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Alcohol abuse kills as many people around the world as tobacco and high blood pressure, a new study shows.

And researchers charge that popular alcohol control measures, such as school-based abstinence programs, have proven to be ineffective.

“These programs may reduce drinking in the short-term, but within two or three years they have no discernible effect,” study researcher Robin Room, PhD, tells WebMD. “This has been shown in study after study.”

Getting Drunk Not Heart Healthy

The news about alcohol and health has been largely favorable in recent years, with an increasing number of studies touting the health benefits of light to moderate alcohol consumption. But the new research sheds light on the downside of drinking.

Room and colleagues report that alcohol is responsible for 4 percent of worldwide disease, contributing to more than 60 different medical conditions. Tobacco is responsible for 4.1 percent and high blood pressure, 4.4 percent.

Moderate drinking, up to two drinks a day for men and one drink a day for women, is now widely believed to help protect against heart disease. But binge drinking has the opposite effect.

“If you get drunk on the weekends you are not helping your heart,” Room says.

Room added that most people probably drink more than they need to reap alcohol’s health benefits.

“One of the special things about alcohol is that you can be both benefiting from it and harmed by it, or harming others, at the same time,” he says. “The same drink can have both effects.”

75,000 Deaths in U.S.

CDC alcohol researcher Robert Brewer, MD, says binge drinking was responsible for more than half of the 75,000 deaths due to excessive drinking in the United States in 2001.

Binge drinking is commonly defined as five or more drinks at one sitting for a man and four for a woman.

In a study published last September, Brewer and CDC colleagues reported that three-quarters of those who died from alcohol abuse were male and 6% were under the age of 21.

Figures from the World Health Organization suggest that alcohol abuse is responsible for roughly 1.8 million deaths annually worldwide.

Brewer tells WebMD that binge drinking is on the rise in the United States, increasing by almost 30 percent since the early 1990s.

“(The CDC) is not in the business of telling people that it is wrong to drink,” he says. “Our focus is on excessive drinking, and our study affirmed that excessive drinking is a very serious public health problem.”

Getting Drunk Cheaper Than Movie

In the Lancet review, Room and colleagues outlined several measures that do seem to help curb alcohol abuse, including strengthening drunken driving laws and increasing taxes on alcohol. Room researches the public health impact of substance abuse at Sweden’s Stockholm University.

The problem of excessive drinking is of particular concern on college campuses. Henry Wechsler, PhD, conducts studies at the Harvard School of Public Health about drinking among college students.

Wechsler blames the alcohol industry for targeting young drinkers and fighting legislation that could help reduce alcohol abuse. He says ease of availability and price are major factors in the culture of college drinking.

“It is cheaper to get drunk on the weekend than to go to a movie,” he says. “And around college campuses most bars and liquor stores have price-based specials.”

The promotions have gone beyond the traditional two-for-one drinks and "happy hour." Wechsler says they may now involve supersizing alcoholic beverages and single price "all-you-can-drink" specials.

By Salynn Boyles, reviewed by Michael W. Smith, MD

SOURCES: Room, R. The Lancet, Feb. 5, 2005; vol 365: pp 519-530. Robin Room, PhD, Center for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden. Robert Brewer, MD, alcohol team leader, National Center for Chronic Disease Prevention and Health Promotion, CDC. Henry Wechsler, PhD, director, Harvard School of Public Health College Drinking Study.