Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Journal article


Griswold, MG, Fullman, N, Hawley, C, Arian, N, Zimsen, SRM, Tymeson, HD, Venkateswaran, V, Tapp, AD, Forouzanfar, MH, Salama, JS, Abate, KH, Abate, D, Abay, SM, Abbafati, C, Abdulkader, RS, Abebe, Z, Aboyans, V, Abrar, MM, Acharya, P, Adetokunboh, OO, Adhikari, TB, Adsuar, JC, Afarideh, M, Agardh, EE, Agarwal, G, Aghayan, SA, Agrawal, S, Ahmed, MB, Akibu, M, Akinyemiju, T, Akseer, N, Al Asfoor, DH, Al-Aly, Z, Alahdab, F, Alam, K, Albujeer, A, Alene, KA, Ali, R, Ali, SD, Alijanzadeh, M, Aljunid, SM, Alkerwi, A, Allebeck, P, Alvis-Guzman, N, Amare, AT, Aminde, LN, Ammar, W, Amoako, YA, Amul, GGH, Andrei, CL, Angus, C, Ansha, MG, Antonio, CAT, Aremu, O, Ärnlöv, J, Artaman, A, Aryal, KK, Assadi, R, Ausloos, M, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Ayele, HT, Ayer, R, Ayuk, TB, Azzopardi, PS, Badali, H, Badawi, A, Banach, M, Barker-Collo, SL, Barrero, LH, Basaleem, H, Baye, E, Bazargan-Hejazi, S, Bedi, N, Béjot, Y, Belachew, AB, Belay, SA, Bennett, DA, Bensenor, IM, Bernabe, E, Bernstein, RS, Beyene, AS, Beyranvand, T, Bhaumik, S, Bhutta, ZA, Biadgo, B, Bijani, A, Bililign, N, Birlik, SM, Birungi, C, Bizuneh, H, Bjerregaard, P, Bjørge, T, Borges, G, Bosetti, C, Boufous, S, Bragazzi, NL, Brenner, H and Butt, ZA (2018). Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 392 (10152), pp. 1015-1035.
AuthorsGriswold, MG, Fullman, N, Hawley, C, Arian, N, Zimsen, SRM, Tymeson, HD, Venkateswaran, V, Tapp, AD, Forouzanfar, MH, Salama, JS, Abate, KH, Abate, D, Abay, SM, Abbafati, C, Abdulkader, RS, Abebe, Z, Aboyans, V, Abrar, MM, Acharya, P, Adetokunboh, OO, Adhikari, TB, Adsuar, JC, Afarideh, M, Agardh, EE, Agarwal, G, Aghayan, SA, Agrawal, S, Ahmed, MB, Akibu, M, Akinyemiju, T, Akseer, N, Al Asfoor, DH, Al-Aly, Z, Alahdab, F, Alam, K, Albujeer, A, Alene, KA, Ali, R, Ali, SD, Alijanzadeh, M, Aljunid, SM, Alkerwi, A, Allebeck, P, Alvis-Guzman, N, Amare, AT, Aminde, LN, Ammar, W, Amoako, YA, Amul, GGH, Andrei, CL, Angus, C, Ansha, MG, Antonio, CAT, Aremu, O, Ärnlöv, J, Artaman, A, Aryal, KK, Assadi, R, Ausloos, M, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Ayele, HT, Ayer, R, Ayuk, TB, Azzopardi, PS, Badali, H, Badawi, A, Banach, M, Barker-Collo, SL, Barrero, LH, Basaleem, H, Baye, E, Bazargan-Hejazi, S, Bedi, N, Béjot, Y, Belachew, AB, Belay, SA, Bennett, DA, Bensenor, IM, Bernabe, E, Bernstein, RS, Beyene, AS, Beyranvand, T, Bhaumik, S, Bhutta, ZA, Biadgo, B, Bijani, A, Bililign, N, Birlik, SM, Birungi, C, Bizuneh, H, Bjerregaard, P, Bjørge, T, Borges, G, Bosetti, C, Boufous, S, Bragazzi, NL, Brenner, H and Butt, ZA
Abstract

Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. 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 lifeyears (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 agestandardised 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.

KeywordsGBD 2016 Alcohol Collaborators; Humans; Population Surveillance; Prevalence; Cause of Death; Risk Assessment; Risk Factors; Retrospective Studies; Prospective Studies; Alcohol Drinking; Age Distribution; Sex Distribution; Quality-Adjusted Life Years; Commerce; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Female; Male; Young Adult; Global Health; Observational Studies as Topic; Global Burden of Disease
Year2018
JournalThe Lancet
Journal citation392 (10152), pp. 1015-1035
PublisherElsevier BV
ISSN0140-6736
Digital Object Identifier (DOI)doi:10.1016/S0140-6736(18)31310-2
Publication dates
Print22 Sep 2018
Publication process dates
Accepted23 Aug 2018
Deposited09 May 2020
Publisher's version
License
CC BY-NC-ND 4.0
File Access Level
Open
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Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017
Dicker, D, Nguyen, G, Abate, D, Abate, KH, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdel-Rahman, O, Abdi, A, Abdollahpour, I, Abdulkader, RS, Abdurahman, AA, Abebe, HT, Abebe, M, Abebe, Z, Abebo, TA, Aboyans, V, Abraha, HN, Abrham, AR, Abu-Raddad, LJ, Abu-Rmeileh, NME, Accrombessi, MMK, Acharya, P, Adebayo, OM, Adedeji, IA, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adhikari, TB, Adib, MG, Adou, AK, Adsuar, JC, Afarideh, M, Afshin, A, Agarwal, G, Aggarwal, R, Aghayan, SA, Agrawal, S, Agrawal, A, Ahmadi, M, Ahmadi, A, Ahmadieh, H, Ahmed, MLCB, Ahmed, S, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Akanda, AS, Akbari, ME, Akibu, M, Akinyemi, RO, Akinyemiju, T, Akseer, N, Alahdab, F, Al-Aly, Z, Alam, K, Alebel, A, Aleman, AV, Alene, KA, Al-Eyadhy, A, Ali, R, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Allen, CA, Alonso, J, Al-Raddadi, RM, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Amini, E, Ammar, W, Amoako, YA, Anber, NH, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Anlay, DZ, Ansari, H, Ansariadi, A, Ansha, MG, Antonio, CAT, Appiah, SCY, Aremu, O, Areri, HA, Ärnlöv, J, Arora, M, Artaman, A and Aryal, KK (2018). Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 1684-1735.
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
Lozano, R, Fullman, N, Abate, D, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdel-Rahman, O, Abdi, A, Abdollahpour, I, Abdulkader, RS, Abebe, ND, Abebe, Z, Abejie, AN, Abera, SF, Abil, OZ, Aboyans, V, Abraha, HN, Abrham, AR, Abu-Raddad, LJ, Abu-Rmeileh, NM, Abyu, GY, Accrombessi, MMK, Acharya, D, Acharya, P, Adamu, AA, Adebayo, OM, Adedeji, IA, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adhikari, TB, Adib, MG, Adou, AK, Adsuar, JC, Afarideh, M, Afshari, M, Afshin, A, Agarwal, G, Aghayan, SA, Agius, D, Agrawal, A, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, MB, Ahmed, S, Akalu, TY, Akanda, AS, Akbari, ME, Akibu, M, Akinyemi, RO, Akinyemiju, T, Akseer, N, Alahdab, F, Al-Aly, Z, Alam, K, Alam, T, Albujeer, A, Alebel, A, Alene, KA, Al-Eyadhy, A, Alhabib, S, Ali, R, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Allen, CA, Almasi, A, Al-Maskari, F, Al-Mekhlafi, HM, Alonso, J, Al-Raddadi, RM, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Amenu, K, Amini, E, Ammar, W, Anber, NH, Anderson, JA, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Ansari, H, Ansariadi, A, Ansha, MG, Antonio, CAT, Anwari, P and Appiah, LT (2018). Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 2091-2138.
Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
Murray, CJL, Callender, CSKH, Kulikoff, XR, Srinivasan, V, Abate, D, Abate, KH, Abay, SM, Abbasi, N, Abbastabar, H, Abdela, J, Abdelalim, A, Abdel-Rahman, O, Abdi, A, Abdoli, N, Abdollahpour, I, Abdulkader, RS, Abebe, HT, Abebe, M, Abebe, Z, Abebo, TA, Abejie, AN, Aboyans, V, Abraha, HN, Abreu, DMX, Abrham, AR, Abu-Raddad, LJ, Abu-Rmeileh, NME, Accrombessi, MMK, Acharya, P, Adamu, AA, Adebayo, OM, Adedeji, IA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adhikari, TB, Adib, MG, Adou, AK, Adsuar, JC, Afarideh, M, Afshin, A, Agarwal, G, Agesa, KM, Aghayan, SA, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmed, MB, Ahmed, S, Aichour, AN, Aichour, I, Aichour, MTE, Akanda, AS, Akbari, ME, Akibu, M, Akinyemi, RO, Akinyemiju, T, Akseer, N, Alahdab, F, Al-Aly, Z, Alam, K, Alebel, A, Aleman, AV, Alene, KA, Al-Eyadhy, A, Ali, R, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Almasi, A, Alonso, J, Al-Raddadi, RM, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Ammar, W, Anber, NH, Andrei, CL, Androudi, S, Animut, MD, Ansari, H, Ansha, MG, Antonio, CAT, Appiah, SCY, Aremu, O, Areri, HA, Arian, N, Ärnlöv, J, Artaman, A, Aryal, KK, Asayesh, H, Asfaw, ET, Asgedom, SW, Assadi, R, Atey, TMM and Atique, S (2018). Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 1995-2051.
Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
James, SL, Abate, D, Abate, KH, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, RS, Abebe, Z, Abera, SF, Abil, OZ, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Accrombessi, MMK, Acharya, D, Acharya, P, Ackerman, IN, Adamu, AA, Adebayo, OM, Adekanmbi, V, Adetokunboh, OO, Adib, MG, Adsuar, JC, Afanvi, KA, Afarideh, M, Afshin, A, Agarwal, G, Agesa, KM, Aggarwal, R, Aghayan, SA, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmadieh, H, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Akinyemiju, T, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Mekhlafi, HM, Al-Raddadi, RM, Alahdab, F, Alam, K, Alam, T, Alashi, A, Alavian, SM, Alene, KA, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Alouani, MML, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Aminde, LN, Ammar, W, Amoako, YA, Anber, NH, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Ansha, MG, Antonio, CAT, Anwari, P, Arabloo, J, Arauz, A, Aremu, O, Ariani, F, Armoon, B, Ärnlöv, J, Arora, A, Artaman, A, Aryal, KK, Asayesh, H, Asghar, RJ, Ataro, Z, Atre, SR, Ausloos, M, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Ayala Quintanilla, BP, Ayer, R, Azzopardi, PS, Babazadeh, A, Badali, H, Badawi, A and Bali, AG (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 1789-1858.
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
Roth, GA, Abate, D, Abate, KH, Abay, SM, Abbafati, C, Abbasi, N, Abbastabar, H, Abd-Allah, F, Abdela, J, Abdelalim, A, Abdollahpour, I, Abdulkader, RS, Abebe, HT, Abebe, M, Abebe, Z, Abejie, AN, Abera, SF, Abil, OZ, Abraha, HN, Abrham, AR, Abu-Raddad, LJ, Accrombessi, MMK, Acharya, D, Adamu, AA, Adebayo, OM, Adedoyin, RA, Adekanmbi, V, Adetokunboh, OO, Adhena, BM, Adib, MG, Admasie, A, Afshin, A, Agarwal, G, Agesa, KM, Agrawal, A, Agrawal, S, Ahmadi, A, Ahmadi, M, Ahmed, MB, Ahmed, S, Aichour, AN, Aichour, I, Aichour, MTE, Akbari, ME, Akinyemi, RO, Akseer, N, Al-Aly, Z, Al-Eyadhy, A, Al-Raddadi, RM, Alahdab, F, Alam, K, Alam, T, Alebel, A, Alene, KA, Alijanzadeh, M, Alizadeh-Navaei, R, Aljunid, SM, Alkerwi, A, Alla, F, Allebeck, P, Alonso, J, Altirkawi, K, Alvis-Guzman, N, Amare, AT, Aminde, LN, Amini, E, Ammar, W, Amoako, YA, Anber, NH, Andrei, CL, Androudi, S, Animut, MD, Anjomshoa, M, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Aremu, O, Arnlov, J, Arora, A, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asfaw, ET, Ataro, Z, Atique, S, Atre, SR, Ausloos, M, Avokpaho, EFGA, Awasthi, A, Ayala Quintanilla, BP, Ayele, Y, Ayer, R, Azzopardi, PS, Babazadeh, A, Bacha, U, Badali, H, Badawi, A and Herteliu, C. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 392 (10159), pp. 1736-1788.
Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016
Wang, H, Abajobir, AA, Abate, KH, Abbafati, C, Abbas, KM, Abd-Allah, F, Abera, SF, Abraha, HN, Abu-Raddad, LJ, Abu-Rmeileh, NME, Adedeji, IA, Adedoyin, RA, Adetifa, IMO, Adetokunboh, O, Afshin, A, Aggarwal, R, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Ahmed, MB, Aichour, AN, Aichour, I, Aichour, MTE, Aiyar, S, Akanda, AS, Akinyemiju, TF, Akseer, N, Al-Eyadhy, A, Al Lami, FH, Alabed, S, Alahdab, F, Al-Aly, Z, Alam, K, Alam, N, Alasfoor, D, Aldridge, RW, Alene, KA, Alhabib, S, Ali, R, Alizadeh-Navaei, R, Aljunid, SM, Alkaabi, JM, Alkerwi, A, Alla, F, Allam, SD, Allebeck, P, Al-Raddadi, R, Alsharif, U, Altirkawi, KA, Martin, EA, Alvis-Guzman, N, Amare, AT, Ameh, EA, Amini, E, Ammar, W, Amoako, YA, Anber, N, Andrei, CL, Androudi, S, Ansari, H, Ansha, MG, Antonio, CAT, Anwari, P, Ärnlöv, J, Arora, M, Artaman, A, Aryal, KK, Asayesh, H, Asgedom, SW, Asghar, RJ, Assadi, R, Atey, TM, Atre, SR, Avila-Burgos, L, Avokpaho, EFGA, Awasthi, A, Ayala Quintanilla, BP, Babalola, TK, Bacha, U, Badawi, A, Balakrishnan, K, Balalla, S, Barac, A, Barber, RM, Barboza, MA, Barker-Collo, SL, Bärnighausen, T, Barquera, S, Barregard, L, Barrero, LH, Baune, BT, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Béjot, Y, Bekele, BB, Bell, ML, Bello, AK, Bennett, DA and Bennett, JR (2017). Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 390 (10100), pp. 1084-1150.
Quantitative and qualitative analysis of editor behavior through potentially coercive citations
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Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016
Naghavi, Mohsen, Abajobir, Amanuel Alemu, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abera, Semaw Ferede, Aboyans, Victor, Adetokunboh, Olatunji, Afshin, Ashkan, Agrawal, Anurag, Ahmadi, Alireza, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Miloud Taki Eddine, Aichour, Ibtihel, Aiyar, Sneha, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alam, Tahiya, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Syed Danish, Alizadeh-Navaei, Reza, Alkaabi, Juma M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amini, Erfan, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andersen, Hjalte H, Andrei, Catalina Liliana, Androudi, Sofia, Ansari, Hossein, Antonio, Carl Abelardo T, Anwari, Palwasha, Ärnlöv, Johan, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon W, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Avokpaho, Euripide 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