The Alcohol-Attributable Burden of Disease in Canada from 2000 to 2016

Objectives: To describe trends in Canada in alcohol consumption from 1990 to 2016, and in the alcohol-attributable burden of disease from 2000 to 2016. Methods: Alcohol consumption was measured using data from production and taxation statistics and from population surveys. Alcohol-attributable deaths and disability adjusted life years (DALYs) lost were estimated using a comparative risk assessment framework, stratified by age, sex, and cause. Relative risks were obtained from meta-analyses and cohort studies. Mortality data were obtained from the World Health Organization's Global Health Observatory. Uncertainty intervals (UIs) were estimated using Monte Carlo-like simulations. Results: From 1990 to 2016, per capita alcohol consumption in Canada decreased from 10.4L (95% UI: 10.0-10.7) to 9.0L (95% UI: 8.7-9.2). Heavy episodic drinking remained largely stable between 1990 and 2016 (an annualized 0.1% increase). In 2016, 10,556 deaths (95% UI: 8285-13,609) and 440,709 DALYs lost (95% UI: 388,853-527,260) were attributable to alcohol use. Men experienced more alcohol-attributable deaths and DALYs lost than did women, and the greatest alcohol-attributable burden was found among those over the age of 54. Alcohol-attributable age-standardized rates of deaths and DALYs lost decreased by g % (95% UI: - 10.2 to 25.2) and by 13.8% (95% UI: -11.4, 15.7), respectively, from 2000 to 2016. Conclusions: Despite reductions in per capita consumption and in the alcohol-attributable burden of disease, alcohol use continues to be a leading risk factor for death and disability in Canada. Accordingly, alcohol control policies should be strengthened to reduce further alcohol-attributable harms.