Jakob Manthey (Mail:, Kevin D Shield, Margaret Rylett, Omer S M Hasan, Charlotte Probst, Jürgen Rehm


Jakob Manthey, Kevin D Shield, Margaret Rylett, Omer S M Hasan, Charlotte Probst, Jürgen Rehm, Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study, The Lancet, 2019, , ISSN 0140-6736,

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




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. The researchers present estimates on the main indicators of alcohol exposure for 189 countries from 1990–2017, with forecasts up to 2030.


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 alcohol use (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.


Between 1990 and 2017, global adult per-capita consumption increased from 5·9 L to 6·5 L, and is forecasted to reach 7·6 L by 2030. Globally, the prevalence of lifetime abstinence decreased from 46% in 1990 to 43% in 2017, albeit this was not a significant reduction, while the prevalence of current alcohol use increased from 45% in 1990 to 47% in 2017.

The researchers forecast both trends to continue, with abstinence decreasing to 40% by 2030 and the proportion of current alcohol users increasing to 50% by 2030. In 2017, 20% of adults were heavy episodic alcohol users (compared with 1990 when it was estimated at 18·5%, and this prevalence is expected to increase to 23% in 2030.


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.

Our study provides a comprehensive overview of the changing landscape in global alcohol exposure. Before 1990, most alcohol was consumed in high-income countries, with the highest use levels recorded in Europe.

However, this pattern has changed substantially, with large reductions across Eastern Europe and vast increases in several middle-income countries such as China, India, and Vietnam. This trend is forecast to continue up to 2030 when Europe is no longer predicted to have the highest level of alcohol use,” says study author Jakob Manthey, TU Dresden, Germany, as per Eureka Alter.

The growing alcohol market in middle-income countries is estimated to more than outweigh the declining use in high-income countries, resulting in a global increase.”


Centre for Addiction and Mental Health and the WHO Collaborating Center for Addiction and Mental Health at the Centre for Addiction and Mental Health.