全球 1990 年至 2017 年期间的酒精暴露情况及 2030 年预测：一项建模研究。
Global alcohol exposure between 1990 and 2017 and forecasts until 2030: a modelling study.
机构信息
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, Medical Sciences Building, University of Toronto, Toronto, ON, Canada.
出版信息
Lancet. 2019 Jun 22;393(10190):2493-2502. doi: 10.1016/S0140-6736(18)32744-2. Epub 2019 May 7.
BACKGROUND
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. We present estimates on the main indicators of alcohol exposure for 189 countries from 1990-2017, with forecasts up to 2030.
METHODS
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 drinking (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.
FINDINGS
Between 1990 and 2017, global adult per-capita consumption increased from 5·9 L (95% CI 5·8-6·1) to 6·5 L (6·0-6·9), and is forecasted to reach 7·6 L (6·5-10·2) by 2030. Globally, the prevalence of lifetime abstinence decreased from 46% (42-49) in 1990 to 43% (40-46) in 2017, albeit this was not a significant reduction, while the prevalence of current drinking increased from 45% (41-48) in 1990 to 47% (44-50) in 2017. We forecast both trends to continue, with abstinence decreasing to 40% (37-44) by 2030 (annualised 0·2% decrease) and the proportion of current drinkers increasing to 50% (46-53) by 2030 (annualised 0·2% increase). In 2017, 20% (17-24) of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5% [15·3-21·6%], and this prevalence is expected to increase to 23% (19-27) in 2030.
INTERPRETATION
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.
FUNDING
Centre for Addiction and Mental Health and the WHO Collaborating Center for Addiction and Mental Health at the Centre for Addiction and Mental Health.
背景
饮酒是全球疾病负担的主要风险因素之一，酒精暴露数据对于评估实现全球非传染性疾病目标的进展至关重要。我们提供了 1990 年至 2017 年 189 个国家主要酒精暴露指标的估计数，并对 2030 年进行了预测。
方法
特定年份的成人人均酒精消费量（每个成人[≥15 岁]的纯酒精消费量，以升计）基于截至 2016 年的经国家验证的数据。截至 2030 年的预测值是从多元对数正态混合泊松分布模型中得出的。使用来自 149 个国家的调查数据，从 Dirichlet 回归中获得终生戒酒和当前饮酒的流行率。使用来自 118 个国家的调查数据，通过分数反应回归估计重度间歇性饮酒（当前饮酒者中至少有一次在 30 天内摄入 60 克纯酒精的 30 天患病率）。
发现
1990 年至 2017 年间，全球成人人均消费量从 5.9 升（95%CI 5.8-6.1）增加到 6.5 升（6.0-6.9），预计到 2030 年将达到 7.6 升（6.5-10.2）。全球范围内，终生戒酒的流行率从 1990 年的 46%（42-49）下降到 2017 年的 43%（40-46），尽管这并不是显著下降，而当前饮酒的流行率从 1990 年的 45%（41-48）增加到 2017 年的 47%（44-50）。我们预测这两种趋势都将继续，到 2030 年，戒酒率将下降到 40%（37-44）（年增长率为 0.2%），当前饮酒者的比例将增加到 50%（46-53）（年增长率为 0.2%）。2017 年，20%（17-24）的成年人是重度间歇性饮酒者（相比之下，1990 年估计为 18.5%[15.3-21.6%]），预计到 2030 年，这一比例将上升至 23%（19-27）。
解释
基于这些数据，全球减少有害饮酒的目标不太可能实现，应实施已知有效且具有成本效益的政策措施，以减少酒精暴露。
资助
成瘾和心理健康中心以及世卫组织成瘾和心理健康中心合作中心，位于成瘾和心理健康中心。
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