Amy Peacock1,2, Janni Leung1,3,4,5,6, Sarah Larney1,7, Samantha Colledge1, Matthew Hickman8, Jürgen Rehm9,10,11,12,13,14, Gary A Giovino15, Robert West16, Wayne Hall4,17, Paul Griffiths18, Robert Ali19, Linda Gowing19, John Marsden17, Alize J Ferrari3,5,6, Jason Grebely20, Michael Farrell1, Louisa Degenhardt1,21,22,23. 1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. 2. School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania, Australia. 3. School of Public Health, Faculty of Medicine, University of Queensland, Queensland, Australia. 4. Centre for Youth Substance Abuse Research, The University of Queensland, St Lucia, Queensland, Australia. 5. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. 6. Queensland Centre for Mental Health Research, Wacol, Queensland, Australia. 7. Alpert Medical School, Brown University, Providence, RI, USA. 8. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. 9. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 10. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 11. Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada. 12. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. 13. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 14. Institute for Clinical Psychology and Psychotherapy, Dresden, Germany. 15. Department of Community Health and Health Behavior, University at Buffalo, New York, NY, USA. 16. Department of Behavioural Science and Health, University College London, London, UK. 17. Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 18. European Monitoring Centre on Drugs and Drug Addiction, Lisbon, Portugal. 19. University of Adelaide, Adelaide, South Australia, Australia. 20. Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia. 21. School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 22. Murdoch Children's Research Institute, Melbourne, Victoria, Australia. 23. Department of Global Health, School of Public Health, University of Washington, WA, USA.
Abstract
AIMS: This review provides an up-to-date curated source of information on alcohol, tobacco and illicit drug use and their associated mortality and burden of disease. Limitations in the data are also discussed, including how these can be addressed in the future. METHODS: Online data sources were identified through expert review. Data were obtained mainly from the World Health Organization, United Nations Office on Drugs and Crime and Institute for Health Metrics and Evaluation. RESULTS: In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8, 0.77, 0.37 and 0.35% for past-year cannabis, amphetamine, opioid and cocaine use, respectively. European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use. The age-standardized prevalence of alcohol dependence was 843.2 per 100 000 people; for cannabis, opioids, amphetamines and cocaine dependence it was 259.3, 220.4, 86.0 and 52.5 per 100 000 people, respectively. High-income North America region had among the highest rates of cannabis, opioid and cocaine dependence. Attributable disability-adjusted life-years (DALYs) were highest for tobacco smoking (170.9 million DALYs), followed by alcohol (85.0 million) and illicit drugs (27.8 million). Substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100 000 people), followed by alcohol and illicit drugs (33.0 and 6.9 deaths per 100 000 people, respectively). Attributable age-standardized mortality rates and DALYs for alcohol and illicit drugs were highest in eastern Europe; attributable age-standardized tobacco mortality rates and DALYs were highest in Oceania. CONCLUSIONS: In 2015 alcohol use and tobacco smoking use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing further tens of millions. Europeans suffered proportionately more, but in absolute terms the mortality rate was greatest in low- and middle-income countries with large populations and where the quality of data was more limited. Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately the geographical and temporal trends in substance use and its disease burden.
AIMS: This review provides an up-to-date curated source of information on alcohol, tobacco and illicit drug use and their associated mortality and burden of disease. Limitations in the data are also discussed, including how these can be addressed in the future. METHODS: Online data sources were identified through expert review. Data were obtained mainly from the World Health Organization, United Nations Office on Drugs and Crime and Institute for Health Metrics and Evaluation. RESULTS: In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8, 0.77, 0.37 and 0.35% for past-year cannabis, amphetamine, opioid and cocaine use, respectively. European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use. The age-standardized prevalence of alcohol dependence was 843.2 per 100 000 people; for cannabis, opioids, amphetamines and cocaine dependence it was 259.3, 220.4, 86.0 and 52.5 per 100 000 people, respectively. High-income North America region had among the highest rates of cannabis, opioid and cocaine dependence. Attributable disability-adjusted life-years (DALYs) were highest for tobacco smoking (170.9 million DALYs), followed by alcohol (85.0 million) and illicit drugs (27.8 million). Substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100 000 people), followed by alcohol and illicit drugs (33.0 and 6.9 deaths per 100 000 people, respectively). Attributable age-standardized mortality rates and DALYs for alcohol and illicit drugs were highest in eastern Europe; attributable age-standardized tobacco mortality rates and DALYs were highest in Oceania. CONCLUSIONS: In 2015 alcohol use and tobacco smoking use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing further tens of millions. Europeans suffered proportionately more, but in absolute terms the mortality rate was greatest in low- and middle-income countries with large populations and where the quality of data was more limited. Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately the geographical and temporal trends in substance use and its disease burden.
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