Dr. Gary Giovino, chair of the department of community health and health behavior at the University at Buffalo School of Public Health and Health Professions, contributed to a review that was recently published online in the journal Addiction that compiled the most comprehensive and up-to-date sources of information on global patterns of use and the morbidity and mortality attributable to use of alcohol, tobacco, and illicit drugs. The report showed that the highest rates of morbidity and mortality worldwide were due to tobacco use, followed by alcohol use, and then illicit drugs.
[Photo: Gary Giovino]
“At least for tobacco we have a Framework Convention, in which almost all nations in the world have committed to implementing proven tobacco control strategies to protect and promote their populations,” said Dr. Giovino, an expert on the epidemiology of tobacco use and dependence. “Although rates of implementation vary across countries, we have already observed good progress in those nations that fully implemented recommended tobacco use prevention and control policies.”
The United States and Canada (combined in this study) demonstrated the highest rates of cannabis (749/100,000 population), cocaine (301/100,000), and opioid (650/100,000) dependence in the world. The death rate attributable to the use of illicit substances in the U.S. and Canada (16/100,000) was second only to that in Eastern Europe (Belarus, Estonia, Latvia, Lithuania, Moldova, Russia, and Ukraine) (24/100,000), which also had a high rate of opioid dependence (584/100,000).
Deaths from alcohol in the U.S. and Canada (20/100,000 population) were lower than the global average (33/100,000 population). The highest rates of death due to alcohol in the world were observed in Eastern Europe (108/100,000), which also demonstrated the highest rate of alcohol dependence (2,787/100,000). Similarly, deaths from tobacco smoking in the U.S. and Canada (101/100,000 population) were below the global rate (111/100,000 population). The highest rates of death due to tobacco smoking in the world were in Oceania (American Samoa, Federated States of Micronesia, Fiji, Guam, Kiribati, Marshall Islands, Papua New Guinea, Samoa, Solomon Islands, Tonga, Vanuatu)(269/100,000), which was essentially tied with Eastern Europe with the highest rate of daily tobacco use (24.0 percent in Oceania and 24.2 percent in Eastern Europe).
The authors recognize some limitations to the data, especially for illicit drugs. That said, this compilation of data from organizations such as the World Health Organization, United Nations Office on Drugs and Crime, and the Institute for Health Metrics and Evaluation, should facilitate the development of policies and programs to combat the use of addictive substances.