Measuring costs of alcohol harm to others: A review of the literature

People other than the drinker experience harmful consequences from alcohol misuse, accounting for part of the economic burden to society. Little has been done on costing harm to others.

1. To recognize the range of costs considered or not when evaluating harm to people other than the drinker.

2. Second, to identify the costing frameworks and quality of the costing used for this purpose.

A literature review was undertaken of various databases, government publications, dissertations, conference papers and reference materials. Publications were included for analysis if they reported costs on alcohol harm to others. Methodological adequacy of costing studies was assessed using a checklist modified from the Drummond 10-point checklist.

In total, 25 publications including costs on alcohol harm to others were reviewed. Fetal alcohol syndrome (FAS) was the harm to others most frequently cost. The cost-of-illness (COI) framework was used in 24 of the publications, while 1 employed a cost–benefit analysis (CBA) serving as starting point for further studies estimating intangible costs (e.g. victim's quality-of-life (QoL) loss). Indirect costs (e.g. victim's lost productivity) were quantified most frequently with the human capital approach. The majority of publications critically assessed on costing received an average quality score (17/25).

Few studies have reported costs on the magnitude from harm to people other than the drinker, therefore the overall economic burden of risky alcohol consumption across countries is underestimated. 

This review may be considered a starting point for future research on costing alcohol harm to others.


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