Alcohol as a cross-cutting theme in preventing NCDs in Europe

Introduction

The European Union is the heaviest drinking area in the world. Alcohol has been ingrained in European societies for generations, and is still an important part of traditions, celebrations, and social rituals¹. Unfortunately, the health impacts and risks associated with and caused by alcohol consumption, are eventually well documented.

In the WHO European Region, one in every 11 deaths is due to alcohol consumption. Alcohol can cause over 200 diseases, including seven types of cancer, cardiovascular diseases, neuropsychiatric disorders, liver diseases and several infectious diseases². Cancer is the leading cause of deaths due to alcohol in the EU, and there is no "safe level of consumption". Even moderate use of alcohol increases the long-term risk of diseases and harm³.

Alcohol harms individuals, families, and communities, including those who are affected by other people's drinking, particularly children. The burden of diseases is also unequally distributed across socioeconomic groups. Individuals with low socioeconomic status (SES) experience disproportionately greater alcohol-attributable health harm than individuals with high SES from similar or lower consumption⁴.

As alcohol is integrated in culture and social life, effective prevention strategies need to be implemented across sectors, at all levels, and adopt a life-course approach. This requires multiple stakeholders and actors engaging in coordinated and joint action considering alcohol as a cross-cutting issue.

European context

EU and EEA countries have the main responsibility for their national alcohol policy. At EU level, the Committee on National Alcohol Policy and Action (CNAPA) plays a major role in facilitating cooperation and coordination between EU countries⁵.

To support member states and in response to growing recognition of the health impact of alcohol consumption, the European Commission adopted the first EU Alcohol Strategy in 2006, later assessed in 2009 and 2013. To continue work on key priorities in the strategy, the European Union funded Joint Action on Reducing Alcohol Related Harm (RARHA) in 2014-2016 under the second EU Health Programme.

Harmful alcohol consumption is addressed as a key risk factor in Europe's Beating Cancer Plan. The WHO Regional Office for Europe with support from the European Commission initiated in 2022 the Evidence into Action Alcohol Project (EVID-ACTION), which is contributing to delivering on the objectives of the cancer plan.

Although increased efforts over time, policy makers are often confronted with conflicting perspectives when addressing alcohol-related issues⁶. Industry actors and commercial practices can influence policy decisions and shape public perceptions of alcohol consumption. However, recent attention about the impact of commercial determinants of health, constitutes an opportunity for policy makers to join efforts and move forward in better understanding and addressing the conflicts of interest, but also potential co-benefits of private sector action for better health⁷.

JA PreventNCD's role and activities

Alcohol is relevant in all work packages of Joint Action Prevent Non-Communicable Diseases (JA PreventNCD), directly or indirectly, but in some tasks and activities, alcohol is the main subject of study.

Alcohol policy "best buys" are those of regulation and taxation, and Work Package 5 includes several alcohol specific activities. Task 5.1 will investigate how existing alcohol (and tobacco) regulations can be improved, also e-commerce/online regulation. Task 5.2 aims to bolster fiscal policy coherence, such as alcohol excise taxes. Task 5.5 concerns alcohol warning labelling and aims to extend the knowledge base on labels and to develop a toolbox for emerging regulations of warning labels in the European alcohol market. Task 5.6 will address alcohol advertisements and online marketing.

Healthy living environment is the centre of attention in Work Package 6. Task 6.4 will aim to promote environments free of unhealthy products, like alcohol.

In Work Package 9, Health in all Policies, task 9.3 will assess evidence-informed alcohol (and tobacco) policies in sectors beyond the health sector in different countries. Work Packages concerning individuals at risk and social inequalities includes alcohol as one of the main risk factors for cancer and NCDs.

Accordingly, alcohol is addressed both at societal- and individual level, and regarding general population strategies and strategies for high-risk populations.

Conclusion

Alcohol use is a main NCD risk factor, and alcohol related harm is a major public health concern in the EU. Despite increased attention, knowledge and policy efforts over many years, the potential for preventing alcohol related harm and diseases in Europe is significant.

Through the development of effective and coordinated alcohol policies in a European context, increased knowledge and collaboration, JA PreventNCD will contribute to reducing the alcohol attributed burden of cancer and NCDs in Europe in the years ahead.

Author: Kristiane Bugge Dugstad, Cross-Cutting Theme Coordinator on Alcohol in the JA PreventNCD

29.09.2025

Alcohol as a cross-cutting theme in preventing NCDs in Europe

Introduction

European context

JA PreventNCD's role and activities

Conclusion

References