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Alcohol has long been known as a risk factor for disease. The 1990 Global Burden of Disease (GBD) study (Murray and Lopez 1996a, 1996b) identified alcohol as one of the major global risk factors, accounting for 1.5% of global deaths, 2.1% of years of healthy life lost owing to premature mortality, 6.0% of years of life lost owing to disability and 3.5% of disability-adjusted life years (DALYs). Based on the epidemiological literature, and modelling the relationship between alcohol exposure and disease, two dimensions of alcohol consumption were defined as exposure variables:

• average volume of alcohol consumption; and

• pattern of drinking.

Average volume of consumption was estimated using both existing estimates of country-specific adult per capita consumption (based on production and sales data) and self-reported alcohol consumption from general population surveys. Country-specific patterns of drinking …