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Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

GBD 2016 modelling across 195 locations: alcohol ranked seventh for age-standardised deaths and DALYs globally; authors estimated the consumption level minimising aggregated health loss was zero (95% UI 0.0–0.8) standard drinks per week.

Methods (high level)

  • Integrated 694 consumption sources and 592 risk–outcome studies into comparative risk assessment models for 23 alcohol-linked outcomes
  • Standard drink defined as 10 g ethanol

Global burden signals (2016; abstract)

  • Alcohol as risk factor ranked 7th for both age-standardised deaths and DALYs
  • In 15–49 y, alcohol was the leading risk factor for combined mortality in aggregate global models (3.8% of female deaths, 12.2% of male deaths attributed in the analysis)

Nonlinear risk framing

Authors report rising all-cause mortality and cancer risk with increasing average consumption and estimate the overall loss-minimising drinking level at zero (95% UI 0.0–0.8) drinks/week—read uncertainty intervals and modelling assumptions before translating to individual counselling.

Evidence hygiene

This is population modelling, not an abstinence RCT; pair with ASCEND, SPRINT, and behaviour-change trials when reasoning about individual risk.

Publication

GBD 2016 Alcohol Collaborators. Lancet. 2018 Sep 22;392(10152):1015-1035. PMID 30146330.

Outcomes

  • GBD 2016: estimated overall risk-minimising alcohol consumption level 0.0 (95% UI 0.0–0.8) standard drinks per week across modelled health outcomes.
  • Among ages 15–49 globally in 2016, alcohol use attributed to 3.8% (95% UI 3.2–4.3) of female deaths and 12.2% (10.8–13.6) of male deaths in GBD comparative risk models.
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