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Burden of alcohol-attributable mortality in the WHO European Region, 1990–2014<br />

Fig. 80. Trends in age-st<strong>and</strong>ardized rates of adult mortality due to alcohol-attributable liver cirrhosis in the<br />

WHO European Region <strong>and</strong> selected subregions, 1990–2014<br />

Rate per million<br />

180<br />

160<br />

140<br />

120<br />

100<br />

80<br />

60<br />

EU<br />

Central-western EU<br />

Mediterranean<br />

South-eastern WHO<br />

European Region<br />

Central-eastern EU<br />

Eastern WHO<br />

European Region<br />

WHO<br />

European Region<br />

40<br />

20<br />

0<br />

1990<br />

1992<br />

1994<br />

1996<br />

1998<br />

2000<br />

2002<br />

2004<br />

2006<br />

2008<br />

2010<br />

2012<br />

2014<br />

Alcohol-attributable cancer mortality rates have shown relatively small variations over the observation period within<br />

regions, <strong>and</strong> predictably, the rates between regions reflect the consumption level, with the south-eastern WHO European<br />

Region having markedly lower consumption <strong>and</strong> lower alcohol-attributable cancer mortality (Fig. 81).<br />

Fig. 81. Trends in age-st<strong>and</strong>ardized rates of adult mortality due to alcohol-attributable cancer in the WHO<br />

European Region <strong>and</strong> selected subregions, 1990–2014<br />

Rate per million<br />

120<br />

100<br />

80<br />

60<br />

40<br />

EU<br />

Central-western EU<br />

Mediterranean<br />

South-eastern WHO<br />

European Region<br />

Central-eastern EU<br />

Eastern WHO<br />

European Region<br />

WHO<br />

European Region<br />

20<br />

0<br />

1990<br />

1992<br />

1994<br />

1996<br />

1998<br />

2000<br />

2002<br />

2004<br />

2006<br />

2008<br />

2010<br />

2012<br />

2014<br />

Alcohol-attributable cardiovascular mortality varies widely between <strong>and</strong> within regions over time (Fig. 82). Cardiovascular<br />

causes of death, especially ischaemic categories, are impacted by fluctuations in heavy drinking occasions, <strong>and</strong> thus<br />

even relatively small changes in the level of consumption, which increase irregular or chronic heavy drinking, will have<br />

a considerable impact also on cardiovascular mortality. During the already-mentioned Gorbachev-era anti-alcohol<br />

campaign, alcohol consumption in the Soviet Union went down, even after correcting for increases in unrecorded alcohol<br />

(170) <strong>and</strong>, in association, deaths due to “circulatory disease” decreased, which was the code used for cardiovascular<br />

causes of death in the Soviet Union in 1987 (–9% in men from 1984, –6% in middle-aged women) (169). Cardiovascular<br />

57

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