The Extent of the Problems and the Epidemiological Aspects of Alcohol Drinking
This chapter focuses on medical problems. The alcohol-attributable fraction, a best estimate of the proportion of diseases or injuries that would be eliminated if alcohol did not exist, relies on not only the prevalence of alcohol drinking but also those of other risk factors, and so varies with country and time. These substances can also have physiological and pathological effects, so that epidemiological findings on effects of consuming alcoholic beverages do not necessarily indicate the effect of ethanol itself. The epidemiological measurements include intakes from homemade products and exclude amounts used for purposes other than drinking such as cooking, but are prone to sampling variations. Pancreatitis has long been associated with excessive alcohol drinking, evidenced mainly on the basis of clinical observations. Nutritional deficiencies of both macro- and micronutrients are frequently found in alcoholics and are likely to play an important role in the pathogenesis of alcohol-related diseases. Consumption of alcohol and tobacco is strongly correlated in most societies.