Conclusion

137

2010). There are no big donors with a strong interest in supporting work to reduce the harmful use of alcohol worldwide or in high-burden countries. The successes in some jurisdictions in reducing the harmful use of alcohol were achieved, as a rule, with internal resources using the most cost-effective interventions promoted by WHO (Chapter 5).

Positive changes in alcohol policies -- and subsequently in levels and patterns of alcohol consumption and associated mortality and morbidity -- in countries where drinking is heavily embedded in cultural norms and traditions indicate that progressive alcohol policy developments are feasible in spite of all challenges; indeed, they can bring public health benefits and returns on investments within relatively short periods of time (WHO, 2018b).

Alcohol consumption is the leading risk factor worldwide for people aged 15–49 years (GBD 2016 Alcohol Collaborators, 2018) – the segment of the population which plays a significant role in the economic and social development of every nation. Increasing awareness of the impact of harmful use of alcohol on child development and maternal health as well as on infectious diseases such as tuberculosis and HIV (Chapter 1) may change the situation with regard to funding support for alcohol policy and programme developments, but this still has to happen.

The lack of resources to finance prevention and treatment programmes and interventions for substance use disorders calls for innovative funding mechanisms to address related SDG targets. Several innovative approaches that combine evidence-based knowledge with more “out of the box” ideas have been reported across countries and at the international level. Recently the WHO Independent High-Level Commission on NCDs recommended exploring the possibility of establishing a Global Solidarity Tobacco and Alcohol Contribution as a voluntary innovative financing mechanism to be used for the prevention and treatment of NCDs (WHO, 2018c). There are existing examples of revenues from taxes on alcoholic beverages being used to fund health promotion initiatives, health coverage of vulnerable populations and/or prevention and treatment of alcohol and substance use disorders (Thow et al., 2010; Kaiser, Bredenkamp & Iglesias, 2016; McIntyre, 2015; Adulyanon et al., 2012;

Okulicz-Kozaryn et al., 2016), as well as, in some cases, supporting international work in these areas. Other ideas for innovative funding mechanisms are directly linked to the notion that governments have the overall responsibility to implement preventive strategies and interventions and to provide access to treatment for affected persons for conditions that directly stem from the consumption of substances or services which are legally traded or operated, such as alcohol or gambling services. There are examples where earmarked funding for the prevention and treatment of substance use disorders and related conditions is provided with funds generated from state-owned retail monopolies, from a profit levy across alcohol beverage value chains, from taxing alcohol advertising, from imposing earmarked fines for noncompliance with alcohol regulations, or from taxation and excise duties on casinos and other forms of gambling (Llopis, 2017).

COUNTRY PROFILES

WHO regions

AFR

AMR

EMR

EUR

SEAR

WPR

5 10 15 20

© World Health Organization, 2018

141 Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 0.4 0.6

Unrecorded 0.3 0.4

Total** 0.7 0.9

Total males / females 1.2 0.1 1.6 0.2

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

57%

BEER

25%

WINE

18%

SPIRITS

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 34.5

Females (15+) 12.4

Both sexes (15+) 29.1

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 90.1 97.0 93.5

Former drinkers* (15+) 5.1 1.5 3.3

Abstainers (15+), past 12 months 95.2 98.5 96.8

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 1.1 23.5 0.6 26.7

Females 0.1 6.2 0.1 7.2

Both sexes 0.6 19.3 0.3 22.1

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan Yes (1975/2015) / Yes

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density Yes, No / Yes, Yes

Specific events / intoxicated persons / petrol stations Yes / Yes / Yes

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.02 / 0.02 / 0.02 Legally binding regulations on alcohol advertising / product

placement (any) Yes / Yes

Legally binding regulations on alcohol sponsorship / sales

promotion (any) Yes / Yes

Legally required health warning labels on alcohol

advertisements / containers (any) No / No

National government support for community action (any) No

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 1.5 1.4

Females 0.0 0.0

Both sexes 0.8 0.7

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 19.0 11.7 22.7 7.0 615 Road traffic injuries, males / females 47.7 12.7 3.1 2.0 278

Cancer, males / females 100.7 97.3 1.1 0.2 159

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 2 3 4 5 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other All

5 10 15 20

© World Health Organization, 2018

142

Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 7.5 5.0

Unrecorded 1.6 1.4

Total** 9.0 6.4

Total males / females 14.7 3.6 10.7 2.3

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

70%

BEER

18%

WINE

11%

SPIRITS

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 17.3

Females (15+) 6.6

Both sexes (15+) 13.4

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 20.6 46.7 33.9

Former drinkers* (15+) 17.8 19.0 18.4

Abstainers (15+), past 12 months 38.4 65.7 52.3

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 55.5 90.1 42.1 91.6

Females 23.0 66.8 14.8 70.0

Both sexes 39.0 81.6 28.4 84.8

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan Yes (2012/—) / Yes

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density No, No / No, No

Specific events / intoxicated persons / petrol stations No / No / No

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.06 / 0.06 / 0.06 Legally binding regulations on alcohol advertising / product

placement (any) No / No

Legally binding regulations on alcohol sponsorship / sales

promotion (any) No / No

Legally required health warning labels on alcohol

advertisements / containers (any) Yes / No

National government support for community action (any) Yes

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 10.6 3.6

Females 1.7 0.7

Both sexes 6.0 2.1

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 63.4 26.6 60.9 40.0 2224 Road traffic injuries, males / females 44.2 13.9 48.7 42.0 3139

Cancer, males / females 112.5 90.9 8.1 2.4 428

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 3 4 ^{> MOST}

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other All

1%

OTHER

5 10 15 20

© World Health Organization, 2018

143 Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 1.3 1.6

Unrecorded 1.0 1.5

Total** 2.4 3.0

Total males / females 4.1 0.7 5.3 0.8

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

64%

BEER

10%

WINE

13%

SPIRITS

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 14.3

Females (15+) 5.3

Both sexes (15+) 11.6

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 59.3 79.5 69.5

Former drinkers* (15+) 3.7 5.1 4.4

Abstainers (15+), past 12 months 63.0 84.6 73.9

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 17.2 46.5 10.9 49.3

Females 2.4 15.8 1.4 17.3

Both sexes 9.7 37.3 6.2 40.6

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan Yes (2008/2013) / Yes

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) No / No / No National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) No / No / No Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density No, No / No, No

Specific events / intoxicated persons / petrol stations No / No / No

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.05 / 0.05 / 0.05 Legally binding regulations on alcohol advertising / product

placement (any) No / No

Legally binding regulations on alcohol sponsorship / sales

promotion (any) No / No

Legally required health warning labels on alcohol

advertisements / containers (any) No / No

National government support for community action (any) Yes

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 10.8 3.7

Females 2.1 0.8

Both sexes 6.4 2.2

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 57.4 41.0 42.9 22.3 743 Road traffic injuries, males / females 58.2 29.1 19.8 13.8 567

Cancer, males / females 94.2 94.5 3.3 1.1 79

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 3 5 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other All

13%

OTHER

5 10 15 20

© World Health Organization, 2018

144

Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 5.6 6.2

Unrecorded 3.0 2.2

Total** 8.6 8.4

Total males / females 14.7 2.5 14.4 2.4

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

48%

BEER

24%

OTHER

4%

SPIRITS

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 32.7

Females (15+) 12.0

Both sexes (15+) 26.2

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 38.0 67.8 53.0

Former drinkers* (15+) 18.0 12.1 15.0

Abstainers (15+), past 12 months 56.0 80.0 68.0

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 31.1 70.8 20.5 74.1

Females 7.0 34.8 4.1 38.0

Both sexes 19.0 59.4 12.4 64.1

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan Yes (2011/—) / No

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density Yes, Yes / Yes, No

Specific events / intoxicated persons / petrol stations Yes / Yes / Yes

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.05 / 0.05 / 0.05 Legally binding regulations on alcohol advertising / product

placement (any) Yes / Yes

Legally binding regulations on alcohol sponsorship / sales

promotion (any) Yes / No

Legally required health warning labels on alcohol

advertisements / containers (any) No / No

National government support for community action (any) Yes

National monitoring system(s) (any) Yes

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 12.4 4.2

Females 1.9 0.7

Both sexes 7.1 2.5

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 23.2 10.1 67.8 41.5 90 Road traffic injuries, males / females 37.0 21.0 34.0 22.6 137

Cancer, males / females 138.5 87.7 10.6 2.1 72

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 3 5 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other All

24%

WINE

5 10 15 20

© World Health Organization, 2018

145 Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 4.6 4.9

Unrecorded 2.5 3.3

Total** 7.1 8.2

Total males / females 12.2 2.3 14.2 2.4

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

18%

BEER

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 27.7

Females (15+) 10.5

Both sexes (15+) 22.2

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 47.2 69.3 58.5

Former drinkers* (15+) 1.7 7.5 4.7

Abstainers (15+), past 12 months 48.8 76.8 63.1

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 29.4 57.5 21.1 59.9

Females 5.2 22.5 3.2 24.3

Both sexes 17.1 46.3 12.3 50.4

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan No / —

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) No / No / No National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 13 / 13 / 13 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density No, No / Yes, No

Specific events / intoxicated persons / petrol stations No / No / No

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.05 / 0.05 / 0.05 Legally binding regulations on alcohol advertising / product

placement (any) Yes / Yes

Legally binding regulations on alcohol sponsorship / sales

promotion (any) No / No

Legally required health warning labels on alcohol

advertisements / containers (any) No / No

National government support for community action (any) Yes

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 3.4 1.4

Females 0.3 0.0

Both sexes 1.8 0.7

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 43.8 38.5 66.9 42.3 1322 Road traffic injuries, males / females 75.9 36.4 30.9 22.2 1660

Cancer, males / females 121.8 125.3 7.4 2.4 324

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 3 4 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other

All

74%

OTHER

5%

SPIRITS

3%

WINE

5 10 15 20

© World Health Organization, 2018

146

Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 4.1 4.1

Unrecorded 3.0 3.4

Total** 7.1 7.5

Total males / females 12.3 2.2 13.0 2.2

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

39%

BEER

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 29.7

Females (15+) 11.1

Both sexes (15+) 23.7

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 37.8 67.4 52.9

Former drinkers* (15+) 18.6 12.6 15.5

Abstainers (15+), past 12 months 56.3 80.0 68.4

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 28.0 64.2 18.9 67.3

Females 5.7 28.6 3.3 30.6

Both sexes 16.6 52.6 11.0 56.8

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan No / —

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density Yes, No / Yes, No

Specific events / intoxicated persons / petrol stations No / No / No

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % No / No / No Legally binding regulations on alcohol advertising / product

placement (any) No / No

Legally binding regulations on alcohol sponsorship / sales

promotion (any) No / No

Legally required health warning labels on alcohol

advertisements / containers (any) Yes / Yes

National government support for community action (any) Yes

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 11.6 3.9

Females 2.3 0.9

Both sexes 6.8 2.4

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 50.6 31.8 66.7 40.3 898 Road traffic injuries, males / females 79.1 24.2 31.4 24.8 1 092

Cancer, males / females 189.1 195.9 8.6 1.9 322

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 3 4 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other

All

61%

OTHER

<1%

WINE

<1%

SPIRITS

5 10 15 20

© World Health Organization, 2018

147 Alcohol per capita (15+) consumption (in litres of pure alcohol)

2010* 2016*

Recorded 4.7 4.1

Unrecorded 2.9 1.6

Total** 7.6 5.7

Total males / females 13.1 2.5 10.0 1.7

WHO African Region 6.3 6.3

* Three-year averages of recorded and unrecorded for 2009–2011 and 2015–2017; **adjusted for tourist consumption.

ALCOHOL CONSUMPTION: LEVELS AND PATTERNS

55%

BEER

45%

WINE

Recorded alcohol per capita (15+) consumption (in litres of pure alcohol) by type of alcoholic beverage, 2016 or latest year available

Recorded alcohol per capita (15+) consumption, 1961–2016

Total alcohol per capita (15+) consumption, drinkers only (in litres of pure alcohol), 2016

Litres

Males (15+) 21.3

Females (15+) 7.9

Both sexes (15+) 17.0

Abstainers (%), 2016

Males Females Both sexes

Lifetime abstainers (15+) 48.5 72.8 60.9

Former drinkers* (15+) 4.6 5.8 5.2

Abstainers (15+), past 12 months 53.1 78.6 66.2

* Persons who used to drink alcoholic beverages but have not done so in the past 12 months.

Prevalence of heavy episodic drinking* (%), 2016 Population

(15+ years) Drinkers only

(15+ years) Population

(15–19 years) Drinkers only (15–19 years)

Males 24.7 52.7 16.6 56.1

Females 4.1 19.2 2.6 21.5

Both sexes 14.2 41.9 9.6 46.3

* Consumed at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days.

Written national policy (adopted/revised) / National

action plan Yes (2016/—) / Yes

Excise tax on beer / wine / spirits Yes / Yes / Yes

National legal minimum age for off-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 National legal minimum age for on-premise sales of

alcoholic beverages (beer / wine / spirits) 18 / 18 / 18 Restrictions for on-/off-premise sales of alcoholic beverages (any):

Hours, days / places, density No, No / Yes, No

Specific events / intoxicated persons / petrol stations No / No / No

POLICIES AND INTERVENTIONS

National maximum legal blood alcohol concentration (BAC)

when driving a vehicle (general / young / professional), in % 0.08 / 0.08 / 0.08 Legally binding regulations on alcohol advertising / product

placement (any) Yes / Yes

Legally binding regulations on alcohol sponsorship / sales

promotion (any) No / No

Legally required health warning labels on alcohol

advertisements / containers (any) No / No

National government support for community action (any) Yes

National monitoring system(s) (any) No

Prevalence of alcohol use disorders and alcohol dependence (%), 2016*

Alcohol use disorders** Alcohol dependence

Males 10.7 3.7

Females 2.0 0.8

Both sexes 6.3 2.2

WHO African Region 3.7 1.3

* 12-month prevalence estimates (15+); **including alcohol dependence and harmful use of alcohol.

HEALTH CONSEQUENCES: MORTALITY AND MORBIDITY

Age-standardized death rates (ASDR) and alcohol-attributable fractions (AAF), 2016

ASDR* AAF (%) AAD**

(Number) Liver cirrhosis, males / females 39.0 21.2 61.5 33.1 39 Road traffic injuries, males / females 48.0 22.2 24.0 14.3 23

Cancer, males / females 115.8 105.8 7.4 2.5 15

*Per 100 000 population (15+); **alcohol-attributable deaths, both sexes.

Years of life lost (YLL) score*, 2016 ^LEAST < 1 2 4 5 > ^MOST

* Based on alcohol-attributable years of life lost.

1960 1965 1975

Litres of pure alcohol

1990 Year

1970 1980 2000

0

1995

1985 2005 2010 2015

Beer Wine Spirits Other All

In document Global Status Report on Alcohol and Health 2018 (Sider 159-200)