Jurgen Rehm

IntroductionSeveral prevalence-based cost-of-illness (COI) studies have been conducted to estimate the economic burden of alcohol consumption borne by a particular society in a given year. Yet there are few studies examining the economic costs incurred by an individual drinker over his/her lifetime. Thus, this study aims to estimate the costs incurred by an individual drinker’s alcohol consumption over his or her lifetime in Thailand.Methods and analysisAn incidence-based COI approach will be employed. To project individuals’ associated costs over a lifetime, a Markov modelling technique will be used. The following six alcohol-related diseases/conditions will be considered in the model: hypertension, haemorrhagic stroke, liver cirrhosis, liver cancer, alcohol use disorders and road injury. The analysis will cover both direct (ie, direct healthcare cost, costs of property damage due to road traffic accidents) and …

ObjectivesTo analyze whether higher alcohol consumption is associated with negative attitudes towards stricter alcohol control policy measures in Estonia.Study designCross-sectional analysis of nationally representative data from 2022 (n = 2059).MethodsAttitudes towards seven alcohol control measures and their association with high-risk alcohol consumption (>140 g absolute alcohol for men and >70 g for women per week) were analyzed using used descriptive statistics and binary logistic regression using nationally representative data on Estonian 15–74-year-old population.ResultsIn general, high-risk consumption associated with lower acceptance for alcohol control policies. Although men had higher prevalence of opposing alcohol control measure for every item considered, both men and women with high-risk alcohol consumption were significantly more likely to be against alcohol control measures in …

ContexteAu Canada, on note que les équipes soignantes et les personnes qui bénéficieraient de soins ciblés connaissent peu les interventions fondées sur des données probantes pour la prise en charge clinique du trouble d’utilisation de l’alcool. Pour combler cette lacune, l’Initiative canadienne de recherche sur l’abus de substances a créé un comité national dans le but d’élaborer une ligne directrice pour la prise en charge clinique de la consommation d’alcool à risque élevé et du trouble lié à la consommation d’alcool.MéthodesL’élaboration de cette ligne directrice s’est faite selon le processus ADAPTE, et est inspirée par une ligne directrice britanno-colombienne de 2019 pour le trouble lié à la consommation d’alcool. Un comité national de rédaction de la ligne directrice (composé de 36 membres de divers horizons, notamment des universitaires, des médecins, des personnes ayant ou ayant eu des expériences de consommation d’alcool et des personnes s’identifiant comme Autochtones ou Métis) a choisi les thèmes prioritaires, a passé en revue les données probantes et atteint un consensus relatif aux recommandations. Nous avons utilisé l’outil AGREE II (Appraisal of Guidelines for Research and Evaluation Instrument II) et les principes de divulgation des intérêts et de gestion des conflits lors du processus de rédaction des lignes directrices (Principles for Disclosure of Interests and Management of Conflicts in Guidelines) publiés en anglais par le Réseau international des lignes directrices (Guidelines International Network) pour nous assurer que la ligne directrice répondait aux normes internationales de transparence, de qualité …

BackgroundAlcohol consumption is the most important risk factor responsible for the disease burden of liver cirrhosis (LC). Estimates of risk relationships available usually neither distinguish between different causes such as alcohol-related LC or hepatitis-related LC, nor differentiate between morbidity and mortality as outcome. We aimed to address this research gap and identify dose–response relationships between alcohol consumption and LC, by cause and outcome.MethodsA systematic review using PubMed/Medline and Embase was conducted, identifying studies that reported an association between level of alcohol use and LC. Meta-regression models were used to estimate the dose–response relationships and control for heterogeneity.ResultsTotally, 44 studies, and 1 secondary data source, with a total of 5,122,534 participants and 15,150 cases were included. Non-linear dose–response relationships …

Economic development has been identified as an important influencing contributor to life expectancies: wealthier countries have lower mortality rates and different causes of death. Economic development also impacts alcohol consumption, as upper-middle and high-income countries, on average, have higher levels of consumption and less abstention. This often leads to a paradoxical situation whereby for low-and middle income countries increases in alcohol consumption are associated with decreases in alcohol-attributable mortality rates. These increases in consumption may diminish the benefits of economic development. Alcohol control policies can reduce the health and social burdens of increased alcohol use that result from economic development. Two case examples of Thailand and Vietnam which are presented. From 2010 to 2019 Thailand experienced a 3.7% increase in APC, a 9.8% decrease in all-cause mortality per 100,000 people, and a 1.4% decrease in alcohol-attributable mortality per 100,000 people. From 2010 to 2019 Vietnam experienced a 26.8% increase in APC, a 6.7% decrease in all-cause mortality per 100,000 people, and a 3.7% increase in alcohol-attributable mortality per 100,000 people. Due to a failure to implement strong alcohol control policies Vietnam has experienced an increase in alcohol-attributable mortality despite decreases in all-cause mortality. Accordingly, the implementation of alcohol control policies, can diminish the increases in alcohol use for low-and middle-income countries that accompany economic development.

Background and aims Quantifying the health burden of alcohol has largely focused upon harm to drinkers, which is an underestimate. There is a growing literature on alcohol‘s harm to others (HTO), but it lacks the systematic transfer of HTO into a comparative risk assessment framework. This study calculated disability‐adjusted life years (DALYs) for fetal alcohol spectrum disorder (FASD), interpersonal violence and traffic injury due to another‘s drinking. Design This study is a disease burden analysis, using modelling of DALYs for New Zealand in 2018. Setting and participants The study took place among the Aotearoa/New Zealand population in 2018. Measurements The involvement of others’ drinking was obtained from prevalence, alcohol‐attributable fraction studies and administrative data. Disability weights (DW) for FASD were adapted from fetal alcohol syndrome (FAS) weights using a Beta–Pert …

BackgroundWhile alcohol use is an established risk factor for interpersonal violence, the extent to which people are affected by interpersonal violence from others' drinking has not yet been quantified for different world regions. This modelling study aims to provide the first estimates of the national and regional prevalence of interpersonal violence from others' drinking.MethodsAn international systematic literature search (02/28/2023, Prospero: CRD42022337364) was conducted to identify general adult population studies assessing the prevalence of interpersonal violence from others' drinking with no restrictions to publication date or language. Reports that did not provide data on interpersonal violence from others' drinking (primary outcome), were no original research studies, or captured a selected group of people only, were excluded. Observed prevalence data were extracted and used to build fractional response …

We appreciate the critical comment made by our colleague Dr Sally Casswell [1]. As pointed out in her critique, the impact of marketing restrictions may not be comparable to the effects of pricing policies and availability restrictions. Casswell acknowledges that ‘ensuring a real change as a result of policy intervention’is difficult to establish for marketing restrictions, summarizing a key finding of our systematic review [2]. We agree that marketing plays a crucial role for the alcohol industry, we endorse any measures that effectively reduce the exposure of the population to marketing and we advocate for more nuanced approaches to evaluate the effectiveness of marketing bans.Although we agree with most of the points raised by Dr Casswell, we disagree with the argument put forward regarding partial marketing bans. As partial marketing bans may not necessarily result in a reduction of marketing exposure in the …