Newswise — The amount of death and disability caused by alcohol globally is similar to that caused by tobacco and high blood pressure, concludes a review in this week's issue of The Lancet.

Overall, four percent of the global burden of disease is attributable to alcohol, 4·1% to tobacco and 4·4% to high blood pressure. Alcohol is causally related to more than 60 different medical conditions, including breast cancer and coronary heart disease. In most cases alcohol has a detrimental effect on health.

The comprehensive review on alcohol and public health is particularly timely as from February 7, 2005 new legislation in the UK will permit pubs, bars, off-licences and nightclubs to remain open 24 hours later this year.

In the review, Robin Room (Stockholm University, Sweden) Thomas Babor (University of Connecticut, USA) and Jurgen Rehm (Centre for Addiction and Mental Health, Canada) assess policy research and options for alcohol control. Studies have shown that raising the price and reducing the availability of alcoholic beverages can lower consumption. Using price elasticity estimates and analysis of UK alcohol related mortality data the authors estimate that a 10% rise in British alcohol prices would produce a drop in cirrhosis mortality of 7% in men and 8·3% in women and a fall of 28·8% in men and 37·4% in women in deaths from explicitly alcoholinvolved causes (alcohol dependence, poisoning etc.) Besides price, drinking and alcoholrelated problems can be affected by restricting the hours and days of alcohol purchasing and of the numbers and types of outlets. Despite this evidence the authors highlight the fact that research findings on effective alcohol control measures fail to impact on policy decisions.

Professor Room comments: "A stark discrepancy exists between research findings about the effectiveness of alcohol control measures and the policy options considered by most governments. In many places, the interests of the alcohol industry have effectively exercised a veto over policies, making sure that the main emphasis is on ineffective strategies such as education."

He concludes: "There has been a growing contrast between the treatment of alcohol in trade agreements and disputes as an ordinary commodity and the more restrictive treatment of such other commodities as tobacco and pharmaceuticals, which also entail a public health risks. In a globalising world of common markets and trade agreements, alcohol policy is thus no longer only a national or subnational matter. To reverse the trend, a new international agreement on alcohol control, along the lines of the Framework Convention on Tobacco Control is needed."

Please remember to cite The Lancet.

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