What are the Economic Costs to Society Attributable to Alcohol Use? A Systematic Review and Modelling Study

Abstract

Background Alcohol-attributable costs to society are captured by cost-of-illness studies, however estimates are often not comparable, e.g. due to the omission of relevant cost components. In this contribution we (1) summarize the societal costs attributable to alcohol use, and (2) estimate the total costs under the assumption that all cost components are considered. Methods A systematic review and meta-analyses were conducted for studies reporting costs from alcohol consumption for the years 2000 and later, using the EMBASE and MEDLINE databases. Cost estimates were converted into 2019 international dollars (Int$) per adult and into percentage of gross domestic product (GDP). For each study, weights were calculated to correct for the exclusion of cost indicators. Results Of 1708 studies identified, 29 were included, and the mean costs of alcohol use amounted to 817.6 Int$ per adult (95% confidence interval [CI] 601.8-1033.4), equivalent to 1.5% of the GDP (95% CI 1.2-1.7%). Adjusting for omission of cost components, the economic costs of alcohol consumption were estimated to amount to 1306 Int$ per adult (95% CI 873-1738), or 2.6% (95% CI 2.0-3.1%) of the GDP. About one-third of costs (38.8%) were incurred through direct costs, while the majority of costs were due to losses in productivity (61.2%). Discussion The identified cost studies were mainly conducted in high-income settings, with high heterogeneity in the employed methodology. Accounting for some methodological variations, our findings demonstrate that alcohol use continues to incur a high level of cost to many societies. Registration PROSPERO #CRD42020139594.

Impact of introducing a minimum alcohol tax share in retail prices on alcohol-attributable mortality in the WHO European Region: A modelling study

“…The present contribution is the first comprehensive overview of the current state of alcohol taxation implementation for the WHO European Region, highlighting the untapped potential of tax measures to benefit public health. Despite the fact that alcohol is a psychoactive substance and a known carcinogen, which causes substantial harms to drinkers, their families, communities, as well as societies and economies in general, 3 , 10 it is far less regulated than tobacco or any other psychoactive substance. 33 , 34 This includes the regulations on the level of taxation.…”

“…Given the high costs to European societies due to alcohol consumption, 10 part of the economic rationale for the taxation of alcohol has been to compensate for negative externalities. 8 Therefore, a further important aspect of alcohol taxation is fiscal revenue generation, which will be discussed in further detail below.…”

Socio-economic determinants of alcohol consumption for South Africa

“…Individual economic costs, such as premature mortality and morbidity, unemployment and early retirement are also associated with harmful use of alcohol (Matzopolous et al, 2014). Harmful use of alcohol further increases the burden on the healthcare, criminal justice, social security and social development systems (Manthey et al, 2021;Matzopolous et al, 2014).…”

Costs of an Alcohol Measurement Intervention in Three Latin American Countries

“…This includes negative social consequences, which go beyond the health care sector, such as interpersonal violence, self-harm, vandalism, criminality, and work-related losses of productivity [ 3 ]. A recent review [ 4 ] found that the costs associated with alcohol constitute around 2.6% of the GDP (95% CI: 2.0% to 3.1%) in middle- and high-income countries, including health care and criminal justice costs, as well as losses in productivity. Latin America is a region with a relatively high magnitude of alcohol-attributable disease burden, with around 6% of the deaths and 6% of DALY’s in the region caused by alcohol [ 2 ].…”