Alcohol-attributable mortality in Switzerland in 2011--age-specific causes of death and impact of heavy versus non-heavy drinking.
BACKGROUND
Alcohol use causes high burden of disease and injury globally. Switzerland has a high consumption of alcohol, almost twice the global average. Alcohol-attributable deaths and years of life lost in Switzerland were estimated by age and sex for the year 2011. Additionally, the impact of heavy drinking (40+grams/day for women and 60+g/day for men) was estimated.


METHODS
Alcohol consumption estimates were based on the Addiction Monitoring in Switzerland study and were adjusted to per capita consumption based on sales data. Mortality data were taken from the Swiss mortality register. Methodology of the Comparative Risk Assessment for alcohol was used to estimate alcohol-attributable fractions.


RESULTS
Alcohol use caused 1,600 (95% CI: 1,472 - 1,728) net deaths (1,768 deaths caused, 168 deaths prevented) among 15 to 74 year olds, corresponding to 8.7% of all deaths (men: 1,181 deaths; women: 419 deaths). Overall, 42,627 years of life (9.7%, 95% CI: 40,245 - 45,008) were lost due to alcohol. Main causes of alcohol-attributable mortality were injuries at younger ages (15-34 years), with increasing age digestive diseases (mainly liver cirrhosis) and cancers (particularly breast cancers among women). The majority (62%) of all alcohol-attributable deaths was caused by chronic heavy drinking (men: 67%; women: 48 %).


CONCLUSIONS
Alcohol is a major cause of premature mortality in Switzerland. Its impact, among young people mainly via injuries, among men mainly through heavy drinking, calls for a mix of preventive actions targeting chronic heavy drinking, binge drinking and mean consumption.
Addiction Switzerland, Lausanne, SWITZERLAND; smarmet@addictionsuisse.ch.
Simon
S
Marmet
Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany; Dalla Lana School of Public Health.
Jürgen
J
Rehm
Centre for Addiction and Mental Health (CAMH), Toronto, Canada; School of Electrical Engineering and Telecommunications, Faculty of Engineering, University of New South Wales, Sydney, Australia; National Information and Communications Technology Australia.
Gerrit
G
Gmel
Department of Statistics, Faculty of Economics and Statistics, Universität Innsbruck, Austria.
Hannah
H
Frick
Addiction Switzerland, Lausanne, Switzerland; Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Centre hospitalier universitaire vaudois (CHUV), Lausanne, Switzerland; University of the West of England, Frenchay Campus, Bristol, United Kingd.
Gerhard
G
Gmel
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality*; D000437:Alcoholism / Q000150:complications / Q000401:mortality*; D004066:Digestive System Diseases / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008108:Liver Diseases, Alcoholic / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D012042:Registries; D017678:Sex Distribution; D013557:Switzerland / Q000453:epidemiology; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality; D055815:Young Adult