Alcohol and tobacco are the substances consumed around the world that do the most damage to human health. That, according to a report on the usage of illicit and licit (illegal and legal) drugs published in the scientific journal Addiction.
By Alexandra Bachot
The substance most abused among the adult population was alcohol. Fully 18.3% of the adult population abused alcohol (“heavy episodic alcohol use in the past 30 days” says the report). This was closely followed by daily tobacco use, with 15.2% of adults smoking at least once a day. Illicit substance use such as cannabis (3.8%) and cocaine (0.35%) landed well behind usage rates of licit drugs.
This 2018 study looked at usage rates in 2015, when the opioid crisis in North Amercia was much less serious than it is today.
There were geographic differences in these usage rates. Whereas in all parts of Europe consumption of alcohol and tobacco were the highest in the world, in North America, use of cannabis, opioids and cocaine were among the highest in the world.
“Disability-adjusted life-years” (DALYs), a metric presented in this report, corresponds to the number of years of good health lost to illness, a disability, or an early death. In terms of damage to human health, the numbers are beyond debate: 170.9 million years of good health are lost to tobacco; 85 million years are lost to alcohol; and 27.8 million years are lost to illicit drugs.
To summarize: in 2015, alcohol and tobacco cost humanity over a quarter of a billion disability-adjusted life years. European countries suffered proportionately more, the study says, but mortality rates were higher in low and middle income countries.
The availability and cultural acceptability of alcohol and tobacco are essential factors in explaining why so many people consume these drugs. “Their consumption is considered perfectly normal in western countries,” says Robert West, one of the authors of the study.
Indeed, mortality rates for these substances are high. For tobacco, it’s 110.7 deaths per 100,000 persons each year, followed by alcohol (33.0 deaths per 100,000) and illicit drugs (6.9 deaths per 100,000).
Robert West observes: “In the West we may think we live in civilized societies, but behaviors we see as normal kill way more people and cause more human misery than things that shake us up like terrorism.”
The costs of alcohol and tobacco consumption don’t end there. The study also says: “Their health burden is accompanied by significant economic costs, namely expenditure on health care and law enforcement, lost productivity and other direct and indirect costs, including harm to others.”