Toward evidence-based public policy for alcohol

Europeans are the world's heaviest drinkers. Per capita consumption is equivalent to each EU citizen aged 15 years or older drinking around 12 litres of pure alcohol per year, or just under three standard drinks per day in most European countries.

The figures have been collected by the EU-funded AMPHORA ('Alcohol Public Health Research Alliance') project, which has been working to provide policy-makers with a more complete and science-based understanding of the economic, social and cultural factors that influence such heavy drinking - and reduce the resulting health and social harm.

About 138 000 people aged 15 to 64 years die prematurely from alcohol every year, mostly from liver cirrhosis, alcohol-related injuries and cancer, according to estimates by the project's researchers.

They have also been examining the effects of alcohol-related public health measures, targeting areas that have not been fully examined before. Their research included analysis of the influence of drinking venues, pricing, marketing, treatment availability, surrogate alcohols, monitoring systems, legislation and national and EU policies.

They found that countries with more strict and comprehensive alcohol policies generally have lower levels of consumption. Policies regulating prices and availability are particularly effective in reducing the harm done by alcohol. Such regulations have tended to become stricter throughout the EU, particularly among eastern European members, the project found.

They also found that the involvement of alcohol producers in policy-making tends to be associated with weaker alcohol policies. The involvement of academia tends to be associated with stronger policies, says Professor Peter Anderson, the project's international coordinator.

Professor Anderson specialises in research on substance use, policy and practice, and is based at the Institute of Health and Society, Newcastle University, England.

He says: 'The problems with alcohol promotion are reminiscent of those seen before tobacco advertising was banned, when attempts to control content resulted in more cryptic and imaginative campaigns. This is where we see alcohol advertising going and we want to see a complete ban as well as the introduction of warning labels on alcohol to highlight the risk of cancer. We also want to see solutions implemented to close the treatment gap. It is important that we use our research to act on decreasing alcohol-related problems in Europe.'

The researchers also found a huge gap between the need for and the actual availability of treatment for alcohol dependency - who could actually benefit from a doctor, and who subsequently received treatment, he says.

One particular area of focus was the influence on young people of online alcohol marketing and alcohol-branded sports sponsorship. Project researchers found that the greater the exposure 13- to 16-year-olds have to online alcohol marketing and alcohol-branded sports sponsorship, the greater the likelihood that they will consume alcohol 14 to 15 months later.

Nearly one-third of students studied reported using a social media site which featured alcohol advertisements, and two-thirds reported noticing alcohol advertisements on an internet page.

They concluded that 13- to 16-year-olds would not feel deprived of information should the advertising of alcohol be banned, says Professor Anderson.

The AMPHORA project also found that EU drinkers consume more than 600 times the exposure level set by the European Food Safety Authority for genotoxic carcinogens.

Ethanol, the type of alcohol found in alcoholic beverages, is classified as a carcinogen by the International Agency for Research on Cancer. Many studies have found that alcohol increases the risk of cancers of the oral cavity and pharynx, oesophagus, stomach, colon, rectum and breast, Professor Anderson adds.

The AMPHORA project also worked to provide scientific support for alcohol policy development through the European Alcohol Policy Research Alliance, which consists of 33 partners from research centres and public administration institutions from 14 countries.

The project was managed by Dr Antoni Gual of the Foundation for Biomedical Research in Barcelona with funding of EUR 4 million, of which some EUR 3 million came from the EU.

The project involved a consortium of 22 partner institutions from 12 EU countries and affiliated organisations.