Chronic diseases and conditions related to alcohol use

Abstract

Alcohol consumption is a risk factor for many chronic diseases and conditions. The average volume of alcohol consumed, consumption patterns, and quality of the alcoholic beverages consumed likely have a causal impact on the mortality and morbidity related to chronic diseases and conditions. Twenty-five chronic disease and condition codes in the International Classification of Disease (ICD)-10 are entirely attributable to alcohol, and alcohol plays a component-risk role in certain cancers, other tumors, neuropsychiatric conditions, and numerous cardiovascular and digestive diseases. Furthermore, alcohol has both beneficial and detrimental impacts on diabetes, ischemic stroke, and ischemic heart disease, depending on the overall volume of alcohol consumed, and, in the case of ischemic diseases, consumption patterns. However, limitations exist to the methods used to calculate the relative risks and alcohol-attributable fractions. Furthermore, new studies and confounders may lead to additional diseases being causally linked to alcohol consumption, or may disprove the relationship between alcohol consumption and certain diseases that currently are considered to be causally linked. These limitations do not affect the conclusion that alcohol consumption significantly contributes to the burden of chronic diseases and conditions globally, and that this burden should be a target for intervention.

Figure 1

Causal model of alcohol consumption, intermediate mechanisms, and long-term consequences, as well as of the influence of societal and demographic factors on alcohol consumption and alcohol-related harms resulting in chronic diseases and conditions. SOURCE: Adapted from Rehm et al. 2010a.

Figure 2

The relationship between increasing amounts of average daily alcohol consumption and the relative risk for cancer, with lifetime abstainers serving as the reference group. SOURCE: Lim et al. 2012.

Figure 3

The relationship between increasing amounts of average daily alcohol consumption and the relative risk for diabetes and epilepsy, with lifetime abstainers serving as the reference group. SOURCE: Lim et al. 2012.

Figure 4

The relationship between increasing amounts of average daily alcohol consumption and the relative risk for cardiovascular diseases (i.e., hypertension, conduction disorders, and ischemic and hemorrhagic stroke), with lifetime abstainers serving as the reference group. For both hypertension and hemorrhagic and ischemic stroke, the relationship differs between men and women. Moreover, for both ischemic and hemorrhagic stroke, the influence of alcohol consumption on mortality is much greater than the influence on morbidity, at least in women. In men, no such difference appears to exist. SOURCE: Lim et al. 2012.

Figure 5

The relationship between increasing amounts of average daily alcohol consumption and the relative risk for ischemic heart disease, with lifetime abstainers serving as the reference group. Low to moderate alcohol consumption has a beneficial effect on both mortality and morbidity from ischemic heart disease. However, the specific effects depend on both the gender and the age of the drinker, with the greatest beneficial effects of low-to-moderate consumption seen on morbidity from ischemic heart disease in women ages 15 to 34. SOURCE: Lim et al. 2012.

Figure 6

The relationship between increasing amounts of average daily alcohol consumption and the relative risk for digestive diseases (i.e., liver cirrhosis and pancreatitis), with lifetime abstainers serving as the reference group. For liver cirrhosis, alcohol’s effects on mortality are greater than those on morbidity, and slight differences exist between the effects in men and women. SOURCE: Lim et al. 2012.

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