Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study

Background Alcohol use is a leading risk factor for global disease burden, and data on alcohol exposure are crucial to evaluate progress in achieving global non-communicable disease goals. We present estimates on the main indicators of alcohol exposure for 189 countries from 1990–2017, with forecasts up to 2030. Methods Adult alcohol per-capita consumption (the consumption in L of pure alcohol per adult [≥15 years]) in a given year was based on country-validated data up to 2016. Forecasts up to 2030 were obtained from multivariate log-normal mixture Poisson distribution models. Using survey data from 149 countries, prevalence of lifetime abstinence and current drinking was obtained from Dirichlet regressions. The prevalence of heavy episodic drinking (30-day prevalence of at least one occasion of 60 g of pure alcohol intake among current drinkers) was estimated with fractional response regressions using survey data from 118 countries. Findings Between 1990 and 2017, global adult per-capita consumption increased from 5·9 L (95% CI 5·8–6·1) to 6·5 L (6·0–6·9), and is forecasted to reach 7·6 L (6·5–10·2) by 2030. Globally, the prevalence of lifetime abstinence decreased from 46% (42–49) in 1990 to 43% (40–46) in 2017, albeit this was not a significant reduction, while the prevalence of current drinking increased from 45% (41–48) in 1990 to 47% (44–50) in 2017. We forecast both trends to continue, with abstinence decreasing to 40% (37–44) by 2030 (annualised 0·2% decrease) and the proportion of current drinkers increasing to 50% (46–53) by 2030 (annualised 0·2% increase). In 2017, 20% (17–24) of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5% [15·3–21·6%], and this prevalence is expected to increase to 23% (19–27) in 2030. Interpretation Based on these data, global goals for reducing the harmful use of alcohol are unlikely to be achieved, and known effective and cost-effective policy measures should be implemented to reduce alcohol exposure. Funding Centre for Addiction and Mental Health and the WHO Collaborating Center for Addiction and Mental Health at the Centre for Addiction and Mental Health.