Alcohol causes nearly 4% of deaths worldwide, more than Aids, tuberculosis or violence, the World Health Organisation has warned.
Rising incomes have triggered more drinking in heavily populated countries in Africa and Asia, including South Africa and India, and binge drinking is a problem in many developed countries, the United Nations agency said.
Yet alcohol control policies are weak and remain a low priority for most governments despite the heavy toll drinking takes on society, from road accidents, violence, disease, child neglect and job absenteeism, it said.
Alcohol kills 2.5 million each year
Approximately 2.5 million people die each year from alcohol related causes, the WHO said in its "Global Status Report on Alcohol and Health."
"The harmful use of alcohol is especially fatal for younger age groups, and alcohol is the world's leading risk factor for death among males aged 15-59," the report found.
In Russia and the Commonwealth of Independent States (CIS), every fifth death is due to harmful drinking; this is the highest rate.
Binge drinking is now prevalent in Brazil, Kazakhstan, Mexico, Russia, South Africa and Ukraine, and rising elsewhere, according to the WHO.
"Worldwide, about 11% of drinkers have weekly heavy episodic drinking bouts, with men outnumbering women by four to one. Men consistently engage in hazardous drinking at much higher levels than women in all regions," the report said.
Health ministers from the WHO's 193 member states agreed last May to try to curb binge drinking and other growing forms of excessive alcohol use through higher taxes on alcoholic drinks and tighter marketing restrictions.
Disease and injury
Alcohol is a causal factor in 60 types of diseases and injuries, according to the WHO's first report on alcohol since 2004.
"Six or seven years ago we didn't have strong evidence of a causal relationship between drinking and breast cancer. Now we do," Dr Vladimir Poznyak, head of the WHO's substance abuse unit and coordinator of the report, told Reuters Health.
Alcohol consumption rates vary greatly, from high levels in developed countries, to the lowest in North Africa, sub-Saharan Africa and southern Asia, whose large Muslim populations largely abstain from drinking.
Illegal alcohol products
Homemade or illegally produced alcohol - falling outside governmental controls and tax nets - accounts for nearly 30% of total worldwide adult consumption.
In France and other European countries with high levels of adult consumption, heavy episodic drinking is rather low, suggesting more regular but moderate drinking patterns.
One of the most effective ways to curb drinking, especially among young people, is to raise taxes, the report said. Setting age limits for buying and consuming alcohol, and regulating alcohol levels in drivers, also reduce abuse if enforced.
Some countries restrict marketing of alcoholic beverages or on the industry's sponsorship of sporting events.
"Yet not enough countries use these and other effective policy options to prevent death, disease and injury attributable to alcohol consumption," the WHO said.
Alcohol producers have said they recognise the importance of industry self-regulation to address alcohol abuse and promote curbs on drunkenness and illegal underage drinking.
But the brewer SABMiller has warned that policy measures like minimum pricing and high excise taxes on alcohol could cause more public health harm than good by encouraging more people to drink homemade or illegally produced alcohol. - (Stephanie Nebehay/Reuters Health, February 2011)