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Aims: To estimate the association between per capita alcohol consumption and fatal accidents in the United States and to compare the outcome with findings from Europe and Canada., Data and Method: Yearly data on fatal accidents by gender and age were analysed in relation to per capita alcohol consumption for 1950-2002 using the Box-Jenkins technique for time series analysis., Findings: A 1-L increase in per capita consumption was on average followed by 4.4 male deaths per 100,000 inhabitants, but had no significant effect on female accident mortality. Regarding specific categories of accidents, the effect on fatal motor vehicle accidents accounted for a large part of the overall effect for men and was also significant for women. With respect to fatal falling accidents and other accidents, the only significant effects were found among young males. As concerns women, the association with per capita consumption in the US was weak in comparison with Canada and Europe. The US effect estimate for overall male accidents was however equally strong as in Northern Europe (5.2) or Canada (5.9), and stronger than that found in Central and Southern Europe (2.1 and 1.6, respectively). With respect to alcohol and fatal motor vehicle accidents, the association for men of 3.2 was stronger than in Europe and more similar to the Canadian finding (3.6)., Conclusions: Per capita alcohol consumption has at least partly been an explanation for the development of male fatal accidents and particularly motor vehicle accident rates in the post-war United States. High traffic density and relatively high legal limits for drunken driving blood alcohol concentration (BAC) are suggested to explain the strong association found between alcohol and fatal motor vehicle accidents. The results also suggest that a reduction in per capita consumption would have its most preventive impact on fatal accidents among younger males.

Objective: To describe trends in overall alcohol consumption and alcohol-related mortality in Canada, and to test regional associations between per capita alcohol consumption and alcohol-related mortality., Method: Alcohol sales for 1950-2000 were used to measure total alcohol consumption; alcohol-related mortality consisted of nine different alcohol-related causes of death for 1950-1998. Alcohol consumption and alcohol-related mortality were described for 1950-2000, and measures of dispersion were calculated to assess the homogeneity across regions., Findings: Both alcohol consumption and alcohol-related mortality increased in all regions up to 1975-80 and then underwent a decline until the 1990s. Since 1996, consumption began to increase. Beer represented more than half of the total consumption throughout the study period, although overall, the share of wine increased, particularly in the larger provinces. Over time there have been fewer differences in per capita consumption and alcohol-related mortality rates across the regions. A strong positive cross-regional relationship was observed between explicitly alcohol-related mortality and per capita consumption, whereas cirrhosis showed only a weak geographical association with consumption., Conclusions: Since 1950, there has been a general trend toward national homogenization, especially with respect to drinking levels but also to alcohol-related mortality. A strikingly close regional relationship between alcohol consumption and alcohol-related mortality suggests that consumption is an important marker of alcohol-related harm in Canada.