Hari Sreenivasan, in our New York studio, has that.

　　HARI SREENIVASAN: The study ranks excessive alcohol consumption as the fourth leading cause of preventable deaths in the U.S., accounting for one in 10 deaths among working-age Americans each year. Its effects also cost the U.S. economy roughly $224 billion every year.

　　And it is not just the alcoholic drinker who is at risk. Partying, bingeing and daily drinking all take a toll.

　　For a closer look, we turn to Dr. Robert Brewer. He's head of the Alcohol Program at the CDC and co-author of the report. He joins us from Chicago.

　　So, first of all, we have known that excessive drinking has different costs on society. It's often a tragedy for the family or the loved ones of the diseased, but what surprised you about these numbers in this study?

　　DR. ROBERT BREWER, Alcohol Program, Centers for Disease Control and Prevention: Well, Hari, you're right.

　　We have known that excessive alcohol use is a huge public health problem for a long time. What surprised us in this study was the extent to which that public health impact was focused on working age adults. And as you noted in your opener, we estimate that about one in 10 deaths among working-age adults, ages 20-64 years, are attributable to excessive~ alcohol use.

　　That's a huge number and certainly indicates to us that we need to redouble our efforts to prevent it.

　　HARI SREENIVASAN: So this study also said that — the other statistic that reached out was the fourth leading cause of death attributable to excessive. How do we define excessive?

　　DR. ROBERT BREWER: Well, excessive alcohol use is sort of an umbrella term that we use for various patterns of alcohol consumption and also for drinking among certain high-risk groups. So, under the umbrella, we would include binge-drinking, which is, for a woman, consuming four or more drinks on an occasion that is within a short period of time, for men, five or more drinks within an occasion that is again within a short period of time, basically drinking to the point of acute intoxication.

　　And then we would also include high average daily alcohol consumption, which would be greater than one drink per day on average for a woman, greater than two drinks per day on average for a man, and then any alcohol consumption by groups that we know to be at particularly high risk of harms from alcohol consumption, specifically underage youth, that is, youth under age 21, and pregnant women.

　　So, collectively, those four different groups would be under the umbrella of excessive alcohol use. Now, of those, binge-drinking is by far the most common pattern of excessive drinking.

　　HARI SREENIVASAN: And what are those factors that influence that? Does it happen more among males, more among young people?

　　DR. ROBERT BREWER: Well, there certainly are some important differences across different population groups.

　　And, yes, we know that men tend to binge-drink more than women. The prevalence, as we call it, the proportion of people who report binge-drinking is higher in younger-age groups, 18-24, but also 25-34.

　　But it's important to recognize that this really is an important public health problem across the lifespan. But, again, a lot of the public health impacts that we see related to excessive alcohol use — and in the case of our study we were looking at deaths in particular — are really concentrated in that group of working-age adults between 20 and 64 years.

　　And that's a huge, tragic loss to the — of course, the individual and to society. But it's also a very expensive problem for all of us. And, as you noted in your opening, we estimate the economic cost of excessive drinking at about $224 billion a year.

　　And a large proportion of that cost, about $2 out of every $5, is paid for by government. So, essentially, all of us are paying the cost of excessive alcohol use.

　　HARI SREENIVASAN: And the results of this survey are self-reported, so is there a possibility that the numbers you're talking about could even be higher?

　　DR. ROBERT BREWER: Absolutely.

　　The estimates that we reported in our study, which, again, are deaths that are attributable to excessive alcohol use, are calculated in a variety of different ways, but part of that calculation does involve self-reports of alcohol consumption by individuals.

　　And we know that people tend to significantly under-report their alcohol consumption. So, yes, we believe that, for that reason, among others, the estimated total number of deaths that we reported, which is 88,000 per year, and shortening the lives of those who die by about 30 years, is probably a significant underestimate.

　　HARI SREENIVASAN: So, what do we know about policies or practices that change alcohol consumption behavior? What works?

　　DR. ROBERT BREWER: Well, actually, there are a lot of similarities in the policies and other services that can affect drinking, parallels between that and smoking.

　　So we know, for example, that people's drinking behavior is very much affected by the price of the alcohol. If alcohol is more expensive, people tend to drink less. We also know that alcohol consumption's very much affected by the availability of alcohol.

　　So, for example, if you have a very high concentration of bars or other establishments selling alcohol within a particular area, people are more likely to drink more as well. So, from a public health perspective, policies that relate to the price and the availability of alcohol are among those that we think can be most impactful in reducing excessive alcohol consumption.

　　HARI SREENIVASAN: All right.

　　DR. ROBERT BREWER: But there's also things that can be done in a doctor's office as well.

　　HARI SREENIVASAN: All right, Dr. Robert Brewer from the CDC, thanks so much.

　　DR. ROBERT BREWER: Thank you. I appreciate your interest.