Researchers Develop a National Indicator to Measure Alcohol Consumption in Brazil

Brazil has developed its own method to measure how much alcohol the population consumes each year. The new indicator, called APC-Brazil, uses national data on beverage production and sales, unlike the World Health Organization (WHO) method, which relies on international estimates.

Alcohol consumption is a serious public health issue in Brazil. It was the seventh leading risk factor for mortality in the country in 2021, causing around 20,000 deaths annually. To develop effective prevention policies, it is crucial to have accurate data on how much alcohol is actually consumed.

The WHO indicator shows a decline in Brazil’s per capita alcohol consumption. However, national surveys such as Vigitel point to a different scenario, with an increase in heavy episodic drinking (binge drinking) in the most recent year of the survey (2023). This discrepancy led Brazilian researchers to develop their own method.

How the New Indicator Works

The APC-Brazil calculates how many liters of pure alcohol each Brazilian consumes per year, considering only individuals aged 15 and older. Unlike population surveys that ask people about their drinking habits, this indicator uses objective data from industrial beverage production (beer, cachaça, wine, etc.), imports and exports, population projections from IBGE, estimates of unrecorded alcohol consumption (such as homemade or counterfeit drinks). The method captures total alcohol available to the population through the following formula:

[(Production + Imports - Exports) / Population aged 15+] + unrecorded alcohol per capita

The formula represents a per capita availability measure, reflecting the total quantity of alcohol theoretically available to each person, regardless of whether their consumption is moderate or excessive.

Scientific Validation

To ensure reliability, the indicator underwent two types of validation:

Expert validation: A workshop with experts from IBGE, the Ministry of Health, universities, and international organizations unanimously approved the calculation method and data sources.

External validation: The results were compared with other national indicators from 2005 to 2020, including population surveys (Vigitel and PNS), sales data, and mortality from alcohol-attributable causes.

Key Findings

Validation revealed important differences between methods.

• APC-Brazil: showed stable consumption (around 7.5 liters per capita in 2020)
• WHO-APC: indicated a 0.9 percent annual decrease during the same period

The Brazilian indicator correlated positively with mortality from causes fully attributable to alcohol, confirming its accuracy.

Concerning Trends

National survey data confirmed several worrying trends.

• 4 percent annual increase in the number of people reporting alcohol use
• 2 percent annual rise in binge drinking
• Increased consumption among women (from 7.8 percent to 16 percent between 2006 and 2020)
• Growth in beer sales (2.3 percent) and wine (3.5 percent)
• Decrease only in daily consumption (–4.7 percent per year)

Limitations and Challenges

The indicator has important limitations.

• Two-year lag (due to time needed to release industrial data)
• Difficulty in capturing unrecorded alcohol (homemade or counterfeit)
• Does not account for consumption context (e.g., with meals vs. alone)

Importance for Public Policy

APC-Brazil is now the official indicator for monitoring Brazil’s progress toward the Sustainable Development Goals (SDGs), specifically the target to reduce harmful alcohol consumption by 10 percent.

With more accurate data on Brazil’s reality, policymakers can

• better evaluate the effectiveness of control policies
• detect concerning trends more quickly
• compare results across different regions
• base decisions on national evidence

Next Steps

Researchers recommend

• including questions about alcohol source in national surveys
• developing methods to better measure unrecorded alcohol
• maintaining annual data updates
• using the indicator to evaluate prevention policies

This study demonstrates the importance of countries developing their own indicators, based on local realities, to monitor complex public health issues like alcohol consumption. However, implementing national indicators comes with limitations that must be considered. The two-year data lag may delay the identification of shifts in consumption patterns. There's also difficulty in accurately capturing unrecorded alcohol consumption, which may represent a substantial portion of total intake. Additionally, the indicator does not reflect important qualitative aspects, such as the context of drinking (e.g., with meals or alone) and regional specificities within the country. The methodology is based on industrial production data, which only includes companies with 30 or more employees, potentially underestimating output from small-scale producers.

These limitations emphasize the need for complementary approaches, including regular population surveys and improved methods for tracking unrecorded alcohol, to continuously enhance the accuracy of monitoring efforts.

References:

Freitas PC et al. Validação do indicador do consumo do álcool per capita (APC) no Brasil. Cad. Saúde Pública 2025; 41(8):e00207024