Reducing the health risks derived from exposure to addictive substances.

PURPOSE OF REVIEW: To discuss the health risks due to exposure to alcohol, illegal drugs and nicotine and how these risks might be reduced.

RECENT FINDINGS: In 2016, worldwide, alcohol, illegal drugs and nicotine were responsible for some 10 million deaths. There is evolutionary and biological evidence that humans are predisposed to consuming alcohol, illegal drugs and nicotine - present-day problems are caused by high levels of potency, exposure and drug delivery systems. The two priority substances for action are alcohol and smoked cigarettes; their exposure can be reduced by price increases, setting minimum prices per product, regulating a shift form smoked cigarettes to electronic nicotine delivery devices and, theoretically, reducing the ethanol content of existing beverages. Legalization of cannabis requires a strict regulatory framework.

SUMMARY: Purposeful policy can reduce the harm done by alcohol, illegal drugs and nicotine. In particular, policy to reduce exposure to alcohol requires considerable strengthening.