by Elliott Morss
Several years back, I documented that drinking, drugs, and sex were the leading entertainment sectors globally. Not surprising – human nature. Everything in moderation is fine – we all dig our own graves, etc. But what happens when “entertainment” becomes addictive? Which are the most dangerous addictions? And what regions are most seriously addicted?
The Most Dangerous Addictions
We often hear that 5+ million die of smoking every year. And most certainly, nicotine is a nasty, addictive drug. However, I have always felt that even though only half as many people die from alcoholism than smoking, alcoholism is more destructive. Why? Because drunks lose jobs, kill people while driving, and destroy family/friend relationships. As I just reported, this is borne out by the World Health Organization (WHO).
The WHO has developed a health risk statistic (the Disability-Adjusted Life Years [DALYs]). It measures years lost both because of a premature mortality and years lost due to time lived in less than full health. The DALYs for dangerous addictions are presented in Table 1.
Table 1. – Dangerous Addictions’
Share of Total DALYs, 2004
DALY | |
Cause | Share |
Alcohol | 9% |
Tobacco | 7% |
Overeating | 5% |
Illicit Drugs | 2% |
Source: WHO
Alcohol has the largest DALYs’ share even though DALYs do not include harm done to families and friends. There are two other items worth remarking on in Table 1:
The inclusion of overeating as a dangerous addiction;
The small DALY share for illicit drugs.
Overeating = Overweight/Obese
The DALYs included in Table 1 for overeating come from the WHO’s “Overweight and Obese” risk category. Overeating leads to being overweight/obese. That makes it a dangerous addiction. The United Nations reports that even in developing countries, the number of obese children now exceeds the number malnourished. And the DALY number could be much higher. Table 2 shows what share of breast cancers, cerebrovascular diseases, colon and rectum cancers, corpus uteri cancers, diabetes mellitus, hypertensive heart disease, ischaemic heart disease, and osteoarthritis the WHO attributed to being overweight or obese (5%). But look at the other headings in Table 2: high blood pressure, high cholesterol, high blood glucose, low fruit and vegetable intake, and physical inactivity. Ask any doctor, and s/he will affirm that all of these are all directly linked to being overweight/obese. As Table 2 indicates, if all of the DALYs listed are included under the overweight/obesity DALY Share, it would be 27%, far more than any other dangerous addiction.
Table 2. – Other DALYs Associated with Being Overweight/Obese
Cause | DALYs | DALY Share |
Overweight and obesity | 35,795,832 | 5% |
Breast cancer | 439,409 | |
Cerebrovascular disease | 6,108,964 | |
Colon and rectum cancers | 749,894 | |
Corpus uteri cancer | 308,195 | |
Diabetes mellitus | 8,692,439 | |
Hypertensive heart disease | 3,028,912 | |
Ischaemic heart disease | 14,401,987 | |
Osteoarthritis | 2,066,032 | |
High blood pressure | 57,226,514 | 7% |
Cerebrovascular disease* | 22,172,940 | |
Hypertensive heart disease* | 5,484,883 | |
Ischaemic heart disease* | 25,068,863 | |
Other cardiovascular diseases | 4,499,827 | |
High cholesterol | 29,723,136 | 4% |
Cerebrovascular disease* | 4,128,251 | |
Ischaemic heart disease* | 25,594,886 | |
High blood glucose | 41,304,911 | 5% |
Cerebrovascular disease* | 7,467,118 | |
Diabetes mellitus* | 19,705,201 | |
Ischaemic heart disease* | 14,132,591 | |
Low fruit and vegetable intake | 15,973,943 | 2% |
Cerebrovascular disease* | 4,011,162 | |
Colon and rectum cancers* | 126,508 | |
Ischaemic heart disease* | 7,762,193 | |
Oesophagus cancer | 1,313,227 | |
Stomach cancer | 1,399,981 | |
Trachea, bronchus, lung cancers | 1,360,870 | |
Physical inactivity | 32,099,068 | 4% |
Breast cancer* | 1,667,906 | |
Cerebrovascular disease* | 4,972,717 | |
Colon and rectum cancers* | 1,218,107 | |
Diabetes mellitus* | 5,241,336 | |
Ischaemic heart disease* | 18,999,001 | |
Total | 212,123,403 | 27% |
* Indicates illness associated with overweight/obesity
Source: WHO
For the reasons stated above, I believe the 5% figure is low. I believe overeating is the most dangerous global addiction. However, I use the data underlying the 5% share for the remainder of this article.
Illicit Drugs
The second notable point about Table 1 is how small the illicit drug share is use is relative to the other dangerous addictions – only 2%. And yet, illicit drugs are the only “illegal” dangerous addiction. What has making them illegal accomplished?
The number of drug users is increasing worldwide;
25% of the people in US jails are non-violent drug offenders, and
The US spends billions annually on unsuccessful drug eradication programs.
One might argue that the DALYs resulting from the use illicit drugs would increase if they were legalized. I agree. But history tells us banning/prohibiting a product for which there is a market never works. It only creates a lucrative new profit center for criminals. The best thing we can do with illicit drugs is what we now do with cigarettes – legalize them, tax them, and use some of the tax revenues for education and rehab services.
Which Region Has the Most Serious Addictions?
Table 3 provides data on per capita DALY’s of dangerous addictions per region. The findings are quite shocking The Commonwealth of Independent States (CIS) has much higher rates on all four dangerous addictions than any other region in the world. Countries in the CIS are: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan.
Table 3. – Per Capita DALYs by Region, 2004
Cause | World | Developed | SE Europe | CIS | Africa | Caribbean /Latin America | Oceania/Asia |
Alcohol use | 10.79 | 8.90 | 14.71 | 41.38 | 8.85 | 17.75 | 8.35 |
Tobacco use | 8.84 | 14.92 | 23.46 | 29.32 | 2.98 | 5.78 | 7.41 |
Overeating | 5.52 | 8.57 | 14.99 | 21.72 | 2.41 | 7.80 | 2.89 |
Illicit drug use | 2.05 | 2.68 | 1.42 | 4.44 | 1.94 | 3.07 | 1.60 |
Source: WHO
In the following sections, I examine CIS country data on these addictions using the US and Japan as reference points.
Alcohol
Table 4 provides data on alcohol consumption for the CIS countries, Japan, and the US. As can be seen, there are significant differences in both the percent of the population that drinks and the amount consumed by drinkers. Men in all countries consume more than women. In my recent article on drinking, I pointed out that 40 liters annually is equivalent to daily consumption of 6.2 cans of beer (12 oz. can) or 1.1 bottles of wine (.75 liter) or 6.8 shots (40 ml per shot) of whiskey.
Table 4. – Annual Alcohol Consumption, Selected Countries
Liters/ | % | Liters/ | Liters/ | ||
Country | Capita | Drinkers | Drinker | Male Drinker | |
Commonwealth of Independent States | |||||
Moldova | 18.22 | 78% | 23.40 | 32.00 | |
Russia | 15.76 | 59% | 26.70 | 35.40 | |
Ukraine | 15.60 | 56% | 27.90 | 37.60 | |
Belarus | 15.13 | 79% | 19.20 | 28.00 | |
Armenia | 11.35 | 62% | 18.30 | 24.40 | |
Kazakhstan | 10.96 | 51% | 21.45 | 29.80 | |
Azerbaijan | 10.60 | na | na | na | |
Georgia | 6.40 | 49% | 13.10 | 14.80 | |
Kyrgyzstan | 5.09 | 49% | 10.40 | 12.80 | |
Turkmenistan | 4.63 | na | na | na | |
Uzbekistan | 3.54 | na | na | na | |
Tajikistan | 3.39 | na | na | na | |
Japan | 8.03 | 81% | 9.90 | 20.00 | |
United States | 9.44 | 66% | 14.40 | 13.80 |
Source: WHO
Alcohol consumption in Japan and the US is much lower than in the CIS.
Smoking
Table 5 presents data the percent of adults that smoke. Men smoke much more than women. The Russian average is higher than any other CIS country. 70% of men in Russia smoke. I have included Greece in this table because it has the highest average rate of smoking in the world. It is higher than Russia because a larger portion of women smoke in Greece than in Russia. The smoking rate in Japan is high while the US rate is lower and declining.
Table 5. – Adult Smoking Prevalence
Country | Male | Female | Average |
Commonwealth of Independent States | |||
Russia | 70% | 28% | 49% |
Ukraine | 65% | 24% | 44% |
Belarus | 64% | 22% | 43% |
Armenia | 61% | 3% | 32% |
Georgia | 57% | 6% | 31% |
Kazakhstan | 43% | 9% | 26% |
Moldova | 45% | 5% | 25% |
Kyrgyzstan | 47% | 2% | 24% |
Tajikistan | 43% | 2% | 23% |
Uzbekistan | 23% | 4% | 13% |
Azerbaijan | na | 1% | Na |
Turkmenistan | na | na | Na |
Greece | 63% | 39% | 51% |
Japan | 42% | 13% | 28% |
US | 26% | 19% | 22% |
Source: WHO
Overeating
Data on the results of overeating are presented in Table 6. And while the CIS as a region has the highest overeating DALYs, the US as a country is off the charts on this dangerous addiction. There are only a few small South Pacific Islands and two oil-rich Middle Eastern States (Kuwait and Qatar) that have higher obesity rates than the US.
Table 6. – Overweight and Obesity Rates
Country | % Overweight | % Obese |
Commonwealth of Independent States | ||
Belarus | 67% | 16% |
Azerbaijan | 57% | 15% |
Armenia | 53% | 12% |
Russia | 49% | 10% |
Turkmenistan | 47% | 9% |
Uzbekistan | 46% | 7% |
Georgia | 45% | 6% |
Ukraine | 45% | 7% |
Kazakhstan | 41% | 8% |
Moldova | 41% | 5% |
Kyrgyzstan | 39% | 5% |
Tajikistan | 37% | 4% |
| ||
Japan | 23% | 2% |
United States | 74% | 36% |
Source: International Association for the Study of Obesity, WHO
Illicit Drugs
Data on illicit drugs are presented in Table 6. Here too, it is clear that while the CIS as a region has the highest DALYs for these drugs, the US as a nation is a major market for these products. As mentioned earlier it is notable how low the use rates are on these drugs relative to the other dangerous addictions.
Table 7. – Illicit Drugs, Prevalence of Adult Use (%)
Country | Opiods/Opiates | Cocaine | Cannabis | Amphetamines | Ecstasy | ||
Commonwealth of Independent States | |||||||
Armenia | 0.60 | 0.10 | 3.50 | <.1 | 0.10 | ||
Azerbaijan | 0.40 | na | 3.50 | na | na | ||
Belarus | 0.86 | <.1 | 1.10 | 0.40 | 0.30 | ||
Georgia | 1.16 | na | 2.70 | 0.60 | 0.50 | ||
Kazakhstan | 2.00 | na | 4.20 | na | na | ||
Kyrgyzstan | 1.60 | na | 6.40 | na | na | ||
Moldova | 0.15 | <.1 | 0.90 | <.1 | na | ||
Russia | 3.28 | 0.20 | 3.50 | 0.40 | 0.70 | ||
Tajikistan | 1.08 | na | na | na | na | ||
Turkmenistan | 0.64 | na | na | na | na | ||
Ukraine | 2.32 | <.1 | 2.50 | 0.40 | 0.70 | ||
Uzbekistan | 1.60 | na | 4.20 | na | na | ||
Japan | na | <.1 | na | na | na | ||
United States | 12.07 | 1.40 | 12.60 | 1.50 | 1.40 |
Source: UNODC
This review needs no summary or conclusion; the data speaks for itself.
Other Posts By Elliott Morss
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About the Author
Elliott Morss has a broad background in international finance and economics. He holds a Ph.D.in Political Economy from The Johns Hopkins University and has taught at the University of Michigan, Harvard, Boston University, Brandeis and the University of Palermo in Buenos Aires. During his career he worked in the Fiscal Affairs Department at the IMF with assignments in more than 45 countries. In addition, Elliott was a principle in a firm that became the largest contractor to USAID (United States Agency for International Development) and co-founded (and was president) of the Asia-Pacific Group with investments in Cambodia, China and Myanmar. He has co-authored seven books and published more than 50 professional journal articles. Elliott writes at his blog Morss Global Finance