Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe

Elisa  Pose; Luis Antonio  Díaz; Richard Parker; Mads Israelsen; Thomas Marjot; Ewan Forrest; Ashwin Dhanda; Catherine Paradis; Juan Pablo  Arab; Aleksander  Krag; Ramon  Bataller; Frank Murray; Jeffrey V. Lazarus; Patrizia Carrieri; Paul N. Brennan

doi:10.1016/j.lanepe.2026.101707

Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe

Elisa Pose (Lead / Corresponding author)
, Luis Antonio Díaz
, Richard Parker
, Mads Israelsen
, Thomas Marjot
, Ewan Forrest
, Ashwin Dhanda
, Catherine Paradis
, Juan Pablo Arab
, Aleksander Krag
, Ramon Bataller
, Frank Murray
, Jeffrey V. Lazarus
, Patrizia Carrieri
, Paul N. Brennan

Respiratory Medicine and Gastroenterology

Research output: Contribution to journal › Article › peer-review

3 Downloads (Pure)

Abstract

Alcohol-related liver disease (ALD) remains a leading cause of preventable morbidity and mortality in Europe. Despite robust evidence that alcohol-related population-level policies delay use initiation and reduce associated harms, their implementation in Europe has been inconsistent and frequently undermined by alcohol industry interference, fragmented governance, and policy inertia. The burden of ALD as well as combined metabolic dysfunction and alcohol-associated liver disease (MetALD) has grown steadily, driven by increased alcohol intake, widespread metabolic risk factors, delayed diagnosis, and poor integration between primary care, substance use services, endocrinology, and hepatology. In this Series paper, we combine epidemiology, policy evaluations, and clinical evidence to examine these findings through the lenses of policy, system preparedness, education, and stigma. We highlight screening strategies for alcohol use and liver disease and describe models of multidisciplinary and digital care. Finally, we outline priorities for policy reform, stigma reduction, youth-focused prevention, and research on biomarkers, pharmacotherapies, and digital/artificial intelligence tools.

Original language	English
Article number	101707
Journal	The Lancet Regional Health - Europe
Volume	65
DOIs	https://doi.org/10.1016/j.lanepe.2026.101707
Publication status	Published - 2 Jun 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

ethanol
alcohol use disorder
policy
screening
industry
alcohol-related liver disease
alcohol-associated liver disease
cirrhosis
epidemiology
high-risk population

Access to Document

10.1016/j.lanepe.2026.101707Licence: CC BY

Final Published VersionFinal published version, 1.95 MBLicence: CC BY

Assessing Europe's policy readiness to confront the MASLD/MASH public health threat
Lazarus, J. V. (Lead / Corresponding author), White, T. M. (Lead / Corresponding author), Agirre-Garrido, L., Abeysekera, K. W. M., Brennan, P. N., Brůha, R., Buttigieg, S., Carrieri, P., Cortez-Pinto, H., Flisiak, R., Francque, S. M. A., Frühbeck, G., Gheorghe, L. S., Hagström, H., Holleboom, A. G., Ivanov, K., Jensterle, M., Jepsen, P., Kupcinskas, J. & Mark, H. E. & 18 others, Mauricio, D., Bibi, S. M., Moreno, C., Mrzljak, A., Papanicolaou, E., Papp, M., Papatheodoridis, G., Peck-Radosavljevic, M., Pugliese, N., Johnson, R. D., Ribeiro, R. T., Salupere, R., Skladany, L., Tolmane, I., Yki-Järvinen, H., Schattenberg, J. M., Pericàs, J. M. & The European MASLD collaborator group, 2 Jun 2026, In: The Lancet Regional Health - Europe. 65, 17 p., 101713.
Research output: Contribution to journal › Article › peer-review

Open Access
File
5 Downloads (Pure)
Diagnostic innovation and models of care to improve fibrosis detection and risk stratification in steatotic liver disease
Pugliese, N., White, T. M., Brennan, P. N., Pannain, S., Hagström, H., Michel, M., Rice-Duek, L., Targher, G., Caussy, C., Dillon, J. F., Tacke, F., Kopka, C. J., Sebastiani, G., Boursier, J., Tsochatzis, E. A., Brouwer, W. P., Guaraldi, G., Vettor, R., Thiele, M. & Roden, M. & 8 others, Stefan, N., Jarvis, H., Ginès, P., Schattenberg, J. M., Pose, E., Buttigieg, S., Byrne, C. D. & Lazarus, J. V. (Lead / Corresponding author), 2 Jun 2026, In: The Lancet Regional Health - Europe. 65, 13 p., 101722.
Research output: Contribution to journal › Article › peer-review

Open Access
File
4 Downloads (Pure)

Cite this

Pose, E., Díaz, L. A., Parker, R., Israelsen, M., Marjot, T., Forrest, E., Dhanda, A., Paradis, C., Arab, J. P., Krag, A., Bataller, R., Murray, F., Lazarus, J. V., Carrieri, P., & Brennan, P. N. (2026). Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe. The Lancet Regional Health - Europe, 65, Article 101707. https://doi.org/10.1016/j.lanepe.2026.101707

@article{15af2a4747674d3baaebb463b2d5f82e,

title = "Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe",

abstract = "Alcohol-related liver disease (ALD) remains a leading cause of preventable morbidity and mortality in Europe. Despite robust evidence that alcohol-related population-level policies delay use initiation and reduce associated harms, their implementation in Europe has been inconsistent and frequently undermined by alcohol industry interference, fragmented governance, and policy inertia. The burden of ALD as well as combined metabolic dysfunction and alcohol-associated liver disease (MetALD) has grown steadily, driven by increased alcohol intake, widespread metabolic risk factors, delayed diagnosis, and poor integration between primary care, substance use services, endocrinology, and hepatology. In this Series paper, we combine epidemiology, policy evaluations, and clinical evidence to examine these findings through the lenses of policy, system preparedness, education, and stigma. We highlight screening strategies for alcohol use and liver disease and describe models of multidisciplinary and digital care. Finally, we outline priorities for policy reform, stigma reduction, youth-focused prevention, and research on biomarkers, pharmacotherapies, and digital/artificial intelligence tools.",

keywords = "ethanol, alcohol use disorder, policy, screening, industry, alcohol-related liver disease, alcohol-associated liver disease, cirrhosis, epidemiology, high-risk population",

author = "Elisa Pose and D{\'i}az, \{Luis Antonio\} and Richard Parker and Mads Israelsen and Thomas Marjot and Ewan Forrest and Ashwin Dhanda and Catherine Paradis and Arab, \{Juan Pablo\} and Aleksander Krag and Ramon Bataller and Frank Murray and Lazarus, \{Jeffrey V.\} and Patrizia Carrieri and Brennan, \{Paul N.\}",

note = "{\textcopyright} 2026 The Authors.",

year = "2026",

month = jun,

day = "2",

doi = "10.1016/j.lanepe.2026.101707",

language = "English",

volume = "65",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier",

}

Pose, E, Díaz, LA, Parker, R, Israelsen, M, Marjot, T, Forrest, E, Dhanda, A, Paradis, C, Arab, JP, Krag, A, Bataller, R, Murray, F, Lazarus, JV, Carrieri, P & Brennan, PN 2026, 'Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe', The Lancet Regional Health - Europe, vol. 65, 101707. https://doi.org/10.1016/j.lanepe.2026.101707

TY - JOUR

T1 - Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe

AU - Pose, Elisa

AU - Díaz, Luis Antonio

AU - Parker, Richard

AU - Israelsen, Mads

AU - Marjot, Thomas

AU - Forrest, Ewan

AU - Dhanda, Ashwin

AU - Paradis, Catherine

AU - Arab, Juan Pablo

AU - Krag, Aleksander

AU - Bataller, Ramon

AU - Murray, Frank

AU - Lazarus, Jeffrey V.

AU - Carrieri, Patrizia

AU - Brennan, Paul N.

PY - 2026/6/2

Y1 - 2026/6/2

N2 - Alcohol-related liver disease (ALD) remains a leading cause of preventable morbidity and mortality in Europe. Despite robust evidence that alcohol-related population-level policies delay use initiation and reduce associated harms, their implementation in Europe has been inconsistent and frequently undermined by alcohol industry interference, fragmented governance, and policy inertia. The burden of ALD as well as combined metabolic dysfunction and alcohol-associated liver disease (MetALD) has grown steadily, driven by increased alcohol intake, widespread metabolic risk factors, delayed diagnosis, and poor integration between primary care, substance use services, endocrinology, and hepatology. In this Series paper, we combine epidemiology, policy evaluations, and clinical evidence to examine these findings through the lenses of policy, system preparedness, education, and stigma. We highlight screening strategies for alcohol use and liver disease and describe models of multidisciplinary and digital care. Finally, we outline priorities for policy reform, stigma reduction, youth-focused prevention, and research on biomarkers, pharmacotherapies, and digital/artificial intelligence tools.

AB - Alcohol-related liver disease (ALD) remains a leading cause of preventable morbidity and mortality in Europe. Despite robust evidence that alcohol-related population-level policies delay use initiation and reduce associated harms, their implementation in Europe has been inconsistent and frequently undermined by alcohol industry interference, fragmented governance, and policy inertia. The burden of ALD as well as combined metabolic dysfunction and alcohol-associated liver disease (MetALD) has grown steadily, driven by increased alcohol intake, widespread metabolic risk factors, delayed diagnosis, and poor integration between primary care, substance use services, endocrinology, and hepatology. In this Series paper, we combine epidemiology, policy evaluations, and clinical evidence to examine these findings through the lenses of policy, system preparedness, education, and stigma. We highlight screening strategies for alcohol use and liver disease and describe models of multidisciplinary and digital care. Finally, we outline priorities for policy reform, stigma reduction, youth-focused prevention, and research on biomarkers, pharmacotherapies, and digital/artificial intelligence tools.

KW - ethanol

KW - alcohol use disorder

KW - policy

KW - screening

KW - industry

KW - alcohol-related liver disease

KW - alcohol-associated liver disease

KW - cirrhosis

KW - epidemiology

KW - high-risk population

U2 - 10.1016/j.lanepe.2026.101707

DO - 10.1016/j.lanepe.2026.101707

M3 - Article

SN - 2666-7762

VL - 65

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 101707

ER -

Implementation of evidence-based alcohol policies to reduce alcohol-related harm and liver disease to advance public health in Europe

Abstract

UN SDGs

Keywords

Access to Document

Fingerprint

Research output

Assessing Europe's policy readiness to confront the MASLD/MASH public health threat

Diagnostic innovation and models of care to improve fibrosis detection and risk stratification in steatotic liver disease

Cite this