Introduction
The first paper in this Series1 summarised the global burden of ill health and the economic cost attributable to alcohol use and alcohol-use disorders, noting that 4·6% of all ill health and premature death worldwide is due to alcohol, with poorer populations and lower-income countries having a greater disease burden per litre of alcohol than higher-income populations and countries. This second paper in the Series reviews the evidence for the effectiveness of policies and programmes to reduce the avoidable harm caused by alcohol, largely on the basis of an analysis of published systematic reviews and meta-analyses, which were identified through searches of the Cochrane library, Medline, Web of Science, and Web of Knowledge with specific search terms for each target policy area. Reference sections of identified papers were cross-checked to identify other relevant studies contributing to this review. This paper briefly summarises the harm to be reduced, and reviews the evidence for effective policies and programmes and estimates their cost-effectiveness. It concludes with a short overview of the implications for policy development and implementation. Since most countries do not have adequate programmes in place, the third paper in the Series will describe how policies and programmes need to be scaled up, concluding with a global call to action.2
Key messages
- •
A substantive evidence base of systematic reviews and meta-analyses inform alcohol policy
- •
Making alcohol more expensive and less available are highly cost-effective strategies to reduce harm
- •
Banning of alcohol advertising, drink-driving countermeasures, and individually-directed interventions to drinkers already at risk are also cost-effective approaches
- •
School-based education does not reduce harm, but public information and education programmes can increase attention to alcohol on public and political agendas
- •
If more stringent alcohol policies are not put into place, global alcohol-related harm is likely to continue to increase