ArticleLancet (London, England)2022
Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020.
Article in Lancet (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 282 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
282 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Cannabinoid exposure across substance use disorders: Short-term symptom benefits without sustained therapeutic gains in a tier-weighted systematic review.European psychiatry : the journal of the Association of European Psychiatrists · 2026Pooled it
- Alcohol consumption and risk of dementia: a systematic review and meta-analysis.Internal medicine journal · 2026Pooled it
- A systematic review of the association between alcohol-related deaths and area-level socioeconomic deprivation and other geographic characteristics in high-income countries.BMC public health · 2026Pooled it
- The impact of alcohol consumption on stroke prognosis: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- Health impact of alcohol regulatory interventions: a systematic review of policies in low- and middle-income countries.Health policy and planning · 2025Pooled it
- Health effects associated with exposure of children to physical violence, psychological violence and neglect: a Burden of Proof study.Nature human behaviour · 2025Pooled it
- Combined pharmacological and psychosocial interventions for alcohol use disorder.The Cochrane database of systematic reviews · 2025Pooled it
- Screening instruments to detect problematic alcohol use among adults in hospitals and their diagnostic test accuracy: A systematic review.Drug and alcohol review · 2025Pooled it
- Alcohol consumption among university students in Ethiopia: a systematic review and meta-analysis of epidemiological studies.Frontiers in public health · 2025Pooled it
- A burden of proof study on alcohol consumption and ischemic heart disease.Nature communications · 2024Pooled it
- Wine consumption, Mediterranean diet, and cardiovascular risk in two Spanish cohorts.European heart journal · 2026Trial
- A large randomized trial assessing alcohol cessation versus moderation on clinical events: UNATI.European journal of epidemiology · 2026Trial
- Multimodal Nutraceutical and Psychological Intervention for GGT Reduction in Individuals with Alcohol Use Disorder.Nutrients · 2026Trial
- Effectiveness of the Components of a Digital Multiple Health Behavior Intervention Among University Students (Buddy): Factorial Randomized Trial.Journal of medical Internet research · 2026Trial
- Effects of brand-matched alcoholic and alcohol-free and low-alcohol drinks adverts on drink selections: A United Kingdom-based randomised controlled trial in an experimental online supermarket.Addiction (Abingdon, England) · 2026Trial
- Four-Year Effects of a Computer-Based Brief Alcohol Intervention Targeting Alcohol Users in the General Population: Randomized Controlled Trial.Journal of medical Internet research · 2025Trial
- Challenging the Wine Component in Mediterranean Diet Scores: Cognitive Outcomes in Portuguese Adults at High Risk of Dementia.Nutrients · 2025Trial
- Setting Goals and Accepting Challenges for Behavior Change-Analysis of Participants' Interactions With a Digital Multiple Health Behavior Intervention: Mixed Methods Study.JMIR human factors · 2025Trial
- Effectiveness of screening and ultra-brief intervention for hazardous drinking in primary care: pragmatic cluster randomised controlled trial.BMJ (Clinical research ed.) · 2025Trial
- Non-Alcoholic Beer Influences Glucose and Lipid Metabolism and Changes Body Composition in Healthy, Young, Male Adults.Nutrients · 2025Trial
222 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Erratum issued
Authors and funding
1 author.
Funding
Abstract
backgroundThe health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year.
methodsFor this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol.
findingsThe burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male.
interpretationThere is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol.
fundingBill & Melinda Gates Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.