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Efforts by alcoholic beverage makers to boost sales by appealing to younger drinkers contribute to drinking patterns that are harmful to health, said experts at a panel discussion on "Alcohol, Chronic Noncommunicable Diseases and Public Health," held this week at the Pan American Health Organization (PAHO).

While alcoholic beverage makers say their ads are aimed only at consumers who are at or over the legal purchase age, research shows that viewing of alcohol ads by under-age youths has increased by nearly 70 percent over the past decade, said David Jernigan, associate professor at the Johns Hopkins Bloomberg School of Public Health.

In addition, some of the fastest-selling categories of alcoholic beverages—such as "alcopops," alcohol energy drinks, and whipped cream alcohol drinks—are purchased disproportionately by younger drinkers. Some of these drinks contain the equivalent of as much as five servings of alcohol in a single can. At the same time, younger drinkers are much more likely than older drinkers to consume large quantities of alcohol over short periods of time, a pattern that significantly increases the risk of injuries and ill health effects.

"Young people in the U.S. are not drinking a glass of wine with their parents at dinner," said Jernigan. "They are drinking to become intoxicated."

Jernigan was one of five experts who participated in the May 2 panel discussion, which focused on alcohol marketing, patterns of consumption, alcohol-related health problems, and public health action to mitigate alcohol's harmful effects, with emphasis on noncommunicable diseases in the Americas
In the Americas as a region, alcohol consumption is on average more than 50 percent higher than worldwide consumption, and the prevailing pattern is irregular heavy drinking—the most harmful type of consumption, said Jurgen Rehm of the Centre for Addiction and Mental Health in Toronto, Canada. These patterns cancel out the protective effects that moderate drinking can have on heart disease, said Rehm.

As a result of harmful consumption patterns, alcohol is now the Americas' number-one risk factor for the total burden of disease—including cancers, stroke, heart disease, diabetes, liver cirrhosis and pancreatitis—and the fifth-leading cause of premature death across all age and sex groups, said Maristela Monteiro, PAHO senior advisor on alcohol and substance abuse. The globalization of alcohol production and marketing have contributed to steady increases in alcohol consumption in the Americas, along with the fact that few countries in Latin America have strong policies on sales and marketing of alcohol, she said.

Compounding the effects of alcohol consumption on chronic disease is the fact that people who consume alcohol are less likely to comply with medically recommended treatment for chronic conditions, said Patrice Vaeth, assistant professor at the University of Texas School of Public Health. Her study of Mexican-Americans with diabetes in the U.S.-Mexico border area found that alcohol consumption was associated with non-adherence to diabetes prevention practices including daily glucose self-monitoring and yearly medical check-ups.

To mitigate the negative health impacts of alcohol consumption, public health practitioners have been developing policies and tools aimed at reducing consumption and improving treatment. Among the most effective of these are controls on marketing and availability of alcohol and, in the health sector, screening and "brief interventions" incorporated into primary healthcare services, said Thomas Babor, professor of community medicine and public health at the University of Connecticut medical school. These interventions allow physicians to identify patients at risk of harmful alcohol use and to advise those patients to reduce consumption or refer them to specialized care.

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