Introduction
Alcohol consumption, and the problem it engenders, has been a familiar fixture in human society since the start of recorded history. Overall, four percent of the global burden of disease is attributable to the consumption of alcoholic beverages, accounting for a significant number of disabilities and deaths globally (Alcohol and Public Policy Group, 2010). Alcohol use continues to present critical issues to public health and medicine due to the neglect of population-based public health approaches. Alcohol consumption is a serious issue affecting almost every age group and it has been associated with major health problems ranging from individual level to global community. For instance, excessive alcohol consumption can lead to various health issues such as various illnesses and injuries sustained due to automobile accidents (Babor et al., 2017). The 2007 report by World Health organization (WHO) provided that the consumption of alcohol is a risk factor for at least sixty body disorders among them liver diseases, cancers , and cardiovascular diseases (Alcohol and Public Policy Group, 2010). The report also provided that harmful consumption of alcohol leading to various health issues represent a substantial economic, social, and health burden in various nations. This has resulted in the shift on international public health priorities to enhance the control of alcohol consumption and its effects. The adverse effects of alcohol consumption has depicted it as a critical public health issue that requires the international community to come up with effective measures and policies to reduce the burden caused by alcohol consumption.
Background
Public health is an integrate measure of many different factors affecting society. Globally, the challenges of upholding public health are ever increasing, making public health issues one of the major concerns in both the developed and developing nations. Psychoactive substance use such as alcohol consumption is one of such health issues that have detrimental impacts on people’s health (Jernigan et al., 2000). Global public health is one the critical aspects of humanity. In the age of globalization, it entails putting appropriate measures in place to protect human life, improve quality of life, and enhance the well-being of future generations. Global health is faced by all sorts of threats, many of which can be controlled by the combined efforts of people in communities as well as enacting effective policies. Government agencies, advocates, volunteers, educators, nurses, and doctors have a responsibility to combat these threats. Alcohol consumption is one of the threats facing global health in the 21st century (Alcohol and Public Policy Group, 2010). Excessive use of alcohol has resulted in extensive cases of morbidity and mortality in the vast majority of human population. The global burden of alcohol consumption is vast, with major detrimental impacts on the quality of life. On the individual level, alcohol consumption has a detrimental impact on the state of the health and the quality of life, but on the international level, is a burden on public health. Public health experts argue that global health in contemporary society is than medicines and vaccines hence the world would be made safer by investing on global health (Alcohol and Public Policy Group, 2010).. By eliminating major public health issues, the global community eliminates many of the root causes of economic instability, civil war, terrorism, and other unrests (Alcohol and Public Policy Group, 2010) Good public health entails improving quality of life and enhancing people’s welfare to enable them flourish by reaching their full potential.
The harmful and hazardous use of alcohol has emerged as one of the critical risks to public health. According to the 2002 report by the WHO, alcohol consumption is the leading risk factor in third world countries with low rates of mortality and ranks third in established countries. While the consumption of alcohol is deeply embedded in a number of societies, drinking patterns have changed significantly over the recent years (Allen et al., 2014). For instance, heavy episodic drinking, drinking to excess, and rates of consumption among young people and the general public are on the rise across the world. Health issues attributable to alcohol consumption have so far reached alarming levels. Notably, the consumption of alcohol contributes to a wide range of health conditions, diseases, and high risk-behaviors, from unsafe sexual behavior and liver diseases to road traffic injuries and mental disorders (Babor et al., 2017. Alcohol use is also related to emotional anguish that affects society. For instance, children brought up by individuals with serious alcohol consumption are at a high risk for health and educational problems. Moreover, heavy alcohol consumption contributes to poverty, criminal activity, homelessness, and unemployment.
The detrimental impacts of alcohol on public health include unsafe sex, drug use, drunk driving, psychiatric illness, disability, violence, injury, disease, premature death and social problems. Besides, alcohol has been scientifically confirmed as a human carcinogen (Mäkelä et al., 2015). According to the International Agency for Research on Cancer, alcohol results in the cancer of the breast, colon-rectum, liver, esophagus, larynx, pharynx, and oral cavity (Wild, 2014). This evidence is a justification to recommend the avoidance of any alcohol consumption. Despite being responsible for 4.6% of disability cases across the world and 3.8% of global deaths in 2004, alcohol consumption has been rising rapidly across the world (Wild, 2014). In 2012, alcohol consumption was responsible for 5.9% of global deaths (3.3 million deaths). This exceeds the proportion of global deaths from tuberculosis (1.7%), violence (0.9%), and HIV/AIDS (2.8%) put together (Wild, 2014). According to the 2014 report by WHO, alcohol consumption accounted for 5.1% of all years of potential life lost globally in 2012 as a result of disability and premature mortality (Allen et al., 2014). In this regard, effective policies such as banning alcohol promotion and advertisement as well as increasing taxation should be put in place by the international community.
Surveys on drug and substance abuse across the world have revealed that cases of alcohol abuse are rampant among the young adults particularly the adolescents and college students who engage in dangerous drinking practices. They end up with poor performances and dropping out of school. Besides facing adverse health effects, these people are faced with sexual and suicide related risks (Allen et al., 2014). Alcohol consumption has for a long time been a critical global health issue. Alcohol abuse has led to the widespread of various unpleasant activities across the world to the extent of attracting global attention by both the general public and the governments. However, policymakers are yet to develop effective strategies necessary to combat high rates of alcohol consumption. Notably, the existing measures such as the monopolization of sales through state agencies and restricting the alcohol market (Babor et al., 2017) to regulate substance availability have not been working effectively to curb the issue. Although these measures help minimize the rate of exposure they are quite costly. Based on the full-cost model, alcohol’s reduced availability often leads to an increase in the cost of the product to consumers thereby resulting in decreased use as well as purchase. It is also apparent the cost of policy administration is at times higher resulting in delays hence increasing the rate of alcohol exposure.
Main Body
Alcoholic drinks cannot be considered ordinary beverages or consumer commodities since they consist of a drug that causes substantial social, psychological, and medical harm by means of dependence, intoxication and physical toxicity. (Babor et al., 2017) Growing scientific evidence has depicted the detrimental impacts of alcohol use prior to adulthood on the cognitive, mental, social functioning and brains of young people and is likely to increase adult alcohol dependence as well as issues associated with alcohol among those who consume alcohol before they fully mature physiologically. Binge drinking and regular alcohol use in adolescents can adversely impact sexual performance and behavior, increase crime rates, and negatively impact school performance (Babor et al., 2017). Heavy drinkers and individuals with alcohol dependence problems demonstrate a significant number of issues associated with alcohol consumption. However, non-dependent ‘social drinkers’ are associated with most of the alcohol related issues because they intention of their hazardous drinking behavior is to become intoxicated. Over the past years, important constraints on alcohol production, patterns of consumption, and mass marketing of alcoholic beverages have been weakened leading to increased alcohol availability and accessibility hence the changes in drinking patterns globally (Babor et al., 2017). This has led to a global health issue that urgently need medical, health care, citizen, and governmental intervention.
In contemporary society, it is apparent that alcohol consumption has a wide array of critical health issues such as liver cirrhosis and injuries sustained due to automobile accidents. However, liver cirrhosis and car crash sustained injuries are not the only health issues related to alcohol consumption. Alcohol use accounts for diseases-causing factors in humans. For instance, excess drinking has been related to various illnesses such as dementia cardiovascular, anemia, and cirrhosis (Babor et al., 2017). Alcohol abuse has also been related to a decrease in red blood cells that are responsible for the transportation of oxygen in the body. This decrease leads to a condition known as anemia and is characterized by fatigue, shortness of breath and lightheadedness. Moreover alcohol abuse among the bingeing has been associated with the clumping of platelets leading to the formation of blood clots that are responsible for heart attacks and stroke. The established study by Mäkelä et al. (2015) has found that binge drinking increases the risk of heart attack especially among people with the history of heart attack. Alcohol abuse also leads to cardiomyopathy, a condition that is characterized by weak heart muscles thereby increasing the risk of heart failure.
According to research by Sagvolden (2005), human brain shrinks with time as one grows older. Normally, it shrinks at an average rate of 1.9% every ten years. However, excess alcohol consumption often speeds the shrinking rate leasing to memory loss and dementia (Babor et al., 2017). Besides, excess alcohol consumption leads to a wide range of mental issues such as depression, self-harm, and suicides. Contrary to the misguided conception that anxiety and stress can be reduced by consuming alcohol, extensive research by Sinha (2016) show that alcohol is associated with high stress levels. Continuous alcohol abuse alters neurotransmitters in a person’s brain hindering it from dealing with stressful situations. Alcohol abuse leads to a decrease in serotonin levels in a person’s brain which is responsible for mood regulation. People who are prone to anxiety and depression are likely to develop a drinking problem while heavy drinkers have a higher risk of developing depression (Babor et al., 2017). In this regard, alcohol abuse adversely affects relationships with one’s friends and family.
Alcohol consumption adversely affects the social, psychological, and physical health of individuals, their families, and society at large. Alcohol accounted for about 3.5 and 4.6 percent of the disability-adjusted life years lost 1990 and 2004 respectively (Babor et al., 2017). This indicates that its effects are more detrimental than that of tobacco and other illegal drugs. Alcohol, therefore, is a risk factor to global public health on a level with malaria, tuberculosis, and measles (Cecchini & Belloni, 2020). The consumption of alcohol may contribute to social, psychological, and physical harm for both non-drinkers and drinkers, and can cause damage to nearly every system and tissue in the body (Cecchini & Belloni, 2020). Harm caused to the drinkers includes methanol toxicity, ethanol toxicity, alcoholic liver cirrhosis, alcoholic gastritis, alcoholic cardiomyopathy, alcoholic polyneuropathy, alcoholic dependence syndrome, and alcoholic psychosis (Keyes et al., 2015). There are relations between the consumption of alcohol and cancers of the breast, liver, esophagus, larynx, pharynx, and oral cavity. Stroke, high blood pressure, heart disease, pancreatic inflammation, fibrosis, and atrophy may also be caused by alcohol consumption (Cecchini & Belloni, 2020). Harm from alcohol consumption for non-drinkers may start prenatally in the form of fetal alcohol effects as well as fetal alcohol syndrome. Both non-drinkers and drinkers may suffer from the consequences alcohol consumption. For instance, by drowning, suicides, burns, and traffic crash. While there is a complex causal connection between criminal behavior and alcohol, crimes of violence are strongly associated with alcohol consumption (Keyes et al., 2015). Alcohol consumption may also be associated with a variety of social problems such as homelessness, child abuse and family violence, high rates of absenteeism, and loss of productivity.
With the continuous increase in the globalization of alcohol production, marketing and trade, there is need for alcohol control policy which should be understood from both national perspective and the international purview. Alcohol science should also focus on policy research to provide insight into the international perspective of alcohol control policy (Jernigan et al. 2000). In the past five decades, there has been a considerable progress in the scientific understanding of the association between human health and alcohol. Ideally, there should be a public debate based on the scientific facts obtained from the cumulative research evidence to enhance an effective formulation of governmental policy. However, the relevance of this cumulative evidence tends to go unrecognized as much of the information ends up in academic publications (Keyes et al., 2015). Alcoholic drinks are not that bad; they are an essential economically embedded commodity. This commodity is a source of employment for people in the agricultural sector, restaurants and bars. It is also a source foreign currency due to exported alcohol beverages. However, the economic benefits associated with alcohol production, sale, and consumption come at a huge cost to individuals, family, and society at large.
Alcohol-related issues do not only adversely affect alcohol dependent people, but also affects the general public. It is therefore important to direct the public health action at the whole drinking community. The world medical Association-WMA statement on reducing the global impact of alcohol on health and society (2018) provides that as alcohol-related issues are caused by many factors; arise in various situations and impact on a diverse range of people in various nations, settings, and cultures, alcohol policies should be formulated on the basis of reliable data in each location. It is also necessary to consider political acceptance and political feasibility when formulating policies (Jernigan et al., 2000). Treating persons who have been adversely affected by alcohol consumption should be regarded as part of society’s social care responsibilities (Jernigan et al., 2000). There is strong evidence on the effectiveness of existing measures that limit alcohol availability. However, in the contemporary society characterized by ideology of free markets and consumer rights, such measures tend to attract the least political popularity. On the other hand, measures with high political popularity such as public information campaigns and education of school students tend to demonstrate the least evidence of effectiveness.
Over the past three decades, some alcohol control policies have been formulated by a substantial body of scientific evidence and practical experience. These policies include the increase in the real price of alcoholic beverages as well as imposing high taxes on these commodities (Keyes et al., 2015). Also, restricting the consumption of alcohol by controlling its availability through measures such as restricting the opening hours, number, and types of outlet selling or serving alcoholic drinks; the rationing of availability; retailing monopolies or the organization of production; and minimum drinking age legislation (Babor et al., 2017). Another policy involves deterring alcohol-related problems though effective measures. For instance, drink-drive laws to combat car accidents. Other measures include severe intervention which involves training alcohol venders to observe the set policies regarding serving of alcohol to various people (Jernigan et al., 2000). According to Babor et al. (2017), the policies set by the substantial body ought to include other appropriate measures such as controlling the times, locations and types of alcohol advertising; placing strict measures on product quality; educating the public on the detrimental impacts of alcohol consumption through active measures ( such as social marketing campaigns and mass media) and passive measures such as warning labels; enhancing the implementation of effective controls against the illicit production and sale of alcohol; and increasing access to affordable and effective rehabilitation and treatment services.
According to many addiction theories, craving plays a critical role in acquiring and maintaining drug dependence. The theories depict craving as the motivational state’s subjective experience directly responsible for alcohol consumption. Paying attention to the cognitive model, it is apparent that the cognitive processes control a multitude of activities that people engage on a daily basis. Although it may appear essay to play, work, drive, read, talk, walk, eat, cook, dress, and groom, none of these activities is a simple skill (Neenan, 2018). Most of the human beings’ activities are automatized are in this way so they may not easily remember their performance level when they started acquiring these skills. Notably, at the start, people’s executions of these activities seem to be awkward, hesitant, and cognitively challenging. Therefore, it required a significant effort, focused attention, and vigilance as they practice on a regular basis, people’s performance changes and what was once clumsy and demanding becomes effortless and highly coordinated (Neenan, 2018). As provided in the cognitive model, this transformation of performance due to regular practice is a representation of the transition from non-automatic to automatic modes of functioning. In this regard, alcohol dependence is an automated mode of functioning.
A powerful trend in the alcoholic beverages industry is the revelation that people have begun to drink less and particularly young drinkers have chosen to consume less alcohol due to the detrimental effects on heath (Costello et al., 2008). This has is leading to increased use of alcohol-free products. Moreover, some regions in the world are currently experiencing reduced grape yields and this has significantly affected the win industry in maintaining its legendary production.
The WHO is left with a sole responsibility to provide leadership on global alcohol policy. It has an important role to play by encouraging the production of data for bridging major knowledge gaps, especially pertaining to developing societies (Cecchini & Belloni, 2020). The setting of societal priorities requires enough evidence on alcohol consumption in association with various kinds of health and social harm (Jernigan et al., 2000). Precise data is critical in the development of political will for action. The WHO is also responsible for identifying, documenting, publicizing and building capacity to implement appropriate measures across the whole range of interventions. The organization is also tasked to examine the available information and provide necessary assistance on the control of alcohol as well as prevention and treatment strategies (Cecchini & Belloni, 2020). Moreover, the WHO is responsible for building and using mechanisms by which the public health interest in the production, marketing, and trade of alcoholic beverages may be taken into account. In this era characterized by a continuous increase in global economy, the control of alcohol is considered an international matter. National measures such as high taxes and drinking age legislations are losing their effectiveness due to the increased permeability in national borders and the expansion of the geographical reach of particular marketers (Jernigan et al., 2000). There should be an international agreement on the appropriate strategies against alcohol smuggling.
Countries use various policies to control the marketing and advertising of alcohol. The most common is co-regulation and self-regulation, in which the major responsibility for the regulation of alcohol marketing is facilitated by the alcoholic beverage industry (Mathers & Bonita, 2009). In this regard, countries need to report self-regulation and regulation of alcohol marketing and advertising in various media categories such as points of scale, billboards, printed magazines and newspapers, local radio, national radio, commercial and private television, public service and national television, cinemas and the internet (Mathers & Bonita, 2009). In this regard, producers, distributers and markers of alcoholic beverages have to comply with the policies in respective countries. For instance, Diageo Alcohol Company has to observe policies for alcohol control. The company has accumulated so much political and financial power hence having the capability to alter and block policies that promote sustainable public health, social justice and sustainable development. However, through putting strict measures on the enforcement of these policies, multinational alcohol companies such as Diageo will have to comply.
Conclusion
Despite its acceptance as drug of dependence, alcohol has been found as a risk factor and probable cause of more than sixty various forms of illnesses as well as injuries and mental disorders. The adverse effects of alcohol consumption have depicted it as a critical public health issue that requires the international community to come up with effective measures and policies to reduce the burden caused. Although various policies required to control alcohol-related issues have to be implemented at the subnational and national levels, global leadership should be incorporated to minimize the impact of alcohol consumption on disability, morbidity, and mortality. In the realm of advance, it is necessary to have an effective global awareness campaign based on the compelling evidence of both the detrimental impact of alcohol consumption and the policies that are likely to combat the alcohol-related harm.
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