Alcohol causes significant harms to many people other than the drinker; in other words it causes substantial “second-hand” effects.
The second-hand effects of alcohol are a compelling justification for strong public policies on alcohol to
protect the health and well-being of all Swedes.
Until recently, research into the extent and nature of second-hand effects have been limited. This report describes emerging research and offers recommendations for their prevention.
Alcohol is the 6th leading risk factor globally for preventable death, disease and disability according to the latest Global Burden of Disease estimate, ahead of high cholesterol and most dietary risk factors.
Alcohol is the leading risk factor globally for persons aged 15-49, ahead of e.g. smoking and high blood pressure.
No other risk factor in the Global Burden of Disease report involves as many types of disease and injury as does alcohol, illustrating the toxicity of alcohol to all tissues and organs of the body through a variety of physiological and psychological mechanisms.
When the second-hand harms are added to the harms to drinkers it has been estimated the total harm from alcohol is about double that from tobacco, which is currently considered the 2nd leading contribution to the global burden of disease.
Similarly, the types of second-hand harms caused by alcohol are pervasive and include impacts on children and families, unintentional injuries and violence, crime, property damage and adverse economic effects.
Notable examples of second-hand effects of alcohol include motor vehicle crashes and drunk driving, sexual assault, domestic violence, child maltreatment and neglect, vandalism, and lost productivity.
The proportion of fatal motor vehicle crashes in Sweden where at least one driver had blood alcohol levels above the legal limit has been 20-25% of dead drivers over the past 8 years.
Survey data suggest 50,000 Swedish households experience financial problems due to a family member’s drinking, 30% of Swedish adults have had a negative alcohol-related experience involving a family member or close associate in the past year, and 10% have had a negative alcohol-related experience involving a stranger.
In developed nations, more than half the economic costs from alcohol are borne by those other than the drinker (e.g., are costs borne by government or individuals not generating the costs).
While most second-hand effects from alcohol are caused by drinking to the point of intoxication (i.e., binge drinking), most second-hand effects are caused by those who are not themselves alcoholdependent.
The most effective ways to prevent second-hand effects and costs from alcohol are policies that reduce its affordability and ease of access; efforts to simply “treat” those with alcohol dependence can only prevent a small proportion of alcohol’s second-hand effects.
Specific examples of effective alcohol policies that should be strengthened include: increasing the overall price of alcohol through taxation, introducing minimum pricing which targets the cheapest alcohol, limiting the number of outlets that can sell alcohol, limiting the hours and/or days of sale for alcohol, and increasing the age at which persons can purchase or possess alcohol in public. Attention should be paid to restricting cross-border sales of alcohol which currently weaken the effectiveness of Systembolaget, and Internet sales, which may pose a future threat.