CHAPTER 3 The cost of harmful alcohol use in South Africa ... - ARA

Chapter 3 │ Cost of harmful alcohol use in SA and policy measures
address the harmful use of alcohol, with specific reference to the restrictions on alcohol advertising and marketing.
South Africa’s proposed legislation in this regard, as well as a synopsis of other restriction globally, is also outlined.
Burden of disease 6 attributable to alcohol
The relationship between alcohol consumption and health outcomes is complex, often resulting from a series of factors,
many of which are related to levels and patterns of alcohol consumption, but also to other factors, such as drinking
culture, alcohol regulation or the lack of it, and alcoholic beverage quality. The quality of alcoholic beverages has a
major impact on health and mortality, for instance, when homemade or illegally produced alcoholic beverages are
contaminated with methanol or lead.
Alcohol-attributable mortality
Alcohol contributes to traumatic outcomes that kill or disable people at a relatively young age, resulting in the loss of
many years of life to death and disability. Alcohol plays a major role in fatal traffic and other accidents as well homicides,
interpersonal injury and suicide. In 2004, 3.8% of all deaths in South Africa were attributable to alcohol. The harmful use
of alcohol is the leading risk factor for death in men aged 15–59. This is mainly because of injuries, including violence
and conflict, and higher levels of heart disease.
If we take into consideration the beneficial impact of low risk alcohol use on morbidity and mortality in some diseases and
in some population groups, the total number of deaths attributable to alcohol consumption was estimated to 21,900 in
2004. This accounts for more deaths than that caused by HIV/AIDS or tuberculosis.
Table 1 gives an overview of non-natural deaths associated with alcohol consumption.
Table 13: Positive Blood Alcohol Concentrations (BAC) cases according to alleged manner of non-natural death (%)
Alleged manner of non-natural death NIMSS 2002 NIMSS 2008
Homicide violence 53 61
Suicide 38 41
Transport 52 56
Non-transport 48 44
Undetermined 41 44
Source: NIMSS
Data from the National Injury Mortality Surveillance System (NIMSS) in 2008 indicate that 34% (10,613 out of 31,177) of
fatally injured deaths in South Africa involved persons with blood alcohol concentrations (BACs) greater than or equal to
0.05g/100 ml.
Levels of BAC positivity were high for homicides (61% positive) and transport related deaths (56% positive). The
majority of transport related deaths that involve positive BAC’s in South Africa are of pedestrians (63%), followed by
unspecified (58%), driver of a motor vehicle (58%) and passenger (45%) of deaths. This means that by far the largest
number of transport related deaths in South Africa is of intoxicated pedestrians.
6 Burden of disease is defined as the gap between current health status and an ideal situation in which everyone lives to old age free of
disease and disability. Premature death, disability risks that contribute to illness and injury are the cause of this health gap. Disabilityadjusted
life years (DALYs) represent a measure of overall disease burden.
Economic Impact of Advertising Ban on Alcoholic Beverages│ ARA Page | 38