Alcohol’s Secondhand Harms: Prevalence and Risk Factors

Harmful drinking can have severe physical and psychological consequences for the person consuming alcohol. However, the negative impact does not just stop at the individual level.

Researchers from the US have examined data from two parallel national surveys to uncover the extent of alcohol harm to others among adult men and women, and the links between alcohol harm to others with sociodemographics and alcohol-related characteristics, including the harmed individual’s own drinking and the presence of a heavy drinker in the household.

The researchers gathered sociodemographic information and descriptions of any harm in the last 12 months caused by “someone who had been drinking,”

Forms of harm included:

  1. being harassed, bothered, called names, or otherwise insulted
  2. feeling threatened or afraid
  3. having clothing or belongings ruined
  4. having house, car, or other property vandalized
  5. being pushed, hit, or assaulted
  6. being physically harmed
  7. being in a traffic accident
  8. being a passenger in a vehicle with a drunk driver
  9. having family problems or marriage difficulties
  10. having financial trouble

On gathering an analysing the data, the researchers found that:

  • One in five adults experienced at least one of ten 12-month harms because of someone else’s drinking
  • Women were more likely to report harm due to drinking by a spouse/partner or family member, whereas men were more likely to report harm due to a stranger’s drinking
  • Younger age increased risk for all alcohol harm to other types, except physical aggression
  • Being of Black/ other ethnicity, being separated/widowed/divorced, and having a college education without a degree each predicted physical aggression harm

The results provide evidence for the extensive harm to others that can be caused by individuals drinking. It highlights populations that are particularly vulnerable and emphasises the need for both broad and targeted interventions to protect society from alcohol-related harm.

Alcohol Use Disorders and the Heart

The negative impact of harmful substance use on societies physical and mental wellbeing is a global issue. Substance use disorders are associated with a significant disease burden.

In recognition of this, Addiction is initiating a new series of commissioned reviews, Clinical issues: substance use disorders and the body.

The first in the series, Alcohol use disorders and the heart, gives an overview of the impact of low, medium and high levels of alcohol consumption on the heart. 

dilated cardiomyopathy
In dilated cardiomyopathy the muscle walls of the heart have become enlarged, stretched and thin, so they can't contract (squeeze) properly to pump blood around the body.

The researchers also focus in on the clinical presentation, pathological mechanisms, assessment, management and prognosis of people who consume alcohol at higher levels or in a binge pattern.

There is a particular focus on:

  • Hypertension- increased blood pressure;
  • Cardiac arrhythmias- irregular heartbeat ; 
  • and alcoholic cardiomyopathy - due to excessive alcohol consumption the heart becomes unable to pump blood efficiently around the body. 

‘Doing More With Less’: An Appropriate Response to Alcohol-Related Death?

Deaths in England directly caused by alcohol rose by 11% between 2006 and 2017. During the same period, hospital admissions in which alcohol misuse was a primary factor increased by 17%.

In 2017 alone almost 1 million hospital admissions were in some way related to this behaviour. That’s around 7% of all hospital admissions that year.

Cuts to alcohol services in the name of austerity have only made the problem worse, with many vulnerable people not receiving the help that they need.

In this context, a recent report by Alcohol Change UK, entitled Learning from Tragedies: An Analysis of alcohol-related Safeguarding Adult Reviews (2017), set out to understand more about alcohol’s role in the lives of vulnerable adults.

The organisation analysed 11 Safeguarding Adult Reviews (SARs) published in England in which alcohol was identified as having a significant role in a person’s life and/or death.

Key report findings include:

  • Most adults featured had multiple and complex needs in addition to alcohol misuse. These included: mental health problems, chronic physical health conditions, self-neglect, exploitation by others, unsuitable living conditions, and experiences of traumatic past events, including bereavement and physical or sexual abuse.
  • In almost all cases, support services failed to adequately cope with such complex demands.

 Given these findings, the report suggests that there is a need for:

  • Improved coordination between separate agencies, leading to better multi-agency working
  • Stronger risk assessments
  • Improved understanding and training for practitioners to help vulnerable adults who are experiencing alcohol harm and better identify support

The report also considers the cases in the context of current legislation and discusses how practitioners could most appropriately apply such laws to similar situations. It also looks at the ways in which existing guidance could better address issues of alcohol-related self-neglect.

Prevalence and Risk Factors for Initiating Tobacco and Alcohol Consumption in Adolescents Living in Urban and Rural Ethiopia

Both alcohol and tobacco use is an increasing public health concern in low- or middle-income countries. Due to an annual economic growth rate of approximately 10%, Ethiopia is a target for both the alcohol and tobacco industries.

Although data is limited, trends suggest that alcohol consumption is a particular problem among secondary school students.

A recent study, published in the Journal of Public Health, has sought to measure the prevalence of alcohol and tobacco consumption in young people living in Ethiopia, and the risk factors associated with alcohol and tobacco initiation.

3967 young people from ten rural and ten urban schools completed questionnaires which asked for information about the use of alcohol and tobacco products and their access to the Internet and frequency of watching football on television.

Results from the study found that:

  • A total of 323 (8.5%) respondents reported that they had ever smoked

  • The risk of ever smoking was higher in urban schools, among boys, and tended to increase with age. The risk of having ever smoked was more likely in those with parents who smoke, and who had access to the internet at home.

  • Twenty-nine per cent of the young people reported ever having used alcohol, and 14% were current users.

  • There was a very strong positive association between ever having smoked cigarettes and ever having tried alcohol

  • Risk factors for currently drinking alcohol included parent alcohol use, home Internet access and regular watching of televised football

Overall the results show that tobacco and alcohol use among Ethiopian teenagers increases among those exposed to family and peer and among those accessing the Internet and, for alcohol, those watching televised football. The study highlights the potential risk that advertising, both through the internet and watches football, poses to young people in Ethiopia.  

Alcohol Evidence in Policy & Practice 2019: 6th Annual Course for Practitioners, Policymakers, Advocates & Researchers

Event Date

This year’s course will feature inputs from Prof. Annie Britton from University College London, Prof. Mark Petticrew from LSHTM, and Dr. Mark Robinson from NHS Health Scotland, as well as Colin Angus (University of Sheffield), Prof. Carol Emslie (Glasgow Caledonian University), Dr. Nathan Critchlow (University of Stirling), Colin Shevills (Balance North East) and Katherine Severi (Institute of Alcohol Studies).

Building on 5 previous highly-rated courses run by the UK Centre for Tobacco and Alcohol Studies (UKCTAS), this year's course is offered as part of the SPECTRUM consortium (Shaping Public Health Policies to reduce Inequalities and Harm), funded by the UK Prevention Research Partnership. The course is co-ordinated by Dr. Niamh Fitzgerald, Associate Professor in Alcohol Studies, Institute for Social Marketing at the University of Stirling/Deputy Director of SPECTRUM.

All those interested in public health and policy, apply here.

Awareness of Information on Alcohol Packaging

Although alcohol consumption among young people in the UK has been declining there remains a concerning level of binge drinking amongst 16–24-year-olds.

One intervention, that is cost-effective and has a wide reach, is the inclusion of health messaging and product-related information on alcohol packaging. It is important therefore to understand how much information is being processed and recalled by young people.

A cross-sectional study, published in the Journal of Public Health, has examined awareness and recall of product information among adolescents and young adults aged 11–19 years old.

Participants were asked:

‘Have you seen any information, health messages or warnings on alcohol packaging over the last month?

‘What messages do you remember seeing?’

‘Have you ever had a whole alcoholic drink? Not just a sip.

‘Do you think you will drink alcohol at any time during the next year?’

Analysis of the questionnaire responses found that just one-third of participants had seen information on alcohol packaging. Awareness of product-related information was greater for current drinkers compared to non-drinker and higher-risk drinkers than lower-risk drinkers. 47% of the young people responded ‘none’ when asked the number of health messages recalled.

The top messages young people remembered were:

  • Drink responsibly
  • Don’t drink during pregnancy
  • Know and stick to your limits

Overall the results show that most young drinkers did not recall seeing any information, health messages or warnings on alcohol packaging in the past month, implying that current labelling is failing to reach this key audience. This suggests the need for alterations to be made to the current intervention to improve the chances of message comprehension and recall.

Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) Report

In 2010 NHS Health Scotland was tasked by the Scottish Government to lead the monitoring and evaluation of Scotland’s alcohol strategy. This was delivered through the Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) work programme.

Minimum unit pricing (MUP), legislation that sets a minimum price at which a unit of alcohol can be sold, was introduced in Scotland on 1 May 2018. The minimum unit price is currently set at 50 pence per unit.

The Monitoring and Evaluating Scotland's Alcohol Strategy (MESAS) monitoring report 2019 presents all the latest available data on key alcohol indicators in Scotland. 

The report provides information on 

  • Alcohol retail sales  
  • Alcohol price and affordability
  • Self-reported alcohol consumption
  • Alcohol health harms
  • Alcohol social harms
Jose Luis Vazquez Martinez

Fuente: Razón Hernández, K. C., Rodríguez Serrano, L. M., & León Jacinto, U. (2018). Neurobiología del sistema de recompensa en las conductas adictivas: consumo de alcohol. Revista Electrónica de Psicología Iztacala20(4).




Prenatal Alcohol Screening During Pregnancy by Midwives and Nurses



Alcohol use during pregnancy can have a variety of harmful consequences on the fetus. Lifelong effects include growth restriction, characteristic facial anomalies, and neurobehavioral dysfunction. This range of effects is known as fetal alcohol spectrum disorders (FASD). There is no amount, pattern, or timing of alcohol use during pregnancy proven safe for a developing embryo or fetus. Therefore, it is important to screen patients for alcohol use, inform them about alcohol's potential effects during pregnancy, encourage abstinence, and refer for intervention if necessary. However, how and how often nurses and midwives inquire about alcohol drinking during pregnancy or use recommended screening tools and barriers they perceive to alcohol screening has not been well established.


This survey was sent to about 6,000 American midwives, nurse practitioners, and nurses who provide prenatal care about their knowledge of the effects of prenatal alcohol exposure, the prevalence of alcohol use during pregnancy, and practices for screening patients’ alcohol use. Participants were recruited by e‐mail from the entire membership roster of the American College of Nurse‐Midwives.


There were 578 valid surveys returned (about 9.6%). Analyses showed that 37.7% of the respondents believe drinking alcohol is safe during at least one trimester of pregnancy. Only 35.2% of respondents reported screening to assess patient alcohol use. Only 23.3% reported using a specific screening tool, and few of those were validated screens recommended for use in pregnant women. Respondents who believe alcohol is safe at some point in pregnancy were significantly less likely to screen their patients.


Respondents who reported that pregnancy alcohol use is unsafe felt more prepared to educate and intervene with patients regarding alcohol use during pregnancy and FASD than respondents who reported drinking in pregnancy was safe. Perceived alcohol safety and perceived barriers to screening appeared to influence screening practices. Improving prenatal care provider knowledge about the effects of prenatal alcohol exposure and the availability of valid alcohol screening tools will improve detection of drinking during pregnancy, provide more opportunities for meaningful intervention, and ultimately reduce the incidence of FASD.

Alcohol Country Fact Sheets

The 30 country fact sheets for EU Member States, Norway and Switzerland present data on consumption, consequence, and policy implementation for the year 2016, aiming to give guidance to national decision-makers for further priority-setting in the field of alcohol and public health.

Besides trends in alcohol consumption, each fact sheet features a section on alcohol consumption and alcohol-attributable harm, with special attention to young people, and a section on the implementation of key alcohol control policies, including the three WHO “best buys” – price increase, limits on availability and bans on advertising of alcohol. This allows for a quick overview of important subsets of alcohol policy measures that will support countries to assess their own progress towards reducing the burden of noncommunicable diseases and their key risk factors.

The fact sheets also present, for the first time, an individual overview of the composite indicator scores of the 10 areas of action to reduce the harmful use of alcohol.