Tackling Harmful Alcohol Use

Economics and Public Health Policy

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Alcoholic beverages, and their harmful use, have been familiar fixtures in human societies since the beginning of recorded history. Worldwide, alcohol is a leading cause of ill health and premature mortality. It accounts for 1 in 17 deaths, and for a significant proportion of disabilities, especially in men. In OECD countries, alcohol consumption is about twice the world average. Its social costs are estimated in excess of 1% of GDP in high- and middle-income countries. When it is not the result of addiction, alcohol use is an individual choice, driven by social norms, with strong cultural connotations. This is reflected in unique patterns of social disparity in drinking, showing the well-to-do in some cases more prone to hazardous use of alcohol, and a polarisation of problem-drinking at the two ends of the social spectrum. Certain patterns of drinking have social impacts, which provide a strong economic rationale for governments to influence the use of alcohol through policies aimed at curbing harms, including those occurring to people other than drinkers. Some policy approaches are more effective and efficient than others, depending on their ability to trigger changes in social norms, and on how well they can target the groups that are most at risk. This book provides a detailed examination of trends and social disparities in alcohol consumption. It offers a wide-ranging assessment of the health, social and economic impacts of key policy options for tackling alcohol-related harms in three OECD countries (Canada, the Czech Republic and Germany), extracting relevant policy messages for a broader set of countries.


English Also available in: French



In a 1726 pamphlet setting out A Brief Case of the Distillers, Daniel Defoe, author of Robinson Crusoe, wrote that: “The distilling trade, considered in its present magnitude, is one of the greatest improvements, and the most to the advantage of the publick, of any business now carried out in England”. Defoe was writing to defend English producers of spirits who were facing Dutch competition, especially from the newly-fashionable “Geneva water”, soon to be known as gin. The English distillers won their case, and soon gin was everywhere, with men and women even drinking together in public for the first time. The authorities soon came to regret their decision (as did Defoe) and over the next 25 years, the UK Parliament would pass no fewer than five Acts to try to put an end to what became known as the Gin Craze (Abel, 2001). The craze died out in the 1750s, although it was revived to some extent in the Victorian “gin palaces” of the following century.

English Also available in: French

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