Alcohol and Chronic Disease

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1 Alcohol and Chronic Disease Dr Gauden Galea Dr Lars Møller World Health Organization, Regional Office for Europe 14 November 212 Bled, Slovenia ++ Breaking News ++ Global Monitoring Framework ++ Release :

2 Set of nine voluntary global targets Mortality and morbidity Premature mortality from NCDs 25% reduction Risk factors Harmful use of alcohol % Tobacco 3% Physical inactivity % Salt/ sodium intake 3% Raised blood pressure 25% Diabetes /obesity % National systems response Drug therapy and counseling 5% Medicines and technologies 8% Set of nine voluntary global targets Mortality and morbidity Premature mortality from NCDs 25% reduction Risk factors Harmful use of alcohol % Tobacco 3% Physical inactivity % Salt/ sodium intake 3% Raised blood pressure 25% Diabetes /obesity % National systems response Drug therapy and counseling 5% Medicines and technologies 8% 2

3 Global monitoring framework, including 25 indicators Mortality and Morbidity Premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases Cancer incidence, by type Global monitoring framework, including 25 indicators Mortality and Morbidity Risk Factors Premature Harmful use of alcohol (3) mortality Low fruit from and vegetable intake cardiovascular Overweight and obesity (2) diseases, cancer, diabetes, Physical or inactivity (2) chronic Raised respiratory blood glucose diseases Raised blood pressure Cancer Raised incidence, total cholesterol by type Salt/sodium intake Tobacco (2) Fat intake 3

4 Global monitoring framework, including 25 indicators Mortality and Morbidity Premature Harmful Cervical use of cancer alcohol screening (3) mortality Low Drug fruit from and therapy vegetable and counseling intake to prevent cardiovascular heart attacks and strokes Overweight and obesity (2) diseases, cancer, diabetes, Physical Essential or inactivity NCD (2) medicines and technologies chronic Raised respiratory Palliative blood glucose care diseases Raised Policies blood to pressure reduce marketing of foods to children Cancer Raised incidence, Vaccination total cholesterol against hepatitis B by type Salt/sodium intake Policies to eliminate partially hydrogenated Tobacco vegetable (2) oils from food supply Fat intake Vaccination against human papillomavirus Risk Factors National system response Alcohol Indicators Alcohol per capita consumption Heavy episodic drinking Alcohol attributable morbidity and mortality 4

5 Alcohol Indicators Alcohol per capita consumption (volume) Heavy episodic drinking (pattern) Alcohol attributable morbidity and mortality Risk of alcohol-related disease (Volume) Source: Australian Guidelines To Reduce Health Risks from Drinking Alcohol (29) 5

6 Risk of alcohol-related injury (Pattern) Source: Australian Guidelines To Reduce Health Risks from Drinking Alcohol (29) Personal reflection Make a note of two numbers What is an acceptable lifetime risk of death from alcohol use? 1:1,,? 1:? Personal risk: 1 : What number of standard drinks per episode should I drink before my lifetime risk exceeds that acceptable level? Number of std drinks: 1 : 6

7 Lifetime risk of death from alcohol-related disease per drinkers, by number of standard drinks per occasion, Australia 22 Source: Australian Guidelines To Reduce Health Risks from Drinking Alcohol (29) Lifetime risk of death from alcohol-related injury per male drinkers, by number of standard drinks per occasion and frequency of occasions Source: Australian Guidelines To Reduce Health Risks from Drinking Alcohol (29) 7

8 Cause specific relative risks by alcohol consumption. White I R et al. BMJ 22;325: by British Medical Journal Publishing Group Recorded alcohol consumption in the EU (in litres pure alcohol per capita 15+) stable but high (more than twice the world average) Total Beer Wine Spirtis Other

9 Regional differences Lifetime abstainers in the EU, candidate countries, Norway and Switzerland, males (29) %

10 % Lifetime abstainers in the EU, candidate countries, Norway and Switzerland, females (29) THE 211 ESPAD REPORT Substance Use Among Students in 36 European Countries (European School Survey Project on Alcohol and Other Drugs)

11 Alcohol use during the past 3 days, males (211) % % Alcohol use during the past 3 days, females (211) 11

12 % Being drunk during the past 3 days, males (211) % Being drunk during the past 3 days, females (211) 12

13 % 7 Having had five or more drinks on one occasion during the past 3 days, males (211) % 6 Having had five or more drinks on one occasion during the past 3 days, females (211)

14 Regional variation of alcohol-attributable deaths to all deaths, year olds Proportion of alcohol-attributable deaths caused by harm to others, 24, years old 14

15 Best buys package population-based approaches Smoke-free environments Warning about the dangers of tobacco use Bans on tobacco advertising Raising taxes on tobacco Raising taxes on alcohol Restricting access to retail alcohol Bans on alcohol advertising Reducing salt intake and salt content of food Replacing trans-fat in food with polyunsaturated fat Promoting public awareness about diet and physical activity European Alcohol Action Plans from

16 Sixty-third World Health Assembly, May 2 Endorsed the global strategy to reduce the harmful use of alcohol. World Health Assembly resolution WHA63.13 European action plan to reduce the harmful use of alcohol (EAAP) action areas Leadership, awareness and commitment, as sustainable intersectoral action requires strong leadership and a solid base of awareness and political will Health services response, as these services are central to tackling health conditions in individuals caused by harmful alcohol use Community action, as governments and other stakeholders can support and empower communities in adopting effective approaches to prevent and reduce harmful alcohol use Policies and countermeasures on drink driving, as it is extremely dangerous to drivers, passengers and other people using the roads Availability of alcohol, as public health policies to regulate commercial or public availability have proved to be very effective in reducing the general level of harmful use and drinking among minors 16

17 EAAP action areas Marketing of alcoholic beverages, as systems are needed to protect people, particularly children and young people, from advanced advertising and promotion techniques Pricing policies, as most consumers, particularly heavy drinkers and young people, are sensitive to changes in the prices of alcohol products Reducing the negative consequences of drinking and alcohol intoxication, in order to minimize violence, intoxication and harm to intoxicated people Reducing the public health impact of illicit and informally produced alcohol, as its consumption could have additional negative health consequences due to its higher ethanol content and potential contamination with toxic substances Monitoring and surveillance, as relevant data create the basis for the appropriate delivery and success of responses 17

18 Policy development at national level Changes in alcohol policy areas over the five years since 26 (N=29) Monitoring and research Workplacesᵃ Community actionsᵃ Advice and treatment Harm reduction in environment Drink driving policies Regulation of marketingᵃ Public awareness raising Illegal alcoholᵇ Affordabilityᵃ Availabiltyᵃ Stronger Unchanged Weaker 2 3 Number of countries a Data missing from one country. b Data missing from two countries. Price and tax measures Trends in price of beer, wine and spirits relative to the consumer price index, previous five years (N=29), Number of countries Beer Wine Spirits Inconclusive Decrease Stable Increase Beverage type 18

19 Euro Average price of 75 ml spirits (local brand) in Euro Thank you! Contact details: Website: European infosystem on alcohol and health: 19

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