Before discussing further implications we would like to lay open limitations of our approach. The CRA as well as the GBD are estimates based on best available data and modelling techniques. With respect to alcohol, even though the underlying data overall has relatively good reliability and validity, the estimates of alcohol exposure in countries with high level of unrecorded consumption confer a higher level of uncertainty [40]. However, as the impact of unrecorded alcohol consumption was modelled the same as the impact of recorded consumption, overall its impact was probably underestimated (for health effects of unrecorded consumptions see [41]). The second potential bias results from basing risk relationships on meta-analyses mainly stemming from cohort studies in high income countries. While the so derived risks may contain bias, especially for disease categories which are highly related to social determinants, the direction of this bias is also towards underestimations, as many research studies have shown that conditions like undernutrition or lack of sanitation which are more prevalent in low and mid income countries, increase the effect of alcohol [10]. Also, the modelling
