Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Science and Society
  • Published:

Alcohol: taking a population perspective

Abstract

Alcohol consumption is a global phenomenon, as is the resultant health, social and economic harm. The nature of these harms varies with different drinking patterns and with the societal and political responses to the burden of harm; nevertheless, alcohol-related chronic diseases have a major effect on health. Strong evidence exists for the effectiveness of different strategies to minimize this damage and those policies that target price, availability and marketing of alcohol come out best, whereas those using education and information are much less effective. However, these policies can be portrayed as anti-libertarian and so viewing them in the context of alcohol-related harm to those other than the drinker, such as the most vulnerable in society, is important. When this strategy is successful, as in Scotland, it has been possible to pass strong and effective legislation, such as for a minimum unit price for alcohol.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Litres of pure alcohol (recorded and unrecorded) consumed per person aged 15 years and over in 2010.
Figure 2: Litres of pure alcohol (recorded) consumed per person aged 15 years and over in the UK (1961–2012), France (1961–2014) and Italy (1961–2010).
Figure 3: Conceptual causal model of alcohol consumption and health outcomes.

References

  1. Davis, K. et al. Mirror, mirror on the wall: how the performance of the U.S. health care system compares internationally. The Commonwealth Fund, http://www.commonwealthfund.org//media/files/publications/fund-report/2014/jun/1755_davis_mirror_mirror_2014.pdf (2014).

    Google Scholar 

  2. World Health Organization. International guide for monitoring alcohol consumption and related harm (WHO, 2000).

  3. World Health Organization. Global status report on alcohol and health (WHO, 2014).

  4. Babor, T. et al. Alcohol: no ordinary commodity: research and public policy 2nd edn (Oxford Univ. Press, 2010).

    Book  Google Scholar 

  5. Organisation for Economic Co-operation and Development. Tackling Harmful Alcohol Use: Economics and Public Health Policy (OECD Publishing, 2015).

  6. Lim, S. et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 2224–2260 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nutt, D., King, L. & Phillips, L. Drug harms in the UK: a multicriteria decision analysis. Lancet 376, 1558–1565 (2010).

    Article  PubMed  Google Scholar 

  8. Williams, R. et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet 384, 1953–1997 (2014).

    Article  PubMed  Google Scholar 

  9. Rehm, J. et al. The costs of substance abuse in Canada 2002 (Canadian Centre on Substance Abuse, 2006).

    Google Scholar 

  10. HM Government. The Government's Alcohol Strategy (HM Government, 2012).

  11. Laslett, A.-M. et al. The Range and Magnitude of Alcohol's Harm to Others (AER Centre for Alcohol Policy Research, 2010).

    Google Scholar 

  12. Sacks, J. et al. 2010 national and state costs of excessive alcohol consumption. Am. J. Prev. Med. 49, e73–e79 (2015).

    Article  PubMed  Google Scholar 

  13. Rehm, J. et al. The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease an overview. Addiction 98, 1209–1228 (2003).

    Article  PubMed  Google Scholar 

  14. Hill, A. The environment and disease: association or causation? Proc. R. Soc. Med. 58, 295–300 (1965).

    CAS  PubMed  PubMed Central  Google Scholar 

  15. English, D. & Holman, D. The quantification of drug caused morbidity and mortality in Australia (Department of Community Services and Health, 1995).

    Google Scholar 

  16. Rehm, J. et al. The relation between different dimensions of alcohol consumption and burden of disease — an overview. Addiction 105, 817–843 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  17. National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol (NHMRC, 2009).

  18. Taylor, B. et al. The more you drink, the harder you fall: a systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend. 110, 108–116 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Rehm, J. et al. Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug Alcohol Rev. 29, 437–445 (2010).

    Article  PubMed  Google Scholar 

  20. Irving, H., Samokhvalov, A. & Rehm, J. Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis. JOP 4, 387–392 (2009).

    Google Scholar 

  21. Gutjahr, E., Gmel, G. & Rehm, J. Relation between average alcohol consumption and disease: an overview. Eur. Addict. Res. 7, 117–127 (2001).

    Article  CAS  PubMed  Google Scholar 

  22. The Royal College of Psychiatrists and The Royal College of General Practitioners. Alcohol and brain damage in adults, with reference to high risk groups (RCPsych & RCGP, 2014).

  23. Samokhvalov, A., Irving, H., Mohapatra, S. & Rehm, J. Alcohol consumption, unprovoked seizures, and epilepsy: a systematic review and meta-analysis. Epilepsia 51, 1177–1184 (2010).

    Article  PubMed  Google Scholar 

  24. Rehm, J. et al. in Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors (eds Ezzati, M. et al.) 959–1108 (World Health Organization, 2004).

    Google Scholar 

  25. Roerecke, M. & Rehm, J. Alcohol intake revisited: risks and benefits. Curr. Atheroscler. Rep. 14, 556–562 (2012).

    Article  CAS  PubMed  Google Scholar 

  26. Taylor, B. et al. Alcohol and hypertension: gender differences in dose–response relationships determined through systematic review and meta-analysis. Addiction 104, 1981–1990 (2009).

    Article  PubMed  Google Scholar 

  27. Briasoulis, A., Agarwal, V. & Messerli, F. Alcohol consumption and the risk of hypertension in men and women: a systematic review and metaanalysis. J. Clin. Hypertens. 14, 792–798 (2012).

    Article  Google Scholar 

  28. Brien, S. et al. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ 342, d636 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ronksley, P. et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342, d671 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  30. Roerecke, M. & Rehm, J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis. Addiction 7, 1246–1260 (2012).

    Article  Google Scholar 

  31. Patra, J. et al. Alcohol consumption and the risk of morbidity and mortality from different stroke types a systematic review and meta-analysis. BMC Public Health 1, 258 (2010).

    Article  Google Scholar 

  32. Roerecke, M. & Rehm, J. Irregular heavy drinking occasions and risk of ischemic heart disease: a systematic review and meta-analysis. Am. J. Epidemiol. 171, 633–644 (2010).

    Article  PubMed  Google Scholar 

  33. Mori, T. et al. Randomized controlled intervention of the effects of alcohol on blood pressure in premenopausal women. Hypertension 66, 517–523 (2015).

    Article  CAS  PubMed  Google Scholar 

  34. Holmes, M. et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 349, g4164 (2014).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Chikritzhs, T., Naimi, T., Stockwell, T. & Liang, W. Mendelian randomisation meta-analysis sheds doubt on protective associations between 'moderate' alcohol consumption and coronary heart disease. Evid. Based Med. 20, 38 (2015).

    Article  PubMed  Google Scholar 

  36. Baan, R. et al. Carcinogenicity of alcoholic beverages. Lancet Oncol. 8, 292–293 (2007).

    Article  PubMed  Google Scholar 

  37. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans: alcohol consumption and ethyl carbamate (IARC, 2010).

  38. International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans: personal habits and indoor combustions (IARC, 2012).

  39. Fillmore, K., Chikritzhs, T., Stockwell, T., Bostrom, A. & Pascal, R. Alcohol use and prostate cancer: a meta-analysis. Mol. Nutr. Food Res. 53, 240–255 (2009).

    Article  CAS  Google Scholar 

  40. Rota, M. et al. Alcohol consumption and prostate cancer risk: a meta-analysis of the dose–risk relation. Eur. J. Cancer Prev. 21, 350–359 (2012).

    Article  PubMed  Google Scholar 

  41. Baliunas, D. et al. Alcohol as a risk factor for type 2 diabetes a systematic review and meta-analysis. Diabetes Care 11, 2123–2132 (2009).

    Article  CAS  Google Scholar 

  42. Pietraszek, A., Gregersen, S. & Hermansen, K. Alcohol and type 2 diabetes. A review. Nutr. Metab. Cardiovasc. Dis. 5, 366–375 (2010).

    Article  CAS  Google Scholar 

  43. Shield, K., Parry, C. & Rehm, J. Chronic diseases and conditions related to alcohol use. Alcohol Res. Curr. Rev. 35, 155–171 (2013).

    Google Scholar 

  44. Patra, J. et al. Dose–response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age a systematic review and meta-analyses. BJOG 118, 1411–1421 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Shukla, S. & Zakhari, S. (eds) Epigenetics — new frontier for alcohol research. Alcohol Res. 35, 1–116 (2013).

    PubMed  PubMed Central  Google Scholar 

  46. Parry, C. et al. Alcohol and infectious diseases: an overlooked causal linkage? Addiction 104, 331–332 (2009).

    Article  PubMed  Google Scholar 

  47. Rehm, J. et al. The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review. BMC Public Health 9, 450 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  48. Shuper, P. et al. Causal considerations on alcohol and HIV/AIDS a systematic review. Alcohol Alcohol. 2, 159–166 (2010).

    Article  Google Scholar 

  49. Samokhvalov, A., Irving, H. & Rehm, J. Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis. Epidemiol. Infect. 138, 1789–1795 (2010).

    Article  CAS  PubMed  Google Scholar 

  50. Gell, L. et al. Alcohol's harm to others (Institute of Alcohol Studies, 2015).

    Google Scholar 

  51. Naimi, T. et al. Cardiovascular risk factors and confounders among nondrinking and moderate-drinking US adults. Am. J. Prev. Med. 28, 369–373 (2005).

    Article  PubMed  Google Scholar 

  52. Fillmore, K. et al. Moderate alcohol use and reduced mortality risk: systematic error in prospective studies. Addict. Res. Theory 14, 101–132 (2006).

    Article  Google Scholar 

  53. Kerr, W., Fillmore, K. & Bostrom, A. Stability of alcohol consumption over time: evidence from three longitudinal surveys from the United States. J. Stud. Alcohol 63, 325 (2002).

    Article  PubMed  Google Scholar 

  54. Ng Fat, L. & Shelton, N. Associations between self-reported illness and non-drinking in young adults. Addiction 107, 1612–1620 (2012).

    Article  PubMed  Google Scholar 

  55. Bergmann, M. et al. The association of pattern of lifetime alcohol use and cause of death in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Int. J. Epidemiol. 42, 1772–1790 (2013).

    Article  PubMed  Google Scholar 

  56. Chikritzhs, T. et al. Has the leaning tower of presumed health benefits from moderate alcohol use finally collapsed? Addiction 110, 726–727 (2015).

    Article  PubMed  Google Scholar 

  57. Stockwell, T. et al. How good is the science? BMJ 344, e2276 (2012).

    Article  CAS  PubMed  Google Scholar 

  58. Stockwell, T. et al. The basis for Canada's new low-risk drinking guidelines: a relative risk approach to estimating hazardous levels and patterns of alcohol use. Drug Alcohol Rev. 31, 126–134 (2012).

    Article  PubMed  Google Scholar 

  59. Room, R. & Rehm, J. Clear criteria based on absolute risk: reforming the basis of guidelines on low-risk drinking. Drug Alcohol Rev. 31, 135–140 (2012).

    Article  PubMed  Google Scholar 

  60. Naimi, T. et al. Confounding and studies of 'moderate' alcohol consumption: the case of drinking frequency and implications for low-risk drinking guidelines. Addiction 108, 1534–1543 (2013).

    Article  PubMed  Google Scholar 

  61. Department of Health. UK Chief Medical Officers' alcohol guidelines review summary of the proposed new guidelines (Department of Health, 2015).

  62. Scafato, E., Silvia, G., Lucia, G. & Claudia, G. The implementation in Europe (EU) of the low risk drinking guidelines: results from the RARHA survey. Addict. Sci. Clin. Pract. 10 (Suppl. 2), 17 (2015).

    Article  Google Scholar 

  63. Fitzgerald, N. & Angus, C. Four Nations: how evidence-based are alcohol policies and programmes across the UK? (Alliance for Useful Evidence/Alcohol Health Alliance, 2015).

    Google Scholar 

  64. Hahn, R. et al. Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review. Am. J. Prev. Med. 42, 418–427 (2012).

    Article  PubMed  Google Scholar 

  65. Room, R. (ed.) The effects of Nordic alcohol policies: what happens to drinking when alcohol controls change? (Nordic Council for Alcohol and Drug Research, 2002).

    Google Scholar 

  66. Jernigan, D. Global alcohol producers, science, and policy: the case of the International Center for Alcohol Policies. Am. J. Public Health 102, 80–89 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  67. Jernigan, D. The global alcohol industry: an overview. Addiction 104, 6–12 (2009).

    Article  PubMed  Google Scholar 

  68. Babor, T. & Robaina, K. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities. Am. J. Public Health 103, 206–214 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  69. Babor, T. et al. The influence of industry actions to increase availability of alcoholic beverages in the African Region. Addiction 110, 561–571 (2015).

    Article  PubMed  Google Scholar 

  70. Stockwell, T. Alcohol supply, demand, and harm reductions: what is the strongest cocktail? Int. J. Drug Policy 17, 269–277 (2006).

    Article  Google Scholar 

  71. Anderson, P., Chisholm, D. & Fuhr, D. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet 373, 2234–2246 (2009).

    Article  PubMed  Google Scholar 

  72. Nelson, T. et al. Efficacy and the strength of evidence of U.S. alcohol control policies. Am. J. Prev. Med. 45, 19–28 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  73. Wagenaar, A., Salois, M. & Komro, K. Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction 104, 179–190 (2009).

    Article  PubMed  Google Scholar 

  74. Holmes, J. et al. Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study. Lancet 383, 1655–1664 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  75. Gruenewald, P. et al. Alcohol prices, beverage quality, and the demand for alcohol: quality substitutions and price elasticities. Alcohol. Clin. Exp. Res. 30, 96–105 (2006).

    Article  PubMed  Google Scholar 

  76. Room, R. et al. Trends in public opinion about alcohol policy initiatives in Ontario and the US 1989–1991. Drug Alcohol Rev. 14, 35–47 (1995).

    Article  CAS  PubMed  Google Scholar 

  77. MacDonald, S., Stockwell, T. & Luo, J. The relationship between alcohol problems, perceived risks and attitudes toward alcohol policy in Canada. Drug Alcohol Rev. 30, 652–658 (2010).

    Article  PubMed  Google Scholar 

  78. Chikritzhs, T., Stockwell, T. & Pascal, R. The impact of the Northern Territory's Living with Alcohol Program, 1992–2002: revisiting the evaluation. Addiction 100, 1625–1636 (2005).

    Article  PubMed  Google Scholar 

  79. Wagenaar, A., Tobler, A. & Komro, K. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am. J. Public Health 100, 2270–2278 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  80. Center for Science in the Public Interest. Why raise alcohol taxes? http://www.cspinet.org/alcohol/taxes.html (2015).

  81. Beer Canada. Case for a reduction in the excise tax on beer. Pre-budget submission to the House of Commons Standing Committee on Finance (Beer Canada, 2014).

  82. Institute of Alcohol Studies. The impact of abolishing the alcohol duty escalator: can society afford for cheap drink to get cheaper? (Institute of Alcohol Studies, 2014).

  83. Australian Tax Office. Excise rates. https://www.ato.gov.au/business/excise-and-excise-equivalent-goods/alcohol-excise/excise-rates-for-alcohol/ (2015).

  84. Stockwell, T. et al. The price of getting high, stoned and drunk in BC: a comparison of minimum prices for alcohol and other psychoactive substances (Univ. of Victoria, 2010).

    Google Scholar 

  85. Stockwell, T. et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am. J. Public Health 103, 2014–2020 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  86. Zhao, J. et al. The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002–2009. Addiction 108, 1059–1069 (2013).

    Article  PubMed  Google Scholar 

  87. Stockwell, T. et al. Relationships between minimum alcohol pricing and crime during the partial privatization of a Canadian government alcohol monopoly. J. Stud. Alcohol Drugs 76, 628–634 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  88. Kendall, P. Public health approach to alcohol policy: an updated report from the Provincial Health Officer (Office of the Provincial Health Officer, 2008).

    Google Scholar 

  89. Giesbrecht, N. et al. Strategies to reduce alcohol-related harms and costs in canada: a comparison of provincial policies. (Centre for Addiction and Mental Health, 2013).

    Google Scholar 

  90. Stockwell, T. et al. The raising of minimum alcohol prices in Saskatchewan, Canada: impacts on consumption and implications for public health. Am. J. Public Health 102, e103–e110 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  91. Stockwell, T., Leng, J. & Sturge, J. Alcohol pricing and public health in Canada: issues and opportunities (Univ. of Victoria, 2006).

    Google Scholar 

  92. Scottish Parliament. Alcohol Act (Scotland) 2012. (Scottish Parliament, 2012).

  93. Purshouse, P. et al. Estimated effect of alcohol pricing policies on health and health economic outcomes in England: an epidemiological model. Lancet 375, 1355–1364 (2010).

    Article  PubMed  Google Scholar 

  94. Thomas, G. Price policies to reduce alcohol-related harms in Canada: current context and recommendations for targeted policies (Canadian Centre on Substance Abuse, 2012).

    Google Scholar 

  95. Gallet, C. The demand for alcohol: a meta-analysis of elasticities. Aust. J. Agric. Resour. Econ. 51, 121–135 (2007).

    Article  Google Scholar 

  96. Sornpaisarn, B., Shield, K. & Rehm, J. Alcohol taxation policy in Thailand: implications for other low- to middle-income countries. Addiction 107, 1372–1384 (2012).

    Article  PubMed  Google Scholar 

  97. Sornpaisarn, B. et al. Can pricing deter adolescents and young adults from starting to drink: an analysis of the effect of alcohol taxation on drinking initiation among Thai adolescents and young adults. J. Epidemiol. Glob. Health 5, S45–S57 (2015).

    Article  PubMed  Google Scholar 

  98. Hughes, K. et al. Environmental factors in drinking venues and alcohol-related harm: the evidence base for European intervention. Addiction 106, 37–46 (2011).

    Article  PubMed  Google Scholar 

  99. Jones, S. et al. The influence of price-related point-of-sale promotions on bottle shop purchases of young adults. Drug Alcohol Rev. 34, 170–176 (2015).

    Article  PubMed  Google Scholar 

  100. Scottish Parliament. Alcohol Act (Scotland) 2005 (Scottish Parliament, 2005).

  101. Scottish Parliament. Alcohol Act (Scotland) 2010 (Scottish Parliament, 2010).

  102. Meng, Y. et al. Model-Based Appraisal of Alcohol Minimum Pricing and Off-Licensed Trade Discount Bans in Scotland Using the Sheffield Alcohol Policy Model (V.2): Second Update Based on Newly Available Data (Univ. of Sheffield, 2012).

    Google Scholar 

  103. Nakamura, R. et al. Impact on alcohol purchasing of a ban on multi-buy promotions: a quasi-experimental evaluation comparing Scotland with England and Wales. Addiction 109, 558–567 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  104. Robinson, M. et al. Evaluating the impact of the alcohol act on off-trade alcohol sales: a natural experiment in Scotland. Addiction 109, 2035–2043 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  105. Gruenewald, P. The spatial ecology of alcohol problems: niche theory and assortative drinking. Addiction 102, 870–878 (2007).

    Article  PubMed  Google Scholar 

  106. Stockwell, T. & Chikritzhs, T. Do relaxed trading hours for bars and clubs mean more relaxed drinking? A review of international research on the impacts of changes to permitted hours of drinking. Crime Prev. Commun. Saf. 11, 153–170 (2009).

    Article  Google Scholar 

  107. Hahn, R. et al. Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms. Am. J. Prev. Med. 39, 590–604 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  108. Kypri, K., Jones, C., McElduff, P. & Barker, D. Effects of restricting pub closing times on night-time assaults in an Australian city. Addiction 106, 303–310 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  109. Kypri, K., McElduff, P. & Miller, P. Restrictions in pub closing times and lockouts in Newcastle Australia 5 years on. Drug Alcohol Rev. 33, 323–326 (2014).

    Article  PubMed  Google Scholar 

  110. Rossow, I. & Norstrom, T. The impact of small changes in bar closing hours on violence. The Norwegian experience from 18 cities. Addiction 107, 530–537 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  111. Campbell, C. et al. The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms. Am. J. Prev. Med. 37, 556–569 (2009).

    Article  PubMed  Google Scholar 

  112. Popova, S. et al. Hours and days of sale and density of alcohol outlets: impacts on alcohol consumption and damage: a systematic review. Alcohol Alcohol. 44, 500–516 (2009).

    Article  PubMed  Google Scholar 

  113. Gmel, G., Holmes, J. & Studer, J. Are alcohol outlet densities strongly associated with alcohol-related outcomes? A critical review of recent evidence. Drug Alcohol Rev. 35, 40–54 (2015).

    Article  PubMed  Google Scholar 

  114. Morrison, C. et al. Commentary on Gmel et al. (2015): are alcohol outlet densities strongly associated with alcohol-related outcomes? A critical review of recent evidence. Drug Alcohol Rev. 35, 55–57 (2016).

    Article  PubMed  Google Scholar 

  115. Callaghan, R. et al. Impacts of drinking-age laws on mortality in Canada, 1980–2009. Drug Alcohol Depend. 138, 137–145 (2014).

    Article  PubMed  Google Scholar 

  116. Grube, J. Preventing sales of alcohol to minors: results from a community trial. Addiction 92, S251–S260 (1997).

    Article  PubMed  Google Scholar 

  117. Elder, R. et al. in Transportation Research Circular: Traffic Safety and Alcohol Regulation: A Symposium 181–188, http://onlinepubs.trb.org/onlinepubs/circulars/ec123.pdf (2006).

    Google Scholar 

  118. Stewart, D. et al. Adolescent substance use and related harms in British Columbia (Univ. of Victoria, 2009).

    Google Scholar 

  119. Federal Trade Commission. Self-regulation in the alcohol industry (Federal Trade Commission, 2014).

  120. [No authors listed.] Global marketers in 2011. Advertising Age, http://adage.com/datacenter/globalmarketers2012 (2012).

  121. Hastings, G. & Sheron, N. Alcohol marketing: grooming the next generation: children are more exposed than adults and need much stronger protection. BMJ 346, f1227 (2013).

    Article  PubMed  Google Scholar 

  122. Kwate, N. & Meyer, I. Association between residential exposure to outdoor alcohol advertising and problem drinking among African American women in New York City. Am. J. Public Health 99, 228–230 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  123. Anderson, P. et al. Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol Alcohol. 44, 229–243 (2009).

    Article  PubMed  Google Scholar 

  124. Smith, L. & Foxcroft, D. The effect of alcohol advertising, marketing and portrayal on drinking behaviour in young people: systematic review of prospective cohort studies. BMC Public Health 9, 1–11 (2009).

    Article  Google Scholar 

  125. Ross, C. et al. The relationship between brand-specific alcohol advertising on television and brand-specific consumption among underage youth. Alcohol. Clin. Exp. Res. 38, 2234–2242 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  126. Hollingworth, W. et al. Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers. J. Stud. Alcohol 67, 300–308 (2006).

    Article  PubMed  Google Scholar 

  127. Chisholm, D. et al. Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J. Stud. Alcohol 65, 782–793 (2004).

    Article  PubMed  Google Scholar 

  128. Saffer, H. & Dave, D. Alcohol advertising and alcohol consumption by adolescents. Health Econ. 15, 617–637 (2006).

    Article  PubMed  Google Scholar 

  129. Jernigan, D. et al. Alcohol advertising and youth: a measured approach. J. Public Health Policy 26, 312–325 (2005).

    Article  PubMed  Google Scholar 

  130. Ross, C. et al. Exposure to magazine advertising for alcohol brands most commonly consumed by youth: evidence of directed marketing. J. Stud. Alcohol Drugs 75, 615–622 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  131. Babor, T. et al. An empirical evaluation of the US Beer Institute's self-regulation code governing the content of beer advertising. Am. J. Public Health 103, e45–e51 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  132. Vendrame, A. et al. Assessment of self-regulatory code violations in Brazilian television beer advertisements. J. Stud. Alcohol Drugs 71, 445–451 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  133. Rigaud, A. & Craplet, M. The 'Loi Evin': a French exception. Institute of Alcohol Studies, http://www.ias.org.uk/What-we-do/Publication-archive/The-Globe/Issue-2-2004-amp-1-2004/The-Loi-Evin-a-French-exception.aspx (2004).

    Google Scholar 

  134. Jernigan, D. & Ross, C. Monitoring youth exposure to advertising on television: the devil is in the details. J. Publ. Aff. 10, 36–49 (2010).

    Article  Google Scholar 

  135. Beguinot, E. France: key role of NGOs in enforcement. Tob. Control 15, 421–422 (2006).

    PubMed  Google Scholar 

  136. Wakefield, M. et al. Effects of anti-smoking advertising on youth smoking: a review. J. Health Commun. 8, 229–247 (2003).

    Article  PubMed  Google Scholar 

  137. World Health Organization. WHO Framework Convention on Tobacco Control (WHO, 2003).

  138. Giesbrecht, N. Reducing alcohol-related damage in populations: rethinking the roles of education and persuasion interventions. Addiction 102, 1345–1349 (2007).

    Article  PubMed  Google Scholar 

  139. World Health Organization. Global information system on alcohol and health, recorded alcohol per capita consumption, 1960–1979 by country. http://apps.who.int/gho/data/node.main.A1025?lang=en.

  140. World Health Organization. Global information system on alcohol and health, recorded alcohol per capita consumption, 1980–1999 by country. http://apps.who.int/gho/data/node.main.A1024?lang=en.

  141. World Health Organization. Global information system on alcohol and health, recorded alcohol per capita consumption, 2000–2015 by country. http://apps.who.int/gho/data/node.main.A1026?lang=en.

Download references

Acknowledgements

The National Drug Research Institute is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund.

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed equally to all aspects of this manuscript.

Corresponding author

Correspondence to Ian Gilmore.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gilmore, W., Chikritzhs, T., Stockwell, T. et al. Alcohol: taking a population perspective. Nat Rev Gastroenterol Hepatol 13, 426–434 (2016). https://doi.org/10.1038/nrgastro.2016.70

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrgastro.2016.70

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing