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[Comment] Alcohol burden in low-income and middle-income countries

Alcohol use contributes to roughly 4% of the global burden of disease.1 Episodic (binge) drinking and high average volume consumed both contribute to this burden in complex ways.1 Episodic drinking increases risks of injury and cardiovascular disease; cancer risk increases with average volume; and low–moderate alcohol use is associated with a reduced risk of death from cardiovascular diseases.2,3 A major limitation of the evidence is that most epidemiological studies of alcohol have been done in high-income and middle-income countries.