Association Internationale de la Mutualité

Factsheet n°3 – Alcohol Facts and Figures - Alcohol consumption contributes to 3 million deaths each year globally. - More than 10.3 million disability-adjusted life-years (DALYs) were attributable to alcohol use in 2016, either because of premature death or due to living with a disability.1 - Harmful use of alcohol is responsible for 5.1% of the global burden of disease. - Alcohol is the n°1 risk factor for premature mortality and disability among those aged 15 to 49 years. - In the 20-24 age group, every fourth death was caused by alcohol.2 - Disadvantaged and especially vulnerable populations have higher rates of alcohol-related death and hospitalization.

…and especially vulnerable populations have higher rates of alcohol-related death and hospitalization. - Even moderate consumption of alcohol increases the long-term risks of certain heart conditions, liver diseases and cancers.3 - Other public health problems are closely linked to alcohol consumption like injuries and domestic violence.4 AIM Recommendations - Reduce availability of alcohol at the point of sale. Easy access to alcoholic beverages should be prevented, especially for vulnerable groups like minors. Reducing the availability of alcohol is the first WHO “best buy” in the fight against non-communicable diseases.

Reducing the availability of alcohol is the first WHO “best buy” in the fight against non-communicable diseases. This could be achieved through different policies: reducing the permitted hours and days for alcohol sales, setting separate points of sales for alcohol, to which minors would not have access, reducing the number of establishments allowed to sell alcohol by introducing licence requirements, enforcing a minimum age for purchase and consumption, bans of drinking in public, etc.5 1 Figure from 2016, WHO, Status report on alcohol consumption, harm and policy responses in 30 European countries, 2019, xi. 2 Idem. 3 In 2016, alcohol-attributable deaths were largely due to cancer (29% of alcohol-attributable deaths), liver cirrhosis (20%), cardiovascular disease (19%) and injury (18%).

…to cancer (29% of alcohol-attributable deaths), liver cirrhosis (20%), cardiovascular disease (19%) and injury (18%). (See WHO, Status report on alcohol consumption, harm and policy responses in 30 European countries, 2019, xi. 4 WHO figures 5 WHO, Fact sheet on alcohol consumption, alcohol-attributable harm and alcohol policy responses in European Union Member States, Norway and Switzerland, 2019, p.2. Ref. Ares(2022)4793021 - 30/06/2022 - Increase the price of alcoholic beverages. AIM calls on the European Commission, the European Parliament, and the Council to keep the objective of price increases in all EU regulations, including the foreseen update on the rules on structures of excise duty.

…of price increases in all EU regulations, including the foreseen update on the rules on structures of excise duty. Increasing the price of alcohol is one of the most cost-effective alcohol policies available.6 Pricing policies have also been identified by WHO as second “best buy” in the fight against non-communicable diseases. Regulating prices through increased taxation or the establishment of Minimum Unit Pricing has proved to reduce overall consumption and associated harm.7 Price control also has the potential to help reduce inequities and protect vulnerable populations, especially young people. It can influence preferences and discourage binge-drinking. As WHO underlines in its latest report, pricing policies are effective both in reducing harm and in delaying the age at which adolescents and young adults start drinking.

…are effective both in reducing harm and in delaying the age at which adolescents and young adults start drinking. The report encourages specific taxation (on basis of alcohol content) as a more powerful instrument. Other types of taxation (unitary or ad valorem) could encourage manufacturers to produce stronger products, which could result in increased consumption.8 Specific taxation is also likely to have the biggest effect on the reduction of health inequalities.9 Alcohol duties are also listed as an effective measure in that report.

…effect on the reduction of health inequalities.9 Alcohol duties are also listed as an effective measure in that report. AIM agrees with WHO in asking Member States to levy duties on all forms of alcoholic beverages, including wine.10 “[By] requiring non-alcoholic beverages to be sold at a lower price, banning below-cost selling and volume discounts, and implementing an additional levy on specific alcoholic products (…)”, Minimum Unit Pricing (MUP) has the potential to reduce alcohol consumption among harmful drinkers and thus decrease alcohol-related mortality and hospitalisations.

…to reduce alcohol consumption among harmful drinkers and thus decrease alcohol-related mortality and hospitalisations. Indeed, it only increases the prices of the cheapest products, which are those most consumed by heavier drinkers.11 In countries like Australia, the introduction of the MUP has led to a decrease in alcohol-related assault offences, alcohol-related ambulance attendances, alcohol-related emergency department presentations and Alcohol-related road traffic crashes (to cite but a few).12 MUP therefore has the potential to improve public health by reducing alcohol-related harm while reducing the burden of that harm on healthcare systems. - Protect children and adolescents from exposure to alcohol marketing both on- and off-line. AIM calls on the EC to make a legally binding proposal of marketing regulation so as to efficiently protect children.

AIM calls on the EC to make a legally binding proposal of marketing regulation so as to efficiently protect children. Legally binding measures are needed to minimise the exposure of children and youth to alcohol marketing, regardless of whether the advertising is directly aimed at them or not. As WHO underlines, there is growing evidence of the link between exposure to alcohol marketing and harmful alcohol use among young people. Regulation of marketing is recognized by the WHO as the third and last “best buy” in the fight against non-communicable diseases. It is vital to understand that children can be exposed even though they are not directly targeted. Therefore, prohibiting 6 WHO, Status report on alcohol consumption, harm and policy responses in 30 European countries, 2019, p.41 7 Idem, p. 34 8 WHO, Alcohol Pricing in the European Union, 2020, p. 3. 9 Idem, p. 21 10 Idem, p. 22.

…2019, p.41 7 Idem, p. 34 8 WHO, Alcohol Pricing in the European Union, 2020, p. 3. 9 Idem, p. 21 10 Idem, p. 22. 11 Idem, p. 4 12 Miller, Peter, Investigating the introduction of the alcohol minimum unit price in the Northern Territory, 2020 sponsorship of sports events and marketing through printed and broadcasted media are key measures, which have already been adopted by some Member States. New and more targeted marketing techniques on digital media further put young people at risk of exposure. Indeed, as underlined by WHO, “(…) digital marketing may be more powerful and less controllable than traditional alcohol marketing.” 13 Self-regulation and voluntary commitments to date have failed to solve important health challenges. There is therefore a clear need for legally binding regulation for online marketing to children and young adults.

There is therefore a clear need for legally binding regulation for online marketing to children and young adults. The European Commission has a clear role to play when it comes to that regulation as online marketing crosses borders. - Use new communication tools to raise awareness on the risks related to alcohol consumption, focussing on vulnerable groups. AIM calls on the European Commission to study new communication technologies and social media use to identify the most effective ones so as to provide guidance to Member States on efficient communication for public health, also key in the fight against misinformation. Increasing health literacy of the population is key in empowering citizens to make healthier choices.

…misinformation. Increasing health literacy of the population is key in empowering citizens to make healthier choices. Information on the risks related to harmful alcohol use should be provided to the general population, while paying specific attention to vulnerable groups such as pregnant women or youth. For those actions to be effective, they should involve many actors, from healthcare professionals, media, NGOs, healthcare payers and local communities to decision-makers, and be properly adapted to the target audience. Campaigns and actions to raise awareness should be monitored and evaluated so as to enable their adaptation and improve their efficacy. - Ensure proper screening, early detection and referral when necessary. Primary healthcare plays a crucial role in health promotion and disease prevention.

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