Mortality and life-years lost due to alcohol: a comparison of acute and chronic causes.

OBJECTIVES: (i) To estimate the numbers of deaths and person-years of life lost (PYLL) due to high-risk alcohol consumption in Australia during 1997, using current estimates of consumption. (ii) To compare the number of deaths and PYLL due to acute conditions associated with bouts of intoxication and chronic conditions associated with long-term misuse of alcohol. METHODS: All Australian deaths during 1997 related to conditions considered to be partially or wholly caused by high-risk alcohol consumption were extracted from the Australian Bureau of Statistics Mortality Datafile and adjusted by alcohol aetiologic fractions calculated for Australia in 1997. A life-table method was used to estimate the PYLL for deaths from alcohol-caused conditions. MAIN OUTCOME MEASURES: Numbers of all deaths and PYLL due to chronic and acute alcohol-related conditions. RESULTS: Of the 3290 estimated alcohol-caused deaths in 1997, chronic conditions (eg, alcoholic liver cirrhosis and alcohol dependence) accounted for 42%, acute conditions (eg, alcohol-related road injuries and assaults) for 28% and mixed (chronic and acute) for 30%. Of the 62914 estimated potential life years lost, acute conditions were responsible for 46%, chronic for 33% and mixed for 21%. The average number of years of life lost through deaths from acute conditions was more than twice that from chronic conditions, because the former mostly involved younger people. CONCLUSIONS: In view of the societal burdens imposed by premature deaths, more effective public health strategies are needed to reduce the harm associated with occasional high-risk drinking (as well as sustained high-risk drinking), especially among young people.

Is wine the drink of moderation?

OBJECTIVE: To examine, in the light of a current national inquiry into taxation for wine, claims that wine drinkers rarely misuse alcohol and that cask wine is more likely to be misused than bottled wine. METHODS: 1272 persons aged 16 years and over and resident in metropolitan Perth were interviewed in their homes regarding their use of alcohol. RESULTS: The alcohol consumption of 524 (373 women, 151 men) who had drunk at least one glass of wine on one or more of their last four drinking days was examined in relation to National Health and Medical Research Council guidelines. While only 2.9% of women and 2.6% of men had an average daily intake of wine above low risk levels, 6.9% of women and 13.2% of men had exceeded these levels when considering all alcoholic beverages. When wine intake was examined for the day of highest consumption of the last four drinking days recalled by each respondent, 41.1% of women and 17.0% [corrected] of men had exceeded low risk levels. There was no significant difference in the amounts of cask and bottled wine consumed in 180 wine drinkers for whom the distinction between cask and bottled varieties could be made and who drank wine on their last drinking occasion. CONCLUSIONS: Past estimates of the contribution of wine consumption to excessive alcohol intake are underestimates. Raising the tax on wine should be considered as a public health measure and taxes should be levied in direct relation to alcohol content to encourage the consumption of lower alcohol varieties.