This document summarizes the work of a multidisciplinary group of twelve experts¹ brought together by Inserm (French National Institute for Health and Medical Research) as part of a collective expert report procedure (Appendix) at the request of the French health authorities. The review, originally published in French², explores the health and socio-economic burden of alcohol consumption and is based on the academic literature available in the first half of 2020. Nearly 3,600 articles constituted the document base for this expert report. The analysis covers recent data on alcohol consumption levels and patterns, the impact of alcohol on health (including low consumption levels and also damage specific to the perinatal period), the socio-economic costs of alcohol, risk factors for consumption, and aspects related to the marketing and lobbying activities of the alcohol industry. Measures for reducing alcohol-related harm are examined and evaluated, including primary and secondary prevention (restricting supply and demand, screening, interventions, alcohol abstinence challenges), as well as management of alcohol dependency. It concludes with a series of recommendations for both public policy and research. Those which have proven their effectiveness are highlighted and must be integrated at the heart of a public health policy of harm reduction based on reducing alcohol consumption.

1

The experts signed a declaration of conflict of interest in accordance with the provisions of the Inserm Expertise Charter.

2

Inserm. Réduction des dommages associés à la consommation d’alcool. Collection Expertise collective. Montrouge : EDP Sciences, 2021

Contents

• Executive summary
• Foreword
• Summary
  • Alcohol consumption levels
  • Health and socio-economic damage
  • Damage specific to the perinatal period
  • Risk factors for alcohol use
  • Marketing of alcohol products
  • Lobbying by the alcohol industry
  • Primary prevention
  • Secondary prevention: screening, brief interventions, other interventions
  • Management of alcohol dependency
• Recommendations
  • Current state of the problem and general recommendations
  • Recommendations for action
  • Recommendations for research
• Annex 1. Inserm Collective Expert Reviews: principles and methods
• Annex 2. Literature search strategy

Authors of a communication

Amine BENYAMINA, Centre d’Enseignement, de Recherche et de Traitement des Addictions (CERTA), Hôpital Universitaire Paul Brousse

Pierre DUCIMETIÈRE, Honorary Inserm Research Director

Viêt NGUYEN THANH, Head of the Addictions Unit, Claudine TANGUY and Pierre ARWIDSON, Associate Directors, Direction de la prévention et de la promotion de la santé, Santé publique France

Michel REYNAUD, President of Fonds Actions Addictions

Michaël SCHWARZINGER for the QalyDays Study Group, Translational Health Economics Network (THEN), Paris and IAME (Infection, Antimicrobials, Modeling, Evolution), UMR 1137, Inserm, Université Paris Cité

The group of experts and the Collective Expert Reports Unit would like to pay tribute to Michel REYNAUD, Psychiatrist and University Professor, who passed away on June 26, 2020.

Acknowledgements

For their contribution to the writing of certain chapters:

Arnaud GATINET, École des Hautes Études en Santé Publique (doctoral candidate)

Jacques GAUME, CHUV Centre hospitalier universitaire vaudois, Lausanne

For their critical reading and advice:

Christine DOSQUET and Pierre LOMBRAIL, rapporteurs for the Inserm Ethics Committee

Scientific, editorial, bibliographic and logistic coordination

Inserm Collective Expert Reports Unit, Paris, France

Head of the unit: Laurent FLEURY

Coordination of the collective expert report: Marie LHOSMOT-MARQUET, Laurent WATROBA, Anne ROCHAT

Scientific information: Chantal GRELLIER, Pascalines CHAUSSENOT

Scientific editing: Anne-Laure PELLIER

Translation: Scott HARVEY

Other contributions and critical reading: Catherine CHENU, Bénédicte VARIGNON

Logistics: Cécile GOMIS

Suggested citation:

Inserm. Reducing the harm associated with alcohol consumption. Summary and recommendations. Collection Expertise collective. Montrouge: EDP Sciences, 2022. Access collective expert reports online at: https://www.ipubli.inserm.fr/handle/10608/1 https://www.inserm.fr/expertise-collective/