title: Alcohol consumption in the Arab region: What do we know, why does it matter, and what are the policy implications for youth harm reduction?
abstract: Alcohol is a recognized global risk factor for many diseases and injury types and a major contributor to disability and death. While cost-effective interventions do exist, many countries lack a comprehensive national alcohol harm reduction policy. The Arab world includes 22 diverse countries stretching from North Africa to Western Asia having varying dispositions with regards to alcohol sale and consumption. Epidemiological data is scattered and the picture on alcohol consumption remains blurry. This paper presents the findings of an extensive review conducted on all 22 Arab countries, specifically describing: (1) the density and methodology of alcohol-related peer-reviewed publications over the last two decades (1993-2013); (2) the epidemiology of alcohol consumption given all available data; and (3) the current status of policies in the region. Our search revealed a strikingly low number of alcohol-related peer-reviewed published studies - a total of 81 publications across 22 countries and two decades. Most studies are based on clinical or student samples. Where data is available, age of onset is low and drinking is frequent, in the absence of any available or enforced harm reduction policies. We submit that countries in the Arab region can be divided into four categories by alcohol ban and published data. One category includes countries where alcohol is not banned but data is absent, suggesting an ostrich-like response to a controversial behavior, or reflecting a weak research infrastructure and/or policy landscape. Evidence-informed recommendations and future directions for policy and research are discussed and tailored to countries' current stance on alcohol legislation and consumption. Given the particular vulnerability of youth to uptake of alcohol as well as the resulting short and long term consequences, the paper concludes by focusing on the implications of the findings for youth alcohol harm reduction.
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Lilian
authors.initials: L
authors.lastname: Ghandour
authors.affiliation: Department of Agricultural Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Ali
authors.initials: A
authors.lastname: Chalak
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Aida
authors.initials: A
authors.lastname: El-Aily
authors.affiliation: Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Nasser
authors.initials: N
authors.lastname: Yassin
authors.affiliation: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Rima
authors.initials: R
authors.lastname: Nakkash
authors.affiliation: Office of the Dean, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Mitra
authors.initials: M
authors.lastname: Tauk
authors.affiliation: Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Noura
authors.initials: N
authors.lastname: El Salibi
authors.affiliation: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon.
authors.forename: Meghan
authors.initials: M
authors.lastname: Heffron
authors.affiliation: Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon. Electronic address: ra15@aub.edu.lb.
authors.forename: Rima
authors.initials: R
authors.lastname: Afifi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology*; D018643:Arab World; D040261:Harm Reduction; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans
keywords: Alcohol; Arab; Harm reduction; Policy