The Voice of Epidemiology


    Web EpiMonitor

► Home ► About ► News ► Job Bank Events ► Resources ► Contact
eport Examines Public Health Burden of Alcohol in UK
and Effectiveness of Policy Interventions

Alcohol is now the leading risk factor for ill-health, early mortality and disability for those aged 15-49 in England, according to a new report published by Public Health England (PHE) last month. The British Department of Health commissioned the report, asking PHE to provide a comprehensive, evidence-based assessment of the public health burden of alcohol as well as the effectiveness and cost-effectiveness of a variety of policies aimed at reducing alcohol-related harm. The report was published both online at the PHE website and in an abridged form in The Lancet.

Public Health Burden

Worldwide, the use of alcohol causes a significant health, social and economic cost to society, ranking among the five top risk factors for disease, disability and injury. Speaking specifically regarding England, Professor Kevin Fenton, the National Director of Health and Wellbeing at PHE, said in a press release, “The harm alcohol causes is much wider than just on the individual drinker. Excessive alcohol consumption can harm children, wreck families, impact on workplace colleagues, and can be a burden and drain on the NHS and economy.” While acknowledging that much of the public health burden of alcohol can be indirect and hard to quantify, the authors quote the following  statistics pertaining to England in the review:

Currently over 10 million people are drinking at levels that increase their health risks
Alcohol-related causes lead to over 1 million hospitalizations annually in England
The average age at death of those dying from an alcohol-specific cause is 54.3 years.  The average age of death from all causes is 77.6 years.
As a result of this age-related effect, more working years of life are lost in England as a result of alcohol-related deaths than from cancer of the lung, bronchus, trachea, colon, rectum, brain, pancreas, skin, ovary, kidney, stomach, bladder and prostate, combined
The economic burden of alcohol is substantial, with estimates placing the annual cost to be between 1.3% and 2.7% of annual GDP
Estimates of the direct costs to the NHS in the UK stood at £3 billion for conditions attributable to alcohol consumption in 2005/06, equivalent to 3.2% of the total healthcare costs
Lower socioeconomic groups often report lower levels of average consumption, yet show greater susceptibility to the harmful effects of alcohol an dare more likely to die or suffer from a disease relating to their alcohol use

Policy interventions

For most alcohol-related diseases and injuries, increasing quantities of alcohol consumed lead to increased risk. This dose-response relationship exists for all alcohol-related cancers, for example, and highlights the great potential for policy interventions that decrease alcohol consumption to positively impact public health in both the short and long-term. Alcohol control policies are generally aimed at one of three factors believed to strongly influence alcohol consumption - affordability, availability and the social norms around its consumption. The PHE review systematically assesses the latest evidence on the effectiveness of a number of these policies.

Regulating Affordability

The affordability of alcohol in the UK has steadily increased, with alcohol currently 60% more affordable today than in 1980. There is broad consensus among research findings and public health organizations that policies aimed at increasing the price of alcohol, typically achieved through increased taxation, are the most effective, cost-effective methods for prevention and health improvement. For instance, a 2010 meta-analysis showed that doubling tax rates would decrease alcohol-related mortality by an average of 34.7%, with traffic-crash deaths decreasing by 11.2%, sexually transmitted infections by 5.5%, and violence and crime episodes by 2.2% and 1.4% respectively.

Regulating availability

Although controlling the availability of alcohol is considered a key approach to reducing harm, implementing these methods effectively has proved challenging, often  yielding mixed results. Policies that limit either the hours, days or locations in which it can be sold can be effective, particularly with late night sales. In addition, these policies have the potential to address inequalities if they are targeted to locations with higher levels of alcohol-related health problems or incidents.

Regulating Social Norms Around Consumption

There are a wide range of interventions targeted at social norms around the acceptability of alcohol consumption, including policies aimed at regulating marketing of alcohol, regulating drinking and driving and education and informational campaigns. According to the authors of the report, the most effective of these involve regulating the marketing of alcohol and reducing drinking and driving. Evidence consistently shows a relationship between exposure to alcohol advertising and subsequent alcohol consumption in children and young people. While the report concludes that self-regulation of marketing by the alcohol industry is not effective, complete or partial advertising bans are a highly-effective and cost-effective approach.

Evidence also suggests that strongly enforced legal policies aimed at preventing drinking and driving are also effective and cost-effective at reducing alcohol-related harm. The report cites a number of examples demonstrating that setting or lowering legal limits for blood alcohol levels while driving reduces the number of alcohol-related traffic accidents. For instance, lowering the legal limit from 100 mg per 100 ml to 80 mg (the current English legal limit) in 19 US states from 1982-2000 reduced the number of alcohol-related fatal traffic  traffic accidents by 15%.

Interestingly, the authors conclude that there is little evidence that education and information programs lead to substantial long-term improvements in alcohol-related harm. However, they note that these programs can increase public support for the implementation of more effective policies.

For more information, the full report can be viewed here:

The abridged version published in the Lancet can be seen here:


Reader Comments:
Have a thought or comment on this story ?  Fill out the information below and we'll post it on this page once it's been reviewed by our editors.

  Name:        Phone:   



      ©  2011 The Epidemiology Monitor

Privacy  Terms of Use  Sitemap

Digital Smart Tools, LLC