Science, Pol icy, and Public Health. Edited by. Peter Boyle. Paolo Boffetta. Albert B. Lowenfels. Harry Burns. Otis Brawley. Witold Zatonski. JOrgen Rehm.
Unrecorded alcohol consumption Dirk W. Lachenmeier, Gerhard Gmel, and JOrgen Rehm
Introduction Alcohol consumption can be broadly classified into recorded and unrecorded consumption, i.e. part of which is officially registered and part of which is not. In the last decade unrecorded alcohol consumption has become the focus of increasing attention, as World Health Organization (WHO) estimations have shown that about 30% of global consumption is unrecorded (1). As the major ingredient of unrecorded alcohol is most typically ethanol, similar to recorded alcohol, all of the health consequences of alcohol consumption described in this book also apply to unrecorded alcohol.
Definition of unrecorded alcohol Unrecorded denotes alcoholic drinks produced andlor consumed that are not recorded in official statistics of sales, production, or trade. In some countries, unrecorded drinks account for the majority of alcohol consumption (2). Unrecorded alcohol stems from a variety of sources (1, 3): home production, illegal production and sales, illegal (smuggling) and legal imports (cross-border shopping), and other production of alcoholic drinks that are not taxed and/or are not included in official production and sales statistics. A portion of unrecorded alcoholic drinks derive from different local or traditional drinks that are produced and consumed in the community or homes. The production may be legal or illegal, depending on the strength of the drink. Worldwide, information on these alcoholic drinks and their production or consumption volumes is scarce (l). Due to the wide diverSity of products that mayfall under unrecorded alcohol, there has been no consistent definition or usage of this term in the literature. Some authors use the terms illegal, informal, artisanal, home-produced, non-beverage, or surrogate alcohol; however, these terms often only describe subgroups of unrecorded alcohol. The industry prefers the term 'non-commercial alcohol' (4). WHO provided the following nomenclature and classification (Figure 15.1; see also the Global Information System on Alcohol and Health-GISAH -at: ). The term 'unrecorded alcohol' comprises four major categories: (i) illegally produced or smuggled alcohol; (ii) surrogate alcohol, i.e. alcohol not officially intended for human consumption, such as perfume; (iii) alcohol not registered in the country where it is consumed; and (iv) legal unregistered alcohol (e.g. home-made alcohol in countries where it is legal). There are various sub categories within these broad categories. For instance, illegally produced alcohol can stem from the same factory as legal alcohol (i.e. beer factories, distilleries, wineries), but a proportion of the alcohol produced is not declared to the authorities in order to evade taxation. It should be noted that home-made alcohols are usually illegally produced but there are exceptions such as in countries where home production is not illegal but would still be part of unrecorded consumption. Some
PER CAPITA CONSUMPTION OF UNRECORDED ALCOHOL
Note: Surrogate alcohol may be intended for human consumption - but not declared as such, to evade taxes
Legal but unrecorded alcohol products (home made or other)
Alcohol products recorded, but not in the jurisdiction where
Surrogate alcohol: non-beverage alcohol products not officially intended for human consumption
Commercial and taxed beer, winez spirits
Homemade fruit spirits; homebrewed beer; wine products for home consumption
Cross-border shopping; medicinal products for human intake
Cosmetics (mouth-wash, perfumes, etc); denatured alcohol; automobile products; medicinal compounds such as rubbing alcohol
Illegally produced or smuggled alcohol products intended for human consumption
(including illegal homemade alcohol)
Moonshine; samogon; untaxed beer, winel or
Figure 15.1 Classification of alcohol products. Reprinted with permission from Lachenmeier DW et aI., The composition of alcohol products from markets in Lithuania and Hungary, and potential health consequences: A pilot study, Alcohol and Alcoholism, Volume 44, Issue 1, pp. 93-102, Copyright © 2009, Oxford University Press, DOl: 10.1 093/aicaldagn095.
common examples of surrogate alcohols include mouthwash, perfumes, and eaux de cologne, which are alcohol products manufactured on a large scale (5, 6). Such alcohols may be produced with human consumption in mind but to evade taxation may be officially classified as 'shaving water' or 'mouthwash' (7). In Russia (e.g. Savchuk et al. (8)), surrogate alcohols are differentiated based on the type of alcohol that the liquid contains: true surrogate alcohols (i.e. solutions and liquids manufactured from ethanol o~ containing large amounts of ethanol) and false surrogate alcohols (i.e. ethanol-free liquids, such as methanol, propanol, and ethylene glycol). In some instances alcohols illegally produced for human consumption contain non-beverage alcohols, e.g. to increase alcohol concentration. Thus, beverage alcohol that is offered for consumption on the illegal market could be adulterated by non-drinkable alcohol and consumers may not be aware of the potential risks. Quantitative estimations of the degree of contamination of unrecorded alcohol are currently not available. Similarly, in Russia, it appears that denatured industrial ethanol is used for producing illegal alcohol for consumption since it is possible to-at least partially-eliminate the common denaturing agent diethyl phthalate through simple distillation (8).
Per capita consumption of unrecorded alcohol While per capita consumption of recorded alcohol is traceable via official statistics based on production, sales, and/or trade data (9), no such data are available for unrecorded alcohol. Therefore, the currently available data are estimates, based on expert opinion or surveys (9), carry
I UNRECORDED ALCOHOL CONSUMPTION Table 15.1 Global distribution of unrecorded adult per capita alcohol consumption, 2005 WHO Region
Unrecorded adult per capita alcohol consumption in L pure ethanol
Total adult per capita alcohol consumption in L pure ethanol
Eastern Mediterranean Region
South East Asia Region
Western Pacific Region
Reprinted from International Journal of Drug Policy, Volume 22, Issue 2, Dirk W. Lachenmeier et aI., Alcohol under the radar: Do we have policy options regarding unrecorded alcohol?, pp. 153-160, Copyright © 2011, with permission from Elsevier, 001: . Source: data from Global status report on alcohol and health, Copyright © World Health Organization 2011. Available from .
.... Unrecorded consumption (in Itr) in World 2005