European Status report on Alcohol and Health Dr Lars Moller Regional Advisor a.i. WHO Regional Office for Europe
Main killers in the WHO European Region Source: Preventing chronic diseases. A vital investment. Geneva, World Health Organization, 2005 (http://www.who.int/chp/chronic_disease_report/en/).
Deaths in EURO due to selected risk factors in 2004 Unsafe sex Urban outdoor air polution Low fruit/vegetables Alcohol use High blood glucose High cholesterol Physical inactivity Overweigh/obesity Tobacco use High blood pressure 0 1000 2000 3000 thousands
Disability adjusted life years lost due to risk factors in EURO in 2004 (total) Suboptimal breastfeeding Illicit drug use Low fruit/vegetables High blood glucose Physical inactivity High cholesterol Overweight/obesity High blood pressure Alcohol use Tobacco use 0 5000 10000 15000 20000 thousands
Disability adjusted life years lost due to risk factors in EURO in 2004 High Income European Countries Low Income European Countries Total European Countries 1 Tobacco use Alcohol use Tobacco 2 Blood pressure Blood pressure Alcohol use 3 Alcohol use Tobacco High blood pressure 4 Overweight/obesity Overweight/obesity Overweight/obesity 5 High blood glucose High cholesterol High cholesterol 6 Physical inactivity Physical inactivity Physical inactivity 7 High cholesterol High blood glucose High blood glucose 8 Illicit drug use Illicit drug use Low fruit/vegetables 9 Low fruit/vegetable Suboptimal breastfeed. Illicit drug use 10 Unsafe sex Unsafe sex Unsafe sex Source: Global Health Risks, WHO 2009
Deaths age 15-29 in EURO due to selected risk factors in 2004 Unsafe water/sanitation Unsafe health care inj. Child sexual abuse High blood glucose Low fruit/vegetables Physical inactivity Unsafe sex Illicit drug use Occupational risks Alcohol use Unmet contracep. needs Child sexual abuse Low fruit/vegetables Iron deficiency Occupational risks Physical inactivity High blood glucose Illicit drug use Unsafe sex Alcohol use 0 20000 40000 60000 0 20000 40000 60000 Men Women
Alcohol consumption (2004) Two main dimensions affect health: Average of volume Patterns of drinking especially binge drinking Estimated 618.000 deaths attributable to alcohol a year in Europe (2004). Estimated 17 mio years lost due to disability and death (DALY) a year in Europe (2004). In Europe, 6.5% of deaths and 11.4% of DALY s were attributed to alcohol use. Globally 3.8% of deaths and 4.6% of DALY s were attributed to alcohol use.
European Alcohol Information System (EAIS) the history Was established in 2002 Measure alcohol consumption, health determinants and alcohol policies throughout the region Provide countries with information to make comparisons and support the development of a national health policy on alcohol Follow and evaluate the Second European Alcohol Action Plan Follow and evaluate the progress of the declaration from the Ministerial Conference in Stockholm, 2001
Problems with EAIS Difficulties to have reliable data on consumption Not possible to collect information for trend analysis Not covering all aspects mentioned in the Framework for Alcohol Policies adopted in 2005 Use different programmes for data presentation Data not always consistent with data from other sources like Global Alcohol Database Data not comparable with alcohol data from other regions Different stakeholders use different surveys and put extra work load on Member States
The EC/WHO project Project started January 2008 and lasted for 27 months. One of the objectives is to update the European Alcohol Information System and ensure its compatibility with the Commission database on alcohol
How to develop a new alcohol database Questionnaire developed 2008 Translated into Russian, Spanish, French Sent to Member States (February-April) (WHO Counterparts and EC Committee members) Data reviewed when received clarification emails to almost all Data entered into SPSS database Data ready for use late 2009
Average alcohol consumption in Europe Average alcohol consumption in Europe - twice the world average 10 9 8 Litres of pure alcohol 7 1998 1997 1996 1995 1994 1993 1992 1991 1990 2006 2005 2004 2003 2002 2001 2000 1999
Total alcohol consumption in 14 12 Europe (litres of pure alcohol) 10 8 6 4 2 0 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 Eur-A Eur-B Eur-C
Total adult alcohol consumption in 48 WHO European Member States, 2005 18 16 14 12 10 8 6 Litres of pure alcohol 4 2 0 Estonia Czech Republic Ireland France Andorra Austria Hungary Lithuania Croatia Portugal Luxembourg Germany United Kingdom Armenia Denmark Belarus Slovakia Russian Federation Bulgaria Netherlands Romania Slovenia Latvia Switzerland Serbia Spain Finland Belgium Bosnia and Herzegovina Poland Cyprus EUR average Greece Ukraine Italy Azerbaijan Iceland Sweden Norway Kazakhstan TFYR Macedonia Malta Albania Georgia Kyrgyzstan Turkmenistan Uzbekistan Turkey Tajikistan
90 80 70 60 50 40 30 20 10 0 Abstainers (15+) during the last Abstainers (15+) during the last 12 months (2005 men) Turkey Bosnia a.. Kazakhstan Kyrgyzstan Portugal Spain Ukraine Andorra Croatia Georgia Estonia Slovakia Romania Ireland Netherlands Poland Armenia Greece Latvia Iceland Hungary Bulgaria Sweden Austria Switzerland Belgium Belarus Czech R... UK Lithuania Italy Finland Norway Slovenia France Germany Denmark
100 90 80 70 60 50 40 30 20 0 10 Abstainers (15+) during the last Abstainers (15+) during the last 12 months (2005 - women) Turkey Bosnia a.. Georgia Kyrgyzstan Portugal Spain Armenia Andorra Kazakhstan Croatia Ukraine Romania Greece Bulgaria Netherlands Poland Latvia Estonia Ireland Belarus Lithuania Switzerland Italy Czech R... Slovakia Sweden Hungary Slovenia Iceland UK Austria Belgium Finland Norway France Denmark Germany
Alcohol consumption (recorded + unrecorded) (men 15+, average 2002-2005), 2005), drinkers only 70 60 50 40 30 20 10 0 France Finland Germany Denmark Greece Switzerland Belgium Italy Sweden Netherlands Georgia Kyrgyzstan Norway Iceland Ireland Poland Latvia Spain Armenia Slovenia Bulgaria Austria United Kingdom Bosnia and Herzegovina Ukraine Estonia Portugal Croatia Romania Turkey Kazakhstan Hungary Slovakia Belarus Andorra Lithuania Czech Republic
Alcohol consumption (recorded + unrecorded) (women 15+, average 2002-2005), 2005), drinkers only 35 30 25 20 15 10 5 0 Poland Austria Georgia Bulgaria France Finland Switzerland Denmark Italy Slovakia Sweden Germany Belgium Kyrgyzstan Norway Iceland Czech Republic Netherlands Ireland Estonia Armenia Slovenia Belarus Lithuania Hungary Greece Latvia United Kingdom Bosnia and Herzegovina Andorra Turkey Portugal Croatia Ukraine Spain Romania Kazakhstan
Mortality due to liver cirrhosis in Europe, men (35 countries) 70 Standardized mortality rate 60 50 40 30 20 10 Eur-A (n=19) Eur-B (n=7) Eur-C (n=9) 0 2005 2004 2003 2002 2001 2000
Mortality due to liver cirrhosis in Europe, women (35 countries) Standardized mortality rate 45 40 35 30 25 20 15 10 5 0 2005 2004 2003 2002 2001 2000 Eur-A (n=19) Eur-B (n=7) Eur-C (n=9)
Alcohol and non-alcohol related mortality due to road traffic accidents among men, 2000-2005. 2005. Standardized mortality rate 40 35 30 25 20 15 10 5 0 2005 2004 2003 2002 2001 2000 Eur-A (n=20) Eur-B (n=7) Eur-C (n=10)
Alcohol and non-alcohol related mortality due to road traffic accidents among women, 2000-2005. 2005. 12 Standardized mortality rate 10 8 6 4 2 Eur-A (n=20) Eur-B (n=7) Eur-C (n=10) 0 2005 2004 2003 2002 2001 2000
Alcohol and non-alcohol related mortality due to road traffic accidents among men, 2000-2005. 2005. 60 50 40 30 20 SMR per 100.000 10 0 Russian Federation Kazakhstan Lithuania Ukraine Latvia Greece Kyrgyzstan Poland Republic of Moldova Croatia Slovakia Slovenia Romania Uzbekistan Spain France Austria Serbia Czech Republic Hungary Ireland Germany United Kingdom Israel Norway Estonia Finland Sweden Netherlands Switzerland
Alcohol and non-alcohol related mortality due to road traffic accidents among women, 2000-2005. 2005. 16 14 12 10 8 6 SMR per 100.000 4 2 0 Kazakhstan Russian Federation Lithuania Latvia Ukraine Kyrgyzstan Greece Hungary Slovenia Romania Republic of Mol... Poland Croatia Slovakia Estonia Austria Spain France Uzbekistan Ireland Czech Republic Serbia Norway Germany Finland Israel Sweden United Kingdom Netherlands Switzerland
Mortality due to poisoning among men, 2000-2005. 2005. 60 Standardized mortality rate 50 40 30 20 10 0 Eur-A (n=20) Eur-B (n=7) Eur-C (n=10) 2005 2004 2003 2002 2001 2000
Mortality due to poisoning among women, 2000-2005. 2005. 14 Standardized mortality rate 12 10 8 6 4 2 0 Eur-A (n=20) Eur-B (n=7) Eur-C (n=10) 2005 2004 2003 2002 2001 2000
Percentage of countries with a written national alcohol policy.
Trends in the price of beer compared with the consumer price index over past five years.
Trends in the price of wine compared with the consumer price index over past five years.
Trends in the price of spirits compared with the consumer price index over past five years.
National maximum legal blood alcohol concentration level for the general population.
Minimum age limits for off-premise purchase of beer
Minimum age limits for off-premise purchase of wine
Minimum age limits for on-premise purchase of spitirs
European Status report on Alcohol Foreword Acknowledgements The geographical scope of the report Summary 1. Alcohol and Health in a European perspective The impact of alcohol on individual health The impact of alcohol on societal health Effective alcohol policies Response of the health sector Overview of effectiveness and cost effectiveness 2. Alcohol consumption in Europe 3. Alcohol related harm Liver cirrhosis Alcohol related liver diseases Non-specific indicators and Health 4. Alcohol policies and responses Presence of written national alcohol policy Price and tax Awareness raising Drink driving Advertising Warning labels Availability Monitoring and evaluation 5. Conclusion The current status, trends and differences in alcohol and health in the European Region WHO instruments 6. Country profiles
Thank you Dr Lars Moller MOLLERL@WHO.INT WWW.EURO.WHO.INT