{
  "abstract": "Introduction: Although alcohol-attributable mortality risk increases with consumption, harm may be distributed across the wider drinking population. Understanding this distribution is important for designing equitable, population-level prevention strategies. This study examined whether alcohol-attributable deaths in Ireland were concentrated among the highest-consuming drinkers.\n\nMethods: Mean annual alcohol-attributable deaths among residents of Ireland aged ≥15 years during 2022-2024 were estimated using comparative risk assessment. Consumption was estimated from the nationally representative Healthy Ireland Survey 2024 and calibrated to recorded per-capita sales. Mortality data were obtained from the General Mortality Register and relative risks from systematically identified meta-analyses. Drinkers were ranked by calibrated average daily consumption, separately by sex. Deaths and deaths per 100,000 drinkers were estimated for the highest-consuming 10% and remaining 90%.\n\nResults: An estimated 1,420 deaths were alcohol-attributable annually, representing 4.0% of all deaths; 1,096 occurred among men and 324 among women. The highest-consuming 10% had calibrated consumption of at least 72.5 g/day among men and at least 32.5 g/day among women. Among men, the highest-consuming 10% accounted for 448 deaths (41%), while 649 (59%) deaths occurred in the remaining population. Corresponding estimates among women were 149 (46%) and 175 (54%). Mortality rates per 100,000 drinkers were higher in the highest-consuming 10% than in the remaining men (259.4 versus 33.8) and women (83.8 versus 8.7).\n\nConclusions: Although alcohol-attributable mortality rates were highest among the heaviest 10% of drinkers, more than half of alcohol-attributable deaths occurred in the remaining population. This is consistent with the prevention paradox. Effective and equitable alcohol prevention is therefore likely to require population-level measures alongside targeted support for those at highest risk.\n\nKey messages: • Most alcohol-attributable deaths occurred outside the highest-consuming 10%, supporting population-level prevention alongside targeted support.\n\n• Findings support equitable alcohol policies that reduce harm across the full drinking population, not only among the heaviest drinkers.",
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  "article_type": "abstract",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "name": "CP McDowell"
    },
    {
      "name": "M Boudou"
    },
    {
      "name": "M O’Neill"
    },
    {
      "name": "L Comber"
    },
    {
      "name": "M Ryan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2cxrddw6nvgsk.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.1853",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699761/",
  "id": "2cxrddw6nvgsk",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.1853",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
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  "native_subjects": [
    [
      "heading",
      "6. Poster Displays"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
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    [
      "heading",
      "AcademicSubjects/SOC01210"
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      "heading",
      "AcademicSubjects/SOC02610"
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    [
      "heading",
      "DU. Public health epidemiology and genomics"
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      "openalex",
      "2713|Substance Abuse Treatment and Outcomes"
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  "openalex": "W7223658602",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699761/pdf/?tool=EBI",
  "pmcid": "PMC13699761",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/2cxrddw6nvgsk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:19Z",
      "native_id": "PMC13699761",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.1853"
    },
    {
      "first_seen": "2026-10-30T12:21:47Z",
      "native_id": "PMC:PMC13699761",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13699761"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Substance Abuse Treatment and Outcomes",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The alcohol prevention paradox in Ireland: implications for equitable population-level policy",
  "title_text": "The alcohol prevention paradox in Ireland: implications for equitable population-level policy",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:17Z",
  "url": "https://research.draconitic.com/paper/2cxrddw6nvgsk",
  "venue": "The European Journal of Public Health",
  "versions": []
}