The AMPHORA Project

   10 Main findings from AMPHORA

1.1. EU adults drink 27g alcohol (nearly three drinks) a day, more than twice the world's average.

On average, European Union adults aged 15+ years drink 27g alcohol per day, more than twice the world's average. One in eight of this consumption is from unrecorded alcohol, which, with the exception of ethanol, is not normally a health risk. One in eight citizens consume 60g or more of alcohol at a time at least several times a week (1, 2).

References:

  1. Shield KD, Kehoe T, Gmel G, Rehm MX & Rehm J. Societal burden of alcohol. In: Anderson P, Møller L, Galea G, editors. Alcohol in the European Union Consumption, harm and policy approaches. Copenhagen: WHO Regional Office for Europe; 2012. [Download]
  2. Rehm J, Shield KD, Rehm MX, Gmel G & Frick U. Alcohol consumption, alcohol dependence and attributable burden of disease in Europe: Potential gains from effective interventions for alcohol dependence. Canada: Centre for Addiction and Mental Health; 2012. [Download]
2. About 138,000 EU citizens, aged 15-64 years, die prematurely from alcohol in any one year.

The best estimate is that about 138,000 people, aged 15-64 years, die prematurely from alcohol in any one year, with two-fifths of deaths due to liver cirrhosis, one third due to injuries, and one in five due to cancer (1). 

References:

  1. Rehm J., Gmel G., Rehm M.X., Scafato E., Shield K.D. What alcohol can do to European societies. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
3. EU drinkers consume more than 600 times the exposure level set by the European Food Safety Authority for genotoxic carcinogens, of which ethanol is one.

Ethanol is a carcinogen, a teratogen and toxic to many body organs. Using the European Food Safety Authority guidance on risky exposure for human consumption of toxic substances in food and drink products, European drinkers consume more than 600 times the exposure level for genotoxic carcinogens, which is set at 50 milligrams alcohol per day; and more than 100 times the exposure level for non-carcinogenic toxins, which is set at 0.3 grams alcohol per day (1, 2). [The average consumption of the 89% of EU citizens who drink alcohol is just over 30g/day].

References:

  1. Lachenmeier DW & Rehm J. Unrecorded alcohol - no worries besides ethanol: a population-based probabilistic risk assessment. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
  2. EFSA (European Food Safety Authority). Opinion of the Scientific Committee on a request from EFSA related to a harmonised approach for risk assessment of substances which are both genotoxic and carcinogenic (Request No EFSA-Q-2004-020). Adopted on 18 October 2005. [Download]
  3. Lachenmeier, D. W., Przybylski, M. C. and Rehm, J. Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approach. Int. J. Cancer. 2012 Apr; 131: E995–E1003. [Download]
4. Countries with stricter and more comprehensive alcohol policies generally have lower levels of alcohol consumption, and policies are tending to get stricter in recent years.

Countries with stricter and more comprehensive alcohol policies generally have lower levels of alcohol consumption. Regulating the economic and physical availability of alcohol are particularly effective in reducing the harm done by alcohol, and such regulations have tended to become more restrictive throughout the European Union in recent years, particular so in the eastern part of the Union. Involvement of alcohol producers in alcohol policy making tends to be associated with weaker alcohol policies, whereas the involvement of academia tends to be associated with stronger policies.

References:

  1. Karlsson T, Lindeman M, Österberg E, Ahtola R, Moskalewicz J, Welbel M et al. Report on the impact of previously studied European changes in the economic and physical availability of alcohol on alcohol-related harm. 2011. [Download]
  2. Lindeman M, Karlsson T & Österberg E. Report on the impact of unstudied European changes in the economic and physical availability of alcohol on alcohol-related harm. 2012.  [Download]
  3. König C, Segura L, Colom J, Mittelmark M, Anderson P. Report on the impact of infrastructures on alcohol policy across Europe. 2012. [Download]
  4. Karlsson T, Lindeman M & Österberg E. Does alcohol policy make any difference? Scales and consumption. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
  5. Karlsson T, Lindeman M & Österberg E. Europe’s diverse alcohol policies: what do all the natural experiments tell us? In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
  6. Kønig C, Segura L & Anderson P. Infrastructures. Building a policy house. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
5. Alcohol policies impact on alcohol consumption, even when talking into account broader socio-demographic changes, such as increased urbanization which is associated with increased consumption and increased maternal age at all childbirths which is associated with decreases in consumption.  

Socio-demographic changes impact on alcohol consumption. In general, increased urbanization results in increases in overall alcohol consumption, and a greater maternal age across all child births results in decreases in overall alcohol consumption. However, even when taking into account the impact of these socio-demographic changes, alcohol policy matters (1, 2). Restricting the availability and advertising of alcohol, increasing the minimum purchase age, and lowering the legal blood alcohol concentration for driving can all reduce alcohol consumption.

References:

  1. Allamani A, Maccari F, Baccini M, Carreras G, Pepe P, Voller F et al. Report of an analysis of European alcohol-related cultural, social and policy interactions and their impact on alcohol consumption and alcohol-related harm. 2013. [Download]
  2. Allamani A, Voller F, Pepe P, Baccini M, Carreras G, Massini G et al. Balance of power in alcohol policy. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
6. Online alcohol marketing and alcohol branded sports sponsorship increase the likelihood of 14 year olds to drink alcohol.

The greater the exposure 13-16 year olds have to online alcohol marketing and alcohol branded sports sponsorship, the greater the likelihood that young drinkers will consume alcohol 14-15 months later (1, 2). Such 13-16 year olds would not feel deprived of information should the advertising of alcohol be banned (3, 4).

References:

  1. de Bruijn A. Exposure to online alcohol advertising and adolescents’ binge drinking: a cross-sectional study in four European countries. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
  2. de Bruijn A, Tanghe J, Beccaria F, Bujalski M, Celata C, Gosselt J et al. Report on the impact of European alcohol marketing exposure on youth alcohol expectancies and youth drinking. 2012. [Download]
  3. Hellman M. Alcohol advertisements. Reception among young Europeans. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
  4. Hellman M. Studying young recipients of alcohol marketing - Two research paradigms and their possible consolidation. Nordic Studies on Alcohol and Drugs. 2011. [Download]
7. Brief interventions for risky drinking and pharmacological treatments for alcohol use disorders are effective.

Brief interventions for risky drinking are effective in primary health care and emergency care settings, also in Europe, in reducing alcohol consumption by 18 grams and 11 grams per week respectively more than the control group at 12 month follow-up. The pharmacological treatments, acamprosate and naltrexone are effective in treating alcohol use disorders, also in Europe, with success rates of 18%-20% at 3-6 months follow-up (1, 2).

References:

  1. Elzerbi C, Donoghue K & Drummond C. Report on the European public health impact and cost effectiveness of early diagnosis and treatment of alcohol use disorders. 2013. [Download]
  2. Kaner E. Health sector responses. In: Anderson P, Møller L, Galea G, editors. Alcohol in the European Union Consumption, harm and policy approaches. Copenhagen: WHO Regional Office for Europe; 2012. p. 40-48 [Download]
8. The proportion of people who actually access treatment out of those who need it ranges from only 1 in 25 to 1 in 7.

Across six European countries studied, there is great variation in the health systems and treatment provision for alcohol use disorders, with the proportion of people in need of treatment who actually access it ranging from 1 in 25 to 1 in 7 (1, 2).

References:

  1. Wolstenholme A, Drummond C, Deluca P, Davey Z, Elzerbi C, Gual A et al. Report on the mapping of European need and service provision for early diagnosis and treatment of alcohol use disorders. 2013. [Download]
  2. Drummond C, Wolstenholme A, Deluca P, Davey Z, Elzerbi C, Gual A et al. Alcohol interventions and treatment in Europe. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
9. Young people are often already drunk by the time they go out, fuelled by cheap alcohol from shops and supermarkets, with drinking venues exacerbating problems further.

Across four countries studied, young people were already drunk by the time they went out to a drinking venue, fuelled by cheap alcohol purchased in shops and supermarkets (1); the drinking venues themselves exacerbate this problem by often being designed to promote further drunkenness and related problems (2, 3, 4).

References:

  1. Hughes K, Quigg Z, Bellis MA, Calafat A, Van Hasselt N, Kosir M. Drinking behaviours and blood alcohol concentration in European nightlife users. BMC Public Health. 2011; 11:918. DOI:10.1186/1471-2458-11-918. [Download]
  2. Hughes K, Quigg Z, Bellis MA, Calafat A, Van Hasselt N, Kosir M, Voorham L, Goossens FX, Duch M, Juan M. Drunk and Disorganised: Relationships between Bar Characteristics and Customer Intoxication in European Drinking Environments. Int. J. Environ. Res. Public Health. 2012, 9, 4068-4082; DOI:10.3390/ijerph9114068. [Download]
  3. Hughes K, Quigg Z, Calafat A, van Hasselt N, Košir M, Voorham L et al. Report on developing safer drinking environments in Europe. 2013. [Download]
  4. Karen Hughes, Zara Quigg, Mark A. Bellis, Amador Calafat, Ninette van Hasselt & Matej Kosir. From home to pub. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]
10. 10. Monitoring alcohol policy and its impact needs much improvement.

Monitoring alcohol policy and its impact in the European Union is rather poor. Although 18 of 32 countries (56%) had prepared a report on alcohol as of 2010, their coverage of relevant issues tended to be poor (1). Reporting of summary measures of alcohol-related harm tends to be outdated, sometimes by as much as eight years (2).

References:

  1. Brummer J, Sevestre L. EU status report on public health policies on alcohol 2011. In: Anderson P, Møller L, Galea G, editors. Alcohol in the European Union Consumption, harm and policy approaches. Copenhagen: WHO Regional Office for Europe; 2012. p. 118-132 [Download]
  2. Rehm J., Gmel G., Rehm M.X., Scafato E., Shield K.D. What alcohol can do to European societies. In:  Anderson P, Braddick F, Reynolds J & Gual A, editors. Alcohol Policy in Europe: Evidence from AMPHORA. 2nd ed. The AMPHORA project. 2013. [Download]

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Video of the AMPHORA Manifesto: for effective alcohol policy in Europe

Read the full AMPHORA manifesto document

See the list of deliverables of the AMPHORA project

Download the press release on AMPHORA participation in AWARH'13

Download the press release of the AMPHORA Final Conference

Click here for more information on the AMPHORA final conference

 

 

      

Addictions in Europe

   

  The AMPHORA ebook (2nd edition)

Alcohol Policy in Europe: Evidence from AMPHORA

This publication gives an overview of the findings of each study carried out under the AMPHORA project, with chapters written by the scientists responsible for the research:

Download the AMPHORA ebook (2nd ed.)

 

    

 

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