Intended for healthcare professionals


Alcohol must be recognised as a drug

BMJ 2018; 362 doi: (Published 20 September 2018) Cite this as: BMJ 2018;362:k3944
  1. Kypros Kypri, professor1,
  2. Jim McCambridge, professor2
  1. 1School of Medicine and Public Health, University of Newcastle, Australia
  2. 2Department of Health Sciences, University of York, UK
  1. Correspondence to: K Kypri kypros.kypri{at}

To strengthen policy responses to harms caused by addiction industries

Alcohol, actually ethanol (C2H5OH), is a psychoactive molecule ingested by 2.4 billion people globally.1 A central nervous system depressant, it exists naturally and can be produced in people’s homes. Any alcohol consumption confers health risks, including for a range of cancers,2 and any possible cardiovascular benefits are smaller than was previously understood.3 Alcohol harms users through intoxication, organ toxicity, and addiction, which cause an estimated 2.8 million deaths every year.1 In a recent systematic review and meta-analysis the Global Burden of Disease Alcohol Collaborators concluded that the “the level of alcohol consumption that minimised harm across health outcomes was zero.”1

Greater access to alcohol increases consumption and a wide range of health and social problems in a dose-response manner, and the most effective policies are those that increase the price and reduce the availability of alcohol.4 Because such measures threaten commercial interests they are challenging to adopt, and ineffectual policy responses often prevail.5 Broadening how we think about alcohol policies based on clear recognition that alcohol is a drug could have important benefits for public health.

Treating alcohol as a drug

Tobacco companies for decades deflected …

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