The health burden related to harmful alcohol consumption, both in terms of morbidity and mortality, is considerable in most parts of the world (WHO, 2018[1]; Sassi, 2015[2]). Alcohol use is associated with numerous harmful health and social consequences, including an increased risk of mouth and throat, larynx, oesophagus, colon and rectal, liver and breast cancers, stroke, and liver cirrhosis, among others. Foetal exposure to alcohol increases the risk of birth defects and intellectual impairment. Alcohol misuse is also associated with a range of mental health problems, including depressive and anxiety disorders, obesity and unintentional injuries (WHO, 2024[3]). In 2019, 2.6 million deaths per year were attributable to alcohol consumption, accounting for 4.7% of all deaths. Notably, 2 million of alcohol-attributable deaths were among men (WHO, 2024[3]). However there has been some progress; from 2010 to 2019, the number of alcohol-attributable deaths per 100 000 people decreased by 20.2% globally (WHO, 2024[3]). While many countries set age limits for purchasing or drinking alcohol, lack of enforcement and no age limits in some countries allow young people to access alcohol easily, increasing their consumption and risk of harmful consequences. People of younger age (20‑39 years) are disproportionately affected by alcohol consumption with the highest proportion (13%) of alcohol-attributable deaths occurring within this age group in 2019 (WHO, 2024[3]).
Alcohol accounts for more deaths than TB, HIV/AIDS, hypertension, diabetes, digestive diseases, road injuries and violence (WHO, 2018[1]). The direct and indirect economic costs of alcohol (which include lost productivity, healthcare costs, and road traffic crashes and crime‑related costs) are substantial – in Thailand and Korea these are about 2% of GDP (WHO, 2018[1]; Rhem et al., 2009[4]; Thavorncharoensap et al., 2010[5]).
In Asia-Pacific, alcohol consumption is highest among more developed countries and territories (Figure 4.17, left panel). Adults aged 15 years and over in Australia, New Zealand and Korea consumed over seven litres of alcohol per capita in 2020. In Japan, Lao PDR, Mongolia and Thailand, alcohol consumption was between six and seven litres (WHO, 2024[6]). Because cultural and religious traditions in a number of the remaining countries and territories prohibit drinking alcohol, consumption figures in these are minimal. In some countries and territories, only certain groups of people consume alcohol. In Thailand, for example, only about one‑third of adults drinks alcohol, but still they have the highest per capita alcohol consumption in South-East Asia. (WHO, 2018[1]).
Average consumption increased very slightly by 0.1‑0.2 litres per capita in upper middle- and lower-middle-income Asia-Pacific countries and territories since 2010 (Figure 4.17, right panel), although variations exist across countries and territories. Alcohol consumption declined by more than 0.5 litres per capita in Australia, China, DPRK and Korea. In Cambodia, Fiji, Lao PDR and Myanmar the increase in alcohol consumption per capita was at more than 0.5 litres per capita.
In many Asia-Pacific countries and territories, the proportion of people with binging and heavy drinking has increased in recent years, and on average across countries and territories in the region, one man in two and almost one woman in three reported heavy episodic drinking during the last 30 days in 2020 (Figure 4.18, left panel) (WHO, 2024[6]). In Korea and Lao PDR, more than 65% of males and over 40% of women reported heavy episodic drinking during the past 30 days.
More than 1 in five road traffic deaths were attributable to alcohol in Asia-Pacific in 2019. New Zealand has the highest proportion of road traffic deaths associated with alcohol in the region, followed by Australia and Lao PDR. In all countries and territories in Asia-Pacific, the proportion of road traffic deaths attributable to alcohol was higher, for males than for females. The difference is particularly large in Thailand where the proportion for male (37%) is nearly than twice the proportion for female (20%) (Figure 4.18, right panel). Based on the blood alcohol concentration (BAC) at which crash risk begins to increase exponentially, WHO recommends drink-driving prevention legislation set maximum legal thresholds at 0.05g/dl (WHO, 2019[7]). For novice and probationary drivers, WHO recommendations go further to specify no higher than 0.02 g/dl due to the interaction of alcohol and inexperience. Setting and enforcing legislation on BAC limits of 0.05 g/dl can lead to significant reductions in alcohol-related crashes. Japan sets the limit of 0.03 g/d; and some countries and territories – such as Australia, Fiji, New Zealand and Viet Nam – have limited BAC level to 0g/dl for novice drivers.
