- Around the world, most deaths from alcohol are among young adults in the prime of their lives, aged 20 to 39.
- Alcohol plays a role in over half of all violent events globally, studies show, including intimate partner violence, child abuse and homicides.
- The alcohol industry continues to market aggressively to women and young people, and in countries with fewer resources.
- The best way to minimize the health, social and economic harms of alcohol is to lower consumption overall using cost-effective policies such as health taxes. For every dollar invested in these policies, the return on investment is more than ninefold.
Dec. 10, 2025 (New York)— At a time when alcohol consumption patterns are shifting globally and the industry is expanding rapidly into regions with fewer safeguards, policy action and clear evidence of alcohol’s harms are essential to protect public health. Despite the toll of alcohol on health, communities and economic development, many countries still don’t have the necessary policies in place to protect their people, according to “Trouble Brewing: The Case for Alcohol Policy,” released today by Vital Strategies in partnership with Economics for Health at the Johns Hopkins Bloomberg School of Public Health.
“Alcohol is widely consumed and broadly accepted socially,” said Jacqui Drope, Managing Director, RESET Alcohol initiative, Vital Strategies. “For years, contradictory messages have sowed doubt about its impact on health. But the science is clear: Alcohol is a unique product that causes harms to individuals, their families, communities and society on a worldwide scale. We need to recalibrate policy environments to drive down alcohol consumption everywhere around the world.”
The second edition of “Trouble Brewing” synthesizes the most up-to-date scientific evidence to offer a clear, authoritative view of the myriad ways in which alcohol harms not only health, but also economies, public safety and the environment. This expanded version of the 2018 report, presented in a powerful graphic format, also provides governments and advocates with tools and arguments to urgently adopt policy solutions that can reduce alcohol harms and economic costs—and save millions of lives. Frequently used industry arguments against common-sense alcohol policies are identified, and responses are offered along with evidence, to help advocates counter the claims sustaining the industry’s misleading public narrative and delaying government action.
Every year, 2.6 million people die from alcohol-related harms around the world, with the highest proportion of these deaths occurring among people aged 20 to 39. In South Africa, the average age at which adolescents try alcohol is 13 years old, and 25% of adolescents report binge drinking in the previous 30 days. Meanwhile, in Mexico, 55% of males 15-19 years and older who consumed alcohol engaged in binge drinking, a particularly risky consumption pattern that leads to the greatest harms. Alcohol also takes a terrible toll on many who don’t consume it: Studies show it could play a role in over half of all violent events, such as homicides, suicides, car crashes, child abuse and violence against women.
This new edition of “Trouble Brewing” shines a light on today’s most critical issues around alcohol, in line with new scientific and policy research from the past 10 years:
- Alcohol Makes Health, Social and Economic Disparities Worse: The report outlines how alcohol is disproportionately harming people with fewer resources.
- Women and Young People Are Prime Targets: The industry aggressively markets to women and young people by tapping into the values and ideas important to them and by showing up where young people gather, especially online, where regulation is limited.
- Public Health Must Take Back the Alcohol Narrative: For years, the industry has framed alcohol as an issue of personal choice. The report shows this framing is misleading, by demonstrating how industry advertising, promotion and sponsorship practices contradict their “moderate drinking” and individual responsibility narrative.
- World Health Organization “Best Buys” Guide the Policy Response: The solution lies in population-wide policy measures from WHO’s SAFER technical package. Among those are cost-effective alcohol policies—such as increasing taxes, restricting marketing and regulating availability—that can deliver extraordinary returns. For every dollar invested in these policies, the return on investment is more than ninefold.
- Health Taxes Are Key to Reducing Alcohol Harms: When set high enough, alcohol taxes are a winning formula to reduce harms while generating much-needed government revenue. For instance, reducing alcohol consumption in Brazil by 20% with the help of an excise tax could save 10,000 lives a year.
“The public health response to alcohol must be commensurate with its health, social and economic burden,” said Dr. David Jernigan, Professor of Health Law, Policy and Management, Boston University. “The alcohol industry is a formidable foe, and its determination to stand in the way of sound alcohol policy should not be underestimated. Industry consolidation has made global companies even larger, and enhanced their capacity to advertise and normalize alcohol across the globe. ‘Trouble Brewing’ addresses the industry’s tactics head-on, and makes a compelling case for why policy advocacy is more crucial than ever for saving lives around the world.”
About the Report
First published in 2018, “Trouble Brewing” uses bold graphics to describe the scale of alcohol harm and bring peer-reviewed evidence to life. The report tracks where progress has been made in alcohol policy and details the latest tactics the alcohol industry deploys to grow profits and delay or derail policy efforts. A Tools and Resources section was designed to build momentum for alcohol policy work.
The report is available at https://www.vitalstrategies.org/resources/trouble-brewing-the-case-for-alcohol-policy-second-edition/
About Vital Strategies
Vital Strategies is a global health organization that believes all people should be protected by strong and equitable health policies and systems. We partner with governments, communities and organizations around the world to reimagine public health so that health is supported in all the places we live, work and play. The result is millions of people living longer, healthier lives around the world.
To find out more, please visit www.vitalstrategies.org or follow us on LinkedIn.
About Economics for Health
Based at the Johns Hopkins Bloomberg School of Public Health in the Department of Health, Behavior and Society, Economics for Health conducts economic research to demonstrate the effects of existing policies and chart pathways to new ones that promote healthier populations and more robust and equal economies. Their approach emphasizes collaboration among economists, health experts, key stakeholders and decision-makers. Fiscal policies are pivotal drivers of everything, from the decision to smoke and consume alcohol, to food choices, and to environmental factors. In its work, Economics for Health supports researchers in low- and middle-income countries to build a local evidence base for effective economic policies like tax that can engender both improved public health and economic prosperity.