Mental health policy and practice across Europe: an overview

254 Mental health policy and practice
Figure 11.3 SDR chronic liver disease and cirrhosis in the original EU-15, the new
EU-10 and the EU-25, 1970–2001 (excluding Hungary)
Source: World Health Organization (2004c)
Hungary, which has more than four times the average cirrhosis death rate of the
EU, possibly due to aliphatic alcohol congeners arising from home-made spirits
(Szucs et al. 2005); this might also suggests a higher rate of unrecorded alcohol
consumption in the new member states, compared with the 15.
Alcohol and the burden of harm in individuals and societies
Alcohol and individuals
The relationship between alcohol consumption and individual harm is summarized
in Table 11.1. For many conditions there is an increasing risk with
increasing levels of alcohol consumption, with no evidence of a threshold
effect. The slopes of the risks vary by gender and the geographical areas in which
studies are performed. The absolute risk of death from alcohol-related cancers
(mouth, oesophagus, pharynx, larynx and liver) increases from 13 per 100,000
at no alcohol consumption to 37 per 100,000 at four or more drinks (40+g) per
day (Thun et al. 1997). The cumulative incidence of breast cancer by age 80 years
increases from 8.8 per 100 women in non-drinkers to 13.3 per 100 women
consuming an average of 60g each day (Collaborative Group on Hormonal Factors
in Breast Cancer 2002). The absolute risk of death from liver cirrhosis