Citation

Rehm J, Hasan OSM. Alcohol 2019; ePub(ePub): ePub.

Affiliation

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, Canada, M5S 2S1; Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, ON, Canada, M5T 3M7.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.alcohol.2019.06.005

PMID

31260796

Abstract

Most epidemiological research on alcohol as a risk factor is based on the assumption that outcomes are linked to pattern and level of alcohol exposure where different beverages are converted into grams of ethanol. This review examines this basic assumption, that alcohol has the same impact, independent of beverage type. We conducted a systematic search on comparative research of beverage-specific alcohol exposure and consequences. Research was divided by methodology (survey, case-control, cohort, time-series analyses, interventional research). Overall, many studies showed higher risks for spirits compared to beer or wine; however, most research was not controlled adequately for confounders such as patterns of drinking. While there is no conclusive evidence for spirits being associated with more harm, given the same pattern and level of alcohol exposure, some evidence supports for certain outcomes such as injuries and poisonings a potential excess risk for spirits consumption due to rapid ethanol intake and intoxication. Accordingly, encouraging people to opt for beverages with lower alcohol content via taxation strategies has the potential to reduce alcohol-attributable harm. This does not necessarily involve switching beverage type, but also can achieved within the same beverage category, by shifting from higher to lower concentration beverages.

Copyright © 2019 Elsevier Inc. All rights reserved.

Language: en

Keywords

Alcoholic beverages; alcoholic strength; attributable burden; causality; spirits; taxation