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14FEATUREDr. CHING Cheuk Tuen Regina, FHKAM(Com Med)Hong Kong Alliance for Advocacy Against Alcohol, Hong Kong College of Community MedicineDOCTORS %u2013 TRUSTED PARTNERS IN REDUCING ALCOHOL HARMA major health and social problemThe importance of alcohol as a major risk factor for non-communicable diseases (NCDs) is evidenced by its inclusion in the World Health Organization%u2019s Global Action Plan for the Prevention and Control of NCDsi as one of four major behavioural (that is, modifiable) risk factors, others being tobacco use, unhealthy diet and physical inactivity. These risks drive metabolic changes like high blood pressure, obesity, and elevated blood glucose, which in turn fuel NCDs. Globally, NCDs accounted for 59.5% of all deaths in 2000, rising to 73.9% in 2019 before coming down as COVID-19 started to take a toll on human lives. It is estimated that, in 2019, 2.6 million deaths worldwide were attributable to alcohol consumption, affecting 2 million men and 0.6 million women. People of younger age (20%u201339 years) are disproportionately affectedii. According to the Department of Health%u2019s Health Behaviour Survey 2023, about one in ten persons aged 15 or above consumed alcohol regularly at least once a week in the past year, which was more common in men than women. About 2.7% adults engaged in monthly binge drinking defined as consuming five or more drinks in one sitting, and 4.1% drank at increased risk, experienced harmful drinking or probable alcohol dependenceiiiAlcohol and alcoholic beverages contain ethanol, which is a psychoactive and toxic substance with dependence-producing properties. Alcohol consumption plays a causal role in more than 200 diseases, injuries and other health conditions including liver diseases, heart diseases, cancers as well as mental health and behavioural issues such as depression, anxiety and alcohol use disorders. Alcohol is an established carcinogen implicated in breast, liver, head and neck, oesophageal and colorectal cancers. Alcohol use affects the incidence or outcome of infectious diseases such as tuberculosis and HIV and, during pregnancy, increases the risk of foetal alcohol spectrum disorders. Often unrecognised and under-reported, alcohol use causes harm to others by way of injuries, road traffic accidents, partner violence, child abuse, sexual assault and absenteeism from work. Between 2007 and 2022, over 2000 annual hospital admissions were recorded due to alcohol-related conditions consisting of mental and behavioural disorders (75%) and alcoholic liver disease (25%). Hospitalizations for heart diseases, stroke, cancer, injuries and other conditions attributed to alcohol use have not, however, been accounted for.Look for the problem and act on itIn general practice, one seldom sees %u201ca patient requesting specific advice for his or her drinking problem%u2019. The drinker may more likely be a young man with hypertension and weight concern, a manual worker with gouty arthritis, a housewife with sleep problem, an office lady with depressive symptoms or a lad with a bruised eyebrow. Drinkers may not see a need to seek medical advice for their drinking behaviour either because they are unaware of the harm related to drinking or they may feel inappropriate or embarrassed to raise the matter during consultation. In the latter scenario, promotion of %u2018socially responsible drinking%u2019 by the alcohol industry probably adds to this stigma.Yet, an encounter with the doctor offers an ideal opportunity to educate patients about alcohol risk and reduce alcohol harm. Using Screening and Brief Intervention (SBI)iv as a public health strategy (similar to conducting a wellness check for smoking, diet and exercise behaviour) helps identify people who drink excessively and prompts the doctor to offer quick, non-judgmental and effective counselling to reduce alcohol use. SBI begins with a 3-item validated questionnaire known as AUDIT-C (Alcohol