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Background: Alcohol use is a leading risk factor for global disease burden, and data on alcohol exposure are crucial to evaluate progress in achieving global non-communicable disease goals. We present estimates on the main indicators of alcohol exposure for 189 countries from 1990-2017, with forecasts up to 2030., Methods: Adult alcohol per-capita consumption (the consumption in L of pure alcohol per adult [≥15 years]) in a given year was based on country-validated data up to 2016. Forecasts up to 2030 were obtained from multivariate log-normal mixture Poisson distribution models. Using survey data from 149 countries, prevalence of lifetime abstinence and current drinking was obtained from Dirichlet regressions. The prevalence of heavy episodic drinking (30-day prevalence of at least one occasion of 60 g of pure alcohol intake among current drinkers) was estimated with fractional response regressions using survey data from 118 countries., Findings: Between 1990 and 2017, global adult per-capita consumption increased from 5·9 L (95% CI 5·8-6·1) to 6·5 L (6·0-6·9), and is forecasted to reach 7·6 L (6·5-10·2) by 2030. Globally, the prevalence of lifetime abstinence decreased from 46% (42-49) in 1990 to 43% (40-46) in 2017, albeit this was not a significant reduction, while the prevalence of current drinking increased from 45% (41-48) in 1990 to 47% (44-50) in 2017. We forecast both trends to continue, with abstinence decreasing to 40% (37-44) by 2030 (annualised 0·2% decrease) and the proportion of current drinkers increasing to 50% (46-53) by 2030 (annualised 0·2% increase). In 2017, 20% (17-24) of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5% [15·3-21·6%], and this prevalence is expected to increase to 23% (19-27) in 2030., Interpretation: Based on these data, global goals for reducing the harmful use of alcohol are unlikely to be achieved, and known effective and cost-effective policy measures should be implemented to reduce alcohol exposure., Funding: Centre for Addiction and Mental Health and the WHO Collaborating Center for Addiction and Mental Health at the Centre for Addiction and Mental Health., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background and Aims: Alcohol use is among the most important risk factors for burden of disease globally. An estimated quarter of the total alcohol consumed globally is unrecorded. However, due partly to the challenges associated with its assessment, evidence concerning the magnitude of unrecorded alcohol use is sparse. This study estimated country-specific proportions of unrecorded alcohol used in 2015., Design: A statistical model was developed for data prediction using data on the country-specific proportion of unrecorded alcohol use from nominal group expert assessments and secondary, nationally representative survey data and country-level covariates., Setting: Estimates were calculated for the country level, for four income groups and globally., Participants: A total of 129 participants from 49 countries were included in the nominal group expert assessments. The survey data comprised 66 538 participants from 16 countries., Measurements: Experts completed a standardized questionnaire assessing the country-specific proportion of unrecorded alcohol. In the national surveys, the number of standard drinks of total and unrecorded alcohol use was assessed for the past 7 days., Findings: Based on predictions for 167 countries, a population-weighted average of 27.9% [95% confidence interval (CI) = 10.4-44.9%] of the total alcohol consumed in 2015 was unrecorded. The proportion of unrecorded alcohol was lower in high (9.4%, 95% CI = 2.4-16.4%) and upper middle-income countries (18.3%, 95% CI = 9.0-27.6%) and higher in low (43.1%, 95% CI = 26.5-59.7%) and lower middle-income countries (54.4%, 95% CI = 38.1-70.8%). This corresponded to 0.9 (high-income), 1.2 (upper middle-income), 3.2 (lower middle-income) and 1.8 (low-income) litres of unrecorded alcohol per capita., Conclusions: A new method for modelling the country-level proportion of unrecorded alcohol use globally showed strong variation among geographical regions and income groups. Lower-income countries were associated with a higher proportion of unrecorded alcohol than higher-income countries., (© 2018 Society for the Study of Addiction.)

Background: The global impact of alcohol consumption on deaths due to cardiomyopathy (CM) has not been quantified to date, even though CM contains a subcategory for alcoholic CM with an effect of heavy drinking over time as the postulated underlying causal mechanism. In this feasibility study, a model to estimate the alcohol-attributable fraction (AAF) of CM deaths based on alcohol exposure measures is proposed., Methods: A two-step model was developed based on aggregate-level data from 95 countries, including the most populous (data from 2013 or last available year). First, the crude mortality rate of alcoholic CM per 1,000,000 adults was predicted using a negative binomial regression based on prevalence of alcohol use disorders (AUD) and adult alcohol per capita consumption (APC) (n = 52 countries). Second, the proportion of alcoholic CM among all CM deaths (i.e., AAF) was predicted using a fractional response probit regression with alcoholic CM crude mortality rate (from Step 1), AUD prevalence, APC per drinker, and Global Burden of Disease region as predictions. Additional models repeated these steps by sex and for the wider Global Burden of Disease study definition of CM., Results: There were strong correlations (>0.9) between the crude mortality rate of alcoholic CM and the AAFs, supporting the modeling strategy. In the first step, the population-weighted mean crude mortality rate was estimated at 8.4 alcoholic CM deaths per 1,000,000 (95% CI: 7.4-9.3). In the second step, the global AAFs were estimated at 6.9% (95% CI: 5.4-8.4%). Sex-specific figures suggested a lower AAF among females (2.9%, 95% CI: 2.3-3.4%) as compared to males (8.9%, 95% CI: 7.0-10.7%). Larger deviations between observed and predicted AAFs were found in Eastern Europe and Central Asia., Conclusions: The model proposed promises to fill the gap to include AAFs for CM into comparative risk assessments in the future. These predictions likely will be underestimates because of the stigma involved in all fully alcohol-attributable conditions and subsequent problems in coding of alcoholic CM deaths.

Aims: This study aimed to estimate the prevalence of life-time abstainers, former drinkers and current drinkers, adult per-capita consumption of alcohol and pattern of drinking scores, by country and Global Burden of Disease region for 2005, and to forecast these indicators for 2010., Design: Statistical modelling based on survey data and routine statistics., Setting and Participants: A total of 241 countries and territories., Measurements: Per-capita consumption data were obtained with the help of the World Health Organization's Global Information System on Alcohol and Health. Drinking status data were obtained from Gender, Alcohol and Culture: An International Study, the STEPwise approach to Surveillance study, the World Health Survey/Multi-Country Study and other surveys. Consumption and drinking status data were triangulated to estimate alcohol consumption across multiple categories., Findings: In 2005 adult per-capita annual consumption of alcohol was 6.1 litres, with 1.7 litres stemming from unrecorded consumption; 17.1 litres of alcohol were consumed per drinker, 45.8% of all adults were life-time abstainers, 13.6% were former drinkers and 40.6% were current drinkers. Life-time abstention was most prevalent in North Africa/Middle East and South Asia. Eastern Europe and Southern sub-Saharan Africa had the most detrimental pattern of drinking scores, while drinkers in Europe (Eastern and Central) and sub-Saharan Africa (Southern and West) consumed the most alcohol., Conclusions: Just over 40% of the world's adult population consumes alcohol and the average consumption per drinker is 17.1 litres per year. However, the prevalence of abstention, level of alcohol consumption and patterns of drinking vary widely across regions of the world., (© 2013 The Authors, Addiction © 2013 Society for the Study of Addiction.)

Background: Alcohol consumption is associated with elevated risks of disease and injury, and the best indicator of the level of consumption in a country is total alcohol per capita (APC) consumption among adults which comprises recorded consumption and unrecorded consumption. While recorded consumption can be assessed with small measurement bias via taxation or other governmental records, unrecorded consumption is more difficult to assess. The objectives of this study were to estimate the country-specific proportion and volume of unrecorded APC in 2015, to identify main sources of unrecorded alcohol and to assess to what extent experts perceive unrecorded alcohol as a public health, social, and financial problem.Methods: Estimates of unrecorded APC were based on a multilevel fractional response regression model using data from World Health Organization's (WHO) STEPwise approach to surveillance surveys (16 countries, 66 188 participants), estimates from the routine WHO reporting on key indicators of alcohol use (189 countries), and a nominal group expert assessment (42 countries, 129 experts). Expert assessments also included data on the sources of unrecorded alcohol and the perception of unrecorded alcohol as a public health, social, and financial problem.Results: The volume of global unrecorded APC was 1.6 L pure alcohol, representing 25% of the total APC. The volume of unrecorded APC was highest in Europe (2.1 L per capita), while the proportion of unrecorded APC was highest in the WHO Eastern Mediterranean region (57% of the total alcohol). In countries with available data, homemade alcohol was identified as a major source of unrecorded alcohol. The majority of experts considered unrecorded alcohol to be a public health (62%), social (60%), and financial problem (54%).Conclusions: High volumes of unrecorded alcohol are consumed globally; however, the volumes consumed and the sources of the unrecorded alcohol exhibit large geographical variation. [ABSTRACT FROM AUTHOR]

Since its inception in 1997, the Global Alcohol Database (GAD) has undergone several iterations and brings together information on a number of topics across countries: alcohol and health situations; consequences of alcohol consumption; trends in alcohol use and related mortality; alcohol production; trade; health effects; and national alcohol control measures and policies. Efforts have been made to make this database compatible with the World Health Organization (WHO) International Guide for Monitoring Alcohol Consumption and Related Harm. A set of indicators was chosen that assesses the most important aspects of the alcohol situation in WHO Member States as they relate to public health. The indicators are grouped into seven broad categories: alcohol production and availability; levels of consumption; patterns of consumption; harms and consequences; economic aspects; alcohol control policies; and prevention, treatment and drinking guidelines. Contents of the GAD are available on the WHO's Global Information on Alcohol and Health Website. [ABSTRACT FROM AUTHOR]

The article examines World Health Organization's (WHO) Global Monitoring System on Alcohol and Health (GISAH). It provides a background of GISAH which was developed to gather, compile, examine, and disseminate information related to alcohol and health as alcoholism is a growing threat to public health. It explores the underlying procedures and processes of GISAH as well as alcohol per capita consumption, and the data validation method.