Alcohol Consumption in Various Regions of the World

Both overall volume of alcohol consumption and patterns of drinking have considerable measurement error but remain the best indicators against which alcohol-related health burden is calculated. Adult per capita consumption should include, in many countries, an estimate of unre­corded consumption (even though that estimate will have limitations).

In addition, systematic collection of data at country level is needed for trend analysis, but given the low priority given to alcohol (despite its importance as a risk factor for disease burden), and the limited resources in middle- and low-income countries, it remains a challenge to promote alcohol policies in the absence of reliable data.

Alcohol consumption has decreased or stabilized in developed countries overall, although averages are still considered high, with a pattern of use that is not as detri­mental as seen in other countries. Several European countries, aware of their high per capita consumption of alcohol, have enacted the best examples of alcohol control policies over the years based on high prices and taxation, low allowance for duty-free imports, and limits on the hours of sale of alcohol.

These have led to measurable decreases in consumption and related harm. More recently, as a result of policy changes, new increases in alcohol consumption and related harm have been reported, such as in Sweden, Finland, Canada, and the UK, among others. Given that in many countries, unrecorded alcohol consumption is signifi­cant but difficult to estimate, these trends can be seen as an underestimation of the real situation, for example, upward trends are informally reported in Latin America.

In contrast, other regions of the world have shown less concern about the drinking habits of their residents. These regions risk further escalation of the problem. European markets are considered saturated, as the levels of consumption have stabilized (although the pattern of drinking might change, e.g., more binge drinking). As a result, alcohol marketing strategies have focused on new markets, including Asia and Latin America.

The Americas. Whereas the United States and Canada have population characteristics similar to Western Europe, in the other regions of the Americas countries are at different stages of development, some with relatively higher child and adult mortality rates, and an age structure different from that in developed countries. Latin America and the Caribbean have large proportions of young people, the age group that drinks the most (Levy, 1999).

The problem is compounded because alcohol policies are absent or nearly so in these countries, thus creating a fertile ground for the growth of alcohol-related problems. Informal and/ or illicit production and smuggling are known to be wide­spread in several countries in the Americas e.g., Brazil, Mexico, Nicaragua, and Bolivia, with little or no govern­ment control over them.

It is useful to look at the situation in the Americas as an example of international trends. Despite great subregional variations in per capita alcohol consumption, the popula­tion-weighted average value in the Americas is about 9 liters per person, well above the global average of 5.8 liters of per capita consumption (Rehm and Monteiro, 2005). In addition, irregular, heavy drinking occasions are very common, leading to a drinking pattern that is harm­ful to health.

This translates into acute health problems, such as intentional and nonintentional injuries, including homicides, traffic crashes, violence, drowning, and sui­cides. At the same time, a significant proportion of the population with alcohol use disorders, particularly depen­dence, develop chronic health problems resulting in many years of life lost to disabilities and accounting for over 50% of all alcohol-related disease burden. It is estimated that there are over 30 million people that meet diagnostic criteria for alcohol use disorders in Latin America and the Caribbean, and over 75% did not receive any care (Kohn et al, 2005).

Most of the alcohol-related disease burden in the Americas (77.4%) occurs in the population aged 15-44, indicating that the most active and productive life years are being lost by a preventable factor, that is, alcohol consumption (Rehm and Monteiro, 2005).

Socioeconomic development tends to be associated with higher levels of alcohol consumption, as people with more disposable income will spend more on alcoholic beverages (as they become more accessible and available). Concomitantly, for those living in poverty, expenditures on alcohol con­sumption can ruin family finances and their chances to attain better education, shelter, nutrition, health, and access to other goods and services (Room et al., 2002).

Conclusion. The absence of effective national policies renders unten­able the current situation. The public is largely unin­formed about how alcohol consumption is related to harms, and what works to reduce public health problems from such consumption. They often believe their personal freedoms are at stake when alcohol controls are proposed.

International and national trends can be critical informa­tion for advocacy groups, policy makers, and the public in the promotion of effective strategies. There is a need to continue to improve the knowledge base about alcohol consumption and patterns of drinking, using standardized indicators and collecting systematic information by age and gender, and both developed and developing countries.

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