The value of prevention: reducing alcohol consumption

Alcohol use contributes significantly to Australia’s health burden as well as contributing billions of dollars each year in health care and non-healthcare economic costs. Primary prevention strategies that target the significant problem of alcohol consumption in Australia have many health, social, economic and other benefits for governments, businesses, communities and individuals.

Dr Elly Howse, Research Manager at the Prevention Centre and Nikki Woolley, Skin and Lifestyle Portfolio Manager at Cancer Institute NSW, discussed the results of the research in our Prevention Works podcast exploring the value and challenges of prevention for reducing alcohol consumption and misuse in Australia.

Dr Howse concedes there is more work to be done in establishing economic evidence on the value of prevention in regards to alcohol use and harms. “There’s lots of economic evidence and evaluations of interventions targeting tobacco use and obesity but there’s much less in regard to alcohol use,” she said.

In 2021 the Prevention Centre produced an Evidence Review on the value of prevention with a full literature review outlining the burden of death and disability attributed to overweight and obesity, unhealthy diet, physical inactivity, tobacco use and smoking. This review quantified the burden on government, businesses and communities including deaths per year in Australia and potentially in NSW, attributable percentage of overall disease burden, annual productivity loss and attributable health expenditure.

Our new evidence check, with Deakin University, focused on the burden associated with alcohol consumption and the economic and health benefits associated with primary prevention strategies for alcohol consumption. It identified numerous co-benefits to addressing and preventing alcohol use and harms including mental wellbeing and social benefits. Where economic evidence does exist, it tended to find that preventive interventions are cost-effective, if not cost saving.

“We have demonstrated if government were to implement these types of interventions, here are the benefits that would accrue and this is the dollar figure that we’re able to put on those benefits for the community and not only is this intervention cost effective but it might also be cost saving.”

Dr Elly Howse, Research Manager

Globally, it is estimated three million deaths per year and 5.1% of the global burden of disease are caused by the harmful use of alcohol. More than 4% of all deaths in Australia were attributable to alcohol in 2018. In Australia, alcohol use is the fifth highest modifiable risk factor causing preventable health burden after tobacco use, overweight including obesity, all dietary risks and high blood pressure.

Alcohol is a known carcinogen for humans and causes many types of cancers including:

• Liver cancer
• Nasopharyngeal cancer
• Lip and oral cavity cancer
• Other oral cavity and pharynx cancers
• Laryngeal cancer
• Oesophageal cancer
• Bowel cancer
• Breast cancer

In Australia over the next decade, it is projected that 15,000 cancers will be attributable to consumption of more than two alcohol drinks per day.

“This is a collection of research on the value of reducing alcohol use, tailor-made for the needs of government policy-makers and other decision-makers. It serves as a reference document summarising the health and economic burden of alcohol use in Australia, as well as the evidence on the effectiveness and cost-effectiveness of actions that can be taken to reduce this burden.”

Paul Crosland, Senior Research Fellow.

The other main causes of alcohol-related health burden are injuries, alcohol use disorder, road traffic injuries for cyclists, drivers, passengers and pedestrians. Most of the available evidence indicates that the more effective interventions to reduce the harms from alcohol use and consumption are comprehensive, multi-component strategies, targeting alcohol supply and use, and targeting populations and individuals.

The Prevention Centre launched this new Evidence Review at the PHAA Preventive Health Conference 2022 and also announced a new research project on liquor licensing in NSW to establish the cost of alcohol-related harms to a local area. Partnering with Deakin University, The North Sydney Local Health District together with the Central Coast Local Health District and the Prevention Centre will analyse international evidence on the associations between outlet density and harms with NSW-specific data on local area characteristics from national, state or local administrative data, such as the Australian Urban Observatory, NSW Health, Bureau of Crime Statistics and Research, and Liquor and Gaming.

The findings of the analysis will enable NSW Health to compare costs to health at a local level against the economic benefits generated by the existing liquor licences in that community. It is hoped this evidence will strengthen the quality of decisions in responding to liquor licence applications improving health outcomes in the community.