Tobacco Smoking and Alcohol Consumption are Biggest Threat to Human Welfare, New Review Says

A new review, published this month in the Addiction, the official journal of the Society for the Study of Addiction, shows that in 2015 alcohol and tobacco use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing a further tens of millions.

According to Peacock et al, in 2015, the estimated prevalence among the adult population was 18.3% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8%, 0.77%, 0.37%, and 0.35% for past-year cannabis, amphetamine, opioid, and cocaine use, respectively. Image credit: Michael Stern / CC BY-SA 2.0.

The review aimed to provide an up-to-date source of information on alcohol, tobacco, and illicit drug use and their associated mortality and burden of disease.

It was prepared by Professor Louisa Degenhardt of the University of New South Wales in Sydney and her colleagues from Australia, the United States and Europe.

The authors used data obtained from the World Health Organization, United Nations Office on Drugs and Crime, and Institute for Health Metrics and Evaluation.

“Nearly one in seven adults (15.2%) smoke tobacco and one in five adults report at least one occasion of heavy alcohol use in the past month,” they said.

“Compared with the rest of the world, Central, Eastern, and Western Europe recorded consistently higher alcohol consumption per capita (11.61, 11.98 and 11.09 liters, respectively) and a higher percentage of heavy consumption amongst drinkers (50.5%, 48.2%, and 40.2%, respectively),”

“The same European regions also recorded the highest prevalence of tobacco smoking (Eastern Europe 24.2%, Central Europe 23.7%, and Western Europe 20.9%).”

“In contrast, use of illicit drugs was far less common.”

Fewer than one in 20 people were estimated to use cannabis in the past year, and much lower estimates were observed for amphetamines, opioids and cocaine.

“Hotspots included the United States, Canada, and Australasia (Australia and New Zealand),” Professor Degenhardt and co-authors said.

“The United States and Canada had one of the highest rates of cannabis, opioid, and cocaine dependence (748.7, 650.0, and 301.2 per 100,000 people, respectively).”

“Australasia had the highest prevalence of amphetamine dependence (491.5 per 100,000 people), as well as high rates of cannabis, opioid and cocaine use dependence (693.7, 509.9, and 160.5 per 100,000 people, respectively).”

“Some countries and regions (e.g., Africa, Caribbean and Latin America, Asia regions) have little or no data on substance use and associated health burden. These are typically low or middle income countries that frequently have punitive drug policies, and may experience serious political and social unrest,” the researchers noted.

“These countries need enhanced monitoring because they are at risk of rapid escalation in substance use and related health burden,” they said.

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Amy Peacock et al. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction, published online May 10, 2018; doi: 10.1111/add.14234