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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.

 

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Trends in alcohol consumption in OECD countries

Levels of alcohol drinking are relatively high in many OECD countries compared with countries in other parts of the world. An average of between 9.1 litres (recorded consumption) and 10.3 litres (including unrecorded consumption) of pure alcohol are consumed annually in OECD countries, compared with an estimate of 6.2 litres worldwide (recorded and unrecorded). Overall, consumption has slightly declined in OECD countries in the past 20 years, and very large relative falls in consumption have been observed in certain countries, but consumption as risen sharply in other OECD countries, as well as in major emerging economies. Alcohol use is very concentrated in the population, with the heaviest-drinking 20% drinking most alcohol, and high-risk drinking behaviours have become more common in recent years in certain population groups. Hazardous and heavy episodic drinking have rapidly gained in popularity among young people, especially women, in countries where they were traditionally less common. At the same time they have decreased in certain countries where they used to be more popular among young people. These trends are especially worrying because they are fuelled by an increasingly early initiation into drinking and drunkenness. The proportion of children who have experienced alcohol at age 15 increased significantly during the 2000s, even faster among girls than boys.

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