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Alcohol

Alcohol is a known risk factor for cancer and is classified by the World Health Organization (WHO) International Agency for Research on Cancer as a Group 1 carcinogen. According to WHO, alcohol consumption is carcinogenic for the following types of cancers: cancer of the mouth, nasopharynx, other pharynx and oropharynz, largyngeal cancer, oesophageal cancer, colon and rectum cancer, liver cancer and female breast cancer. There is also evidence suggesting alcohol consumption is likely to cause pancreatic cancer. The effect of alcohol on cancer risk is dose-dependent, which means that any level of consumption will increase the risk of cancer and the risks increase with higher levels of consumption.

WHO estimates that, in 2012, the harmful use of alcohol was responsible for 3.3 million deaths (5.9% of all deaths) globally with a significant portion of these deaths from noncommunicable diseases (NCDs) including 12.5% from cancers. 5.1% of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years.

Source: WHO Global Status Report on Alcohol and Health 2014

According to WHO, the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions including: neuropsychiatric conditions (such as alcohol use disorders), gastrointestinal diseases (such as liver cirrhosis), intentional and unintentional injuries, cardiovascular diseases, fetal alcohol syndrome, diabetes and infectious diseases. In 2016, WHO reported that the worldwide level of alcohol consumption was 6.4 litres of pure alcohol per person aged 15 years or older, with considerable variation between WHO regions.

At the May 2008 meeting of the World Health Assembly, Member States adopted resolution WHA61.4 on Strategies to Reduce the Harmful Use of Alcohol which requested the Director-General of the WHO to prepare a draft global strategy to reduce the harmful use of alcohol. In 2010, the 193 Member States of the WHO reached unanimous consensus on a global strategy to reduce the harmful use of alcohol.

The WHO Global Strategy to Reduce the Harmful Use of Alcohol (Global Alcohol Strategy) defines the ‘harmful use of alcohol’ as:

broad and encompasses the drinking that causes detrimental health and social consequences for the drinker, the people around the drinker and society at large, as well as the patterns of drinking that are associated with increased risk of adverse health outcomes.

The Political Declaration on the Prevention and Control of NCDs (2011 Political Declaration), adopted following the first High-Level Meeting of the United Nations General Assembly on the prevention and control of NCDs in 2011, reaffirmed the Global Alcohol Strategy with Member States committing to promote implementation of the Global Alcohol Strategy while recognising the need to develop appropriate domestic action plans.

A global commitment to addressing the harmful use of alcohol has been entrenched within the broader global sustainable development framework through the inclusion of relevant targets in the 2030 Agenda for Sustainable Development.

The global framework on harmful use of alcohol includes the following strategies and reports:

 
  • The Global Alcohol Strategy endorsed by the 63rd World Health Assembly in May 2010 by resolution WHA63.13. The Global Alcohol Strategy provides a portfolio of policy options and interventions to guide Member States on ways to reduce the harmful use of alcohol. The policy options and interventions are grouped into ten recommended target areas including: leadership, awareness and commitment; health services’ response; community action; drink-driving policies and countermeasures; availability of alcohol; marketing of alcoholic beverages; pricing policies; reducing the negative consequences of drinking and alcohol intoxication; reducing the public health impact of illicit alcohol and informally produced alcohol and monitoring and surveillance.
 
  • The WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020 (Global Action Plan) endorsed by the 66th World Health Assembly by resolution WHA66.10 of 27 May 2013. The Global Action Plan provides a road map and a menu of policy options for all Member States and other stakeholders, to take coordinated and coherent action, at all levels, local to global, to attain the nine voluntary global targets. In the context of the harmful use of alcohol, the Global Action Plan builds on the Global Alcohol Strategy and includes targets of a 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases and at least a 10% relative reduction in the harmful use of alcohol as appropriate, within the national context. An updated Appendix 3 of the Global Action Plan ‘Best Buys' and other recommended interventions for the prevention and control of NCDs was endorsed at the 70th World Health Assembly in May 2017 by resolution WHA70.11 and provides a menu of policy options and cost-effective interventions. The best buys for the harmful use of alcohol include: increasing excise taxes on alcoholic beverages; enacting and enforcing bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media); and enacting and enforcing restrictions on the physical availability of retailed alcohol (via reduced hours of sale).
  
  • The Global Status Report on Alcohol and Health 2014 tracks progress made in alcohol policy development in WHO Member States after the Global Alcohol Strategy was endorsed and provides information on alcohol-related indicators for the comprehensive WHO Global Monitoring Framework for the Prevention and Control of NCDs which was adopted at the 66th World Health Assembly. The Report also presents an overview of some of the mechanisms and pathways which underlie the impact of the harmful use of alcohol on public health. The Report notes that ‘progress is uneven and there is no room for complacency given the enormous public health burden attributable to alcohol consumption’.

 The following tools have been established in relation to the harmful use of alcohol:

  • Addressing the Harmful Use of Alcohol: A Guide to Developing Effective Alcohol Legislation published in 2011 by the WHO Western Pacific Region. The Guide provides advice on approaches to alcohol regulation to support development of effective legislation appropriate to each country. The Guide provides legislative advice for implementing policies: to reduce the affordability of alcohol through policies on taxation and price; to reduce the availability of alcohol by restricting and/or regulating the sale of alcohol to the public; to reduce alcohol consumption by children and young people by setting a minimum age for sale and purchase; to monitor and enforce legislation and policy; to reduce exposure to alcohol marketing; and to deter drinking and driving.
  • The Global Information System on Alcohol and Health (GISAH) a tool for assessing and monitoring the health situation and trends related to alcohol consumption, alcohol-related harm and policy responses in countries. The GISAH data covers categories including: levels of consumption; patterns of consumption; harms and consequences; economic aspects; alcohol control policies; prevention, research, treatment; youth and alcohol; key alcohol indicators relevant to Sustainable Development Goals; and key alcohol indicators relevant to NCDs. In addition, the GISAH links to the alcohol policy timeline database of countries in the WHO European Union.

The harmful use of alcohol also falls within the broader global sustainable development framework:

 
  • The 2030 Agenda for Sustainable Development adopted by the UN General Assembly by resolution 70/1 on 25 September 2015 and entered into force on 1 January 2016. The 2030 Agenda for Sustainable Development includes 17 Sustainable Development Goals and 169 targets including the following specifically relevant to the harmful use of alcohol:

Goal 3 ensure healthy lives and promote well-being for all at all ages;

Target 3.5 strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol; and

Target 3.6 by 2020, halve the number of global deaths and injuries from road traffic accidents. 

 

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