Few substances are as deeply woven into everyday life as alcohol. It is a fixture at holiday celebrations, work-related social gatherings, sporting events, airports, and brunch or dinner tables. A raised glass for a toast, the ubiquitous wedding open bar or drinks shared during a Fourth of July celebration all demonstrate how deeply alcohol has become embedded in social customs and cultural traditions.
Yet alcohol contributes to millions of deaths globally each year and is linked to cancer, liver disease, unintentional accidents, violence and, importantly, dependence and addiction. Despite this, the disconnect between alcohol’s cultural role and its serious health burden is striking.
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