The Global Burden of Disease (GBD) is a measure of the years of life lost as a result of premature mortality or complete disability. The contribution of a disease or risk factor to the GBD is commonly used by public health epidemiologists as a measure of the relative importance of that disease or risk factor. The metric used for these contributions is “disability adjusted life years” (DALYs).
First a look at the latest data from developed countries (technically countries with a high Socio-demographic Index (SDI). SDI is a summary measure of a country’s socio-demographic development. It is based on average income per person, educational attainment, and total fertility rate.)
Consumption of tobacco products is the single largest contribution to GBD in developed countries — contributing roughly 10% of the total DALYs. Consumption of alcohol and other drugs contributes another roughly 8% of the total DALYs. The combined contribution of tobacco, alcohol and drugs is about 18% of the total Burden of Disease in highly developed countries — clearly the largest single public health problem we face.
The global data looks a little different:
The single largest contributor to the GBD including data from all countries is Child and Maternal Malnutrition which contributes roughly 21% of the total DALYS. Tobacco consumption is the fourth largest contributor at 13%. Alcohol and drug consumption is the eighth largest contributor at roughly 11% of the total. If you combine the contributions of tobacco, alcohol and drugs, they represent roughly 24% of the total GBD — again suggesting that consumption of addictive substances is one of the largest, if not the largest, public health problems on the planet.
It should be emphasized that this data includes all DALY’s attributable to, for example, alcohol consumption – it does not distinguish between mild, moderate, and severe substance use disorders.
For more details than you probably want: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Lancet 2017; 390: 1345–422