Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes

作者：Luis Antonio Díaz, Eduardo Fuentes–López, Francisco Idalsoaga, Gustavo Ayares, Óscar Corsi, Jorge Arnold, Macarena Cannistra, Danae Vio, Andrea Márquez‐Lomas, Carolina Ramírez, María Paz Medel, María Hernández‐Tejero, Catterina Ferreccio, Mariana Lazo, Juan Pablo Roblero, Thomas G. Cotter, Anand V. Kulkarni, Won Kim, Mayur Brahmania, Alexandre Louvet, Elliot B. Tapper, Winston Dunn, Douglas A. Simonetto, Vijay H. Shah, Patrick S. Kamath, Jeffrey V. Lazarus, Ashwani K. Singal, Ramón Bataller, Marco Arrese, Juan Pablo Arab · 发表于：Journal of Hepatology · 年份：2023 · DOI：10.1016/j.jhep.2023.11.006 · 被引用次数：102 · 研究领域：Alcohol Consumption and Health Effects、Substance Abuse Treatment and Outcomes、Alcoholism and Thiamine Deficiency

BACKGROUND & AIMS: The long-term impact of alcohol-related public health policies (PHPs) on disease burden is unclear. We aimed to assess the association between alcohol-related PHPs and alcohol-related health consequences. METHODS: We conducted an ecological multi-national study including 169 countries. We collected data on alcohol-related PHPs from the WHO Global Information System of Alcohol and Health 2010. Data on alcohol-related health consequences between 2010-2019 were obtained from the Global Burden of Disease database. We classified PHPs into five items, including criteria for low, moderate, and strong PHP establishment. We estimated an alcohol preparedness index (API) using multiple correspondence analysis (0 lowest and 100 highest establishment). We estimated an incidence rate ratio (IRR) for outcomes according to API using adjusted multilevel generalized linear models with a Poisson family distribution. RESULTS: The median API in the 169 countries was 54 [IQR 34.9-76.8]. The API was inversely associated with alcohol use disorder (AUD) prevalence (IRR 0.13; 95% CI 0.03-0.60; p = 0.010), alcohol-associated liver disease (ALD) mortality (IRR 0.14; 95% CI 0.03-0.79; p = 0.025), mortality due to neoplasms (IRR 0.09; 95% CI 0.02-0.40; p = 0.002), alcohol-attributable hepatocellular carcinoma (HCC) (IRR 0.13; 95% CI 0.02-0.65; p = 0.014), and cardiovascular diseases (IRR 0.09; 95% CI 0.02-0.41; p = 0.002). The highest associations were observed in the Americas, Africa, ...