Drinking alcohol poses significant health risks and has no benefits for young adults

Man refuses beer no alcohol

A new study finds that young people (under the age of 40) face greater health risks from alcohol use than older adults.

  • The new Global Burden of Disease analysis estimates that 1.34 billion people will have consumed harmful amounts of alcohol (1.03 billion men and 0.312 billion women) in 2020.
  • The analysis suggests that for young adults aged 15-39, there are no health benefits to drinking alcohol, only health risks. 59.1% of people who consumed unsafe amounts of alcohol in 2020 were between the ages of 15 and 39, and 76.7% were male.
  • Given the complex relationship between alcohol and disease and different background rates of disease around the world, the risks of alcohol consumption vary by age and by geographic location, the authors note.
  • Health risks of alcohol consumption vary by age and region for adults over the age of 40. Consuming a small amount of alcohol (for example, drinking between one and two 3.4 ounce glasses of red wine) for people in this age group may provide some health benefits. such as reducing the risk of cardiovascular disease, stroke and diabetes.
  • Researchers are calling for a revision of alcohol consumption guidelines to emphasize consumption levels by age. They emphasize that the level of alcohol consumption recommended by many existing guidelines is too high for young people in all regions. They also advocate policies targeting men under the age of 40, who are most likely to be harmful to alcohol use.

According to a new analysis published in

Based on estimates of alcohol use in 204 countries, researchers calculated that 1.34 billion people worldwide consumed harmful amounts in 2020. In each region, the largest proportion of the population who drank unsafe amounts of alcohol was men aged 15-39. For this age group, drinking alcohol offers no health benefits and carries many health risks. In addition, 60% of alcohol-related injuries occur in people in this age group, including motor vehicle accidents, suicides, and homicides.

“Our message is simple: young people should not drink, but the elderly can benefit from drinking small amounts. While it may not be realistic to think that young adults will abstain from drinking, we think it’s important to communicate the latest evidence so everyone can make informed decisions about their health,” said senior author Dr. Emmanuela Gakidou, Professor of Health Metrics Sciences. at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington‘s School of Medicine.[2]

The Lancet Alcohol Consumption Infographic

Drinking alcohol has significant health risks for young people, small amounts may be beneficial for some older adults. New analysis suggests that recommendations for how much to drink should be based on age and local disease rates. Credit: The Lancet

Age and region should guide alcohol consumption policy

The researchers looked at the risk of alcohol use on 22 health outcomes, including injuries, cardiovascular disease and cancers[3] using 2020 Global Burden of Disease data for men and women aged 15-95 years and older between 1990 and 2020, in 204 countries and territories. From this, the researchers were able to estimate the average daily intake of alcohol that minimizes the risk to a population. The study also estimates another critical amount: how much alcohol a person can drink before taking too much of a risk to their health compared to someone who doesn’t drink alcohol.

The recommended amount of alcohol for people aged 15-39 before risking health loss was 0.136 standard drink per day (just over a tenth of a standard drink). For women aged 15-39, that amount was slightly higher at 0.273 drinks (about a quarter of a standard drink per day). One standard drink is defined as 10 grams of pure alcohol, which is equivalent to a small glass of red wine (100 ml or 3.4 fluid ounces) with 13% alcohol by volume, a can or bottle of beer (375 ml or 12 fluid ounces) with 3 .5% alcohol by volume, or a shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) containing 40% alcohol by volume.[1]

The analysis also suggests that for adults age 40 and older with no underlying health conditions, drinking a small amount of alcohol may provide some benefits, such as reducing the risk of ischemic heart disease, stroke and diabetes. Overall, levels of safe alcohol consumption for individuals aged 40-64 in 2020 ranged from about half a standard drink per day (0.527 drinks per day for men and 0.562 standard drinks per day for women) to nearly two standard drinks (1.69 standard drinks per day). . day for men and 1.82 for women). For individuals over 65 years of age in 2020, the risks of health loss from alcohol consumption were reached after consuming just over three standard drinks per day (3.19 drinks for men and 3.51 for women). The estimates suggest that small amounts of alcohol consumption in populations over the age of 40 without underlying conditions may be associated with improved health outcomes, especially in populations primarily affected by a higher burden of cardiovascular disease.

The disease burden distribution for a given age group varied significantly between regions, resulting in variations in the risks of alcohol consumption, particularly among individuals 40 years of age and older. For example, among individuals aged 55-59 in North Africa and the Middle East, 30.7% of alcohol-related health risks were attributable to cardiovascular disease, 12.6% to cancer and less than 1% to tuberculosis. In contrast, in the same age group in central sub-Saharan Africa, 20% of alcohol-related health risks were attributable to cardiovascular disease, 9.8% to cancer and 10.1% to tuberculosis. As a result, consumption levels for this age group before the risk of health loss were 0.876 drinks (or nearly one standard drink per day) in North Africa and the Middle East and 0.596 drinks (about half a standard drink per day) in central sub-Saharan Africa. .

Overall, the recommended alcohol intake for adults remained low, between 0 and 1.87 standard drinks per day, regardless of geography, age, gender or year.

“Even if a conservative approach is taken and the lowest level of safe consumption is used to make policy recommendations, it means that the recommended level of alcohol consumption is still too high for younger populations. Our estimates, based on currently available evidence, support guidelines that vary by age and region. Understanding the variation in levels of alcohol consumption that minimizes the risk of health loss to the population can help establish effective consumption guidelines, support alcohol control policies, monitor progress in reducing harmful alcohol consumption, and design messages about risks to public health,” said lead author Dana Bryazka, a researcher at IHME.

Young men are most at risk of harmful alcohol use

Using these estimates, the proportion of the population consuming alcohol in amounts exceeding these thresholds was also calculated based on location, age, gender, and year, and served as a guideline for targeting alcohol control efforts.

Of those who consumed harmful amounts of alcohol in 2020, 59.1% were aged 15-39, and 76.7% were male, with 1.03 billion men and 0.312 billion women drinking harmful amounts of alcohol. Harmful alcohol use was particularly concentrated among young men in Australia, Western Europe and Central Europe.

“While the risks of alcohol use are similar for men and women, young men stood out as the group with the highest levels of harmful alcohol use. This is because a greater percentage of men drink alcohol than women and their average consumption level is also significantly higher,” he says. Dr. Gakidou.

The authors acknowledge some limitations of this paper, including the fact that drinking patterns have not been studied. Therefore, this study did not distinguish between individuals who rarely drink heavily episodic and those who consume the same amount of alcohol over several days. Alcohol consumption was also self-reported, which could have caused bias, and the study was unable to include data on consumption during the[{” attribute=””>COVID-19 pandemic due to pandemic-related delays with routine data collection, which could also have affected these estimates.

Writing in a linked Comment, Robyn Burton and Nick Sheron of King’s College London (who were not involved in the study) say, “These findings seemingly contradict a previous GBD estimate published in The Lancet, which emphasized that any alcohol use, regardless of amount, leads to health loss across populations. There are three main differences between the two GBD publications. First, the most recent study uses data from 2020 instead of 2016. Second, the relative risk curves for five alcohol-related outcomes have been updated. However, neither of these changes is driving the differences in results. Instead, the differences are due to the novel method of weighting relative risk curves according to levels of underlying disease, alongside the calculation of more disaggregated estimates by sex, age, and geographical region. The causes that contribute to all-cause mortality vary across groups, and this changes the proportional risk of alcohol on mortality. Across most geographical regions in this latest analysis, injuries accounted for most alcohol-related harm in younger age groups. This led to a minimum risk level of zero, or very close to zero, among individuals aged 15–39 years across all geographical regions. This is lower than the level estimated for older adults, due to a shift in alcohol-related disease burden toward cardiovascular disease and cancers. This highlights the need to consider existing rates of disease in a population when trying to determine the total harm posed by alcohol.”


This study was funded by the Bill and Melinda Gates Foundation. A full list of GBD 2020 Alcohol Collaborators is available in the paper.

[1] One standard drink is defined as 10 grams of pure alcohol. Examples are:

  • A small glass of red wine (100 ml or 3.4 fluid ounces) with 13% alcohol by volume;
  • A can or bottle of beer (375 ml or 12 fluid ounces) with an alcohol content of 3.5%;
  • A shot of whiskey or other spirits (30 ml or 1.0 fluid ounces) with an alcohol content of 40%.

[2] Quote directly from author and cannot be found in the text of the article.

[3] These health problems include:

  • Ischemic stroke, intracerebral hemorrhage, ischemic heart disease, hypertensive heart disease, atrial fibrillation and flutter;
  • Cancers including: lip and oral cavity cancer, nasopharynx cancer, other pharyngeal cancer, esophageal cancer, larynx cancer, colon and rectal cancer, breast cancer, liver cancer;
  • Type 2 diabetes, cirrhosis and other chronic liver diseases, pancreatitis, idiopathic epilepsy, tuberculosis;
  • Transport injuries, accidental injuries, self-harm and interpersonal violence.

Reference: “Risks of Alcohol Use by Population Level by Amount, Geography, Age, Gender, and Year: A Systematic Analysis for the Global Burden of Disease Study 2020” by GBD 2020 Alcohol Collaborators, Jul 16, 2022, The Lancet.
DOI: 10.116/S0140-6736(22)00847-9

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