations by year
- 2026: 30 · 2025: 44 · 2024: 60 · 2023: 68 · 2022: 76 · 2021: 67 · 2020: 68 · 2019: 66 · 2018: 77 · 2017: 102 · 2016: 84 · 2015: 96 · 2014: 89 · 2013: 98 · 2012: 76
- FWCI
- 53.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (HHSN267200700041C)
- National Institute of Diabetes and Digestive and Kidney Diseases (HHSN267200700041C)
- 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, binge drinking, global burden of disease, alcohol-related injuries, alcohol-related disorders, dose-response relationship, alcohol quality, alcoholism, fetal alcohol syndrome, ischemic heart disease, stroke, liver cancer, cancer, diabetes mellitus, depression, liver cirrhosis, preterm birth, childbirth complications
- MeSH terms
- Alcohol Drinking, Chronic Disease, Epidemiologic Methods, Female, Humans, Infections, Male, Review Literature as Topic, Meta-Analysis as Topic, Cost of Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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