Breaking the Silence: Europe Unites Against Alcohol Harm
The World Health Organization (WHO) European Region has the heaviest alcohol consumption of all regions in the world, causing a significant reduction in life expectancy, especially among men. Approximately 800,000 lives are lost each year to alcohol. It is also a leading risk factor for disability, a major cause of more than 200 chronic diseases, and a factor in many injuries and mental health disorders.
Despite this, cultural and societal narratives around alcohol use are at odds with the clinical evidence, fueling alcohol-related harm.
A roundtable event organized yesterday at the congress convened clinicians, policymakers, and a patient with alcohol-related liver disease (ARLD) to challenge some of society's most pervasive narratives about alcohol use and reveal the deeply entrenched ways it shapes health and society.
'This isn't about judgement,' said David Barrett, internal communications and multimedia manager at the WHO, Copenhagen, Denmark, who chaired the event. 'It's about cutting past all of the noise; all of the myths.'
Margarida Santos, MD
Carina Ferreira-Borges, PhD
The discussion featured a cross-sectoral panel including Margarida Santos, MD, general practitioner, Portugal; Hazel Martin, patient with ARLD and BBC journalist, Glasgow, Scotland; Aleksander Krag , MD, PhD, professor and department chair, department of gastroenterology and hepatology, Odense University Hospital, Denmark and secretary general of EASL; Riina Sikkut, member of the Estonian Parliament; and Carina Ferreira-Borges, PhD, regional advisor on alcohol, illicit drugs, and prison health at the WHO Regional Office for Europe.
'I Was the Story'
Sharing her experience, Martin reflected on her dual role as reporter and subject of the BBC Panorama episode Binge Drinking and Me .
Hazel Martin, BBC journalist
'It's never the goal of a journalist to be the story,' said Martin, speaking candidly about her diagnosis of ARLD at the age of 31 and reflecting on how deeply alcohol is embedded in everyday life. 'I didn't feel like I was drinking any differently than the people around me. And yet I received a diagnosis of fibrosis; alcohol-related liver damage. That was a huge shock.'
Martin described the dissonance between what is perceived as normal drinking habits and the clinical reality, with her diagnosis surprising her but also prompting questions about societal understanding of drinking behavior.
'Why are so many people unaware they are at risk? There's this public health message of 'Spread your drinking across the week. Know your units.' But no one really knows what that means,' she said. 'Binge drinking is defined as six drinks in one session [for a female]. That's about two large glasses of wine. Yet so few people recognize when they're doing it,' she explained, adding that so many people she spoke with after making the show were shocked.
Santos, who works in the Portuguese primary care system, said that common misperceptions of alcohol use present one of the biggest barriers to reducing harm, and that people often harbor a narrow stereotype of who alcohol harms. 'People think alcohol disorder is only about someone from a low socioeconomic background who drinks daily and visibly gets drunk. But often it's more subtle—and just as harmful.'
She admits it can be difficult to discuss alcohol consumption with patients. 'They may say 'a glass with meals' or 'a beer here and there,' without recognizing it may already cross risky thresholds.'
More worrying, she stressed, was the communication gap. 'We [health professionals] talk in terms of units and liver damage, but what the public wants to know is if it 'increases my breast cancer probability' and 'how does this impact me?' They don't realize that it makes your work harder or impacts fertility.'
Stigma remains a major issue too, she pointed out. 'There's 'sober shaming' at weddings and parties that pressures people into drinking. People ask, 'Why aren't you drinking? Are you pregnant?' That's a cultural issue and it needs to change.'
Industry Promotion and Societal Disconnect
Santos also sounded the alarm over industry influence in policymaking, pointing out that, in Portugal, major alcohol companies have had direct contact with the health ministry. 'We need to stop normalizing this,' she said.
Podcasts and influencers on social media, largely used by teenagers, are also sponsored by the alcohol industry, but no action is taken against this. Santos has her own podcast. 'I find this so upsetting because it would be unthinkable for a person or a podcast to be sponsored by a tobacco company. No one does anything about it. I think it's very cultural.'
WHO public health expert, Carina Ferreira-Borges, reflected that people's choices are not made in a vacuum but are shaped by environments saturated with marketing and a culture that infiltrates to the point where clear societal principles become lost. 'It's absurd that profit-driven industries go to schools to teach children how to drink and there is an acceptance that this is okay. How do all of these systems encourage harm while claiming to promote so-called choice?'
Santos concurred and called for a reframing of public health communication and investment in health communication strategies that match the scale and savvy of the alcohol industry's campaigns.
Debunking the Alcohol Myths: Red Wine Is (Not) Healthy!
Turning to systems propagating misinformation that fuel alcohol-related harm as opposed to individual blame, Karg reflected on the persistent myth that moderate alcohol consumption, especially red wine, offers cardiovascular benefits. 'I think it has been a myth that's been around a lot and it's also one that the alcohol industry loves to say. If you look at hundreds of diseases in large datasets, there might be some [outliers] popping up that support this, but the reality is that the more you drink, the higher your risk is, and we need to be careful, because they [the industry] are twisting it,' said Karg, emphasizing the clear dose-response relationship between alcohol use and mortality.
The experts called for sharper, more relatable health communication together with robust policies that prioritize public wellbeing over profit.
The newly launched European Health Alliance on Alcohol will be highlighting the often-overlooked impacts of alcohol on heart disease, suicide, sleep, and mental health. It aims to strengthen the influence of healthcare professionals on alcohol policy at local, national, and European levels.
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