When it comes to drinking alcohol, the healthiest thing to do is abstain entirely, according to a large, wide-ranging report published by scientists. Alcohol led to 2.8 million premature deaths in 2016; it was the leading risk factor for premature mortality and disability in the 15 to 49 age group, accounting for 20 percent of deaths, according to the researchers at the Institute for Health Metrics and Evaluation, who carried out the study.

Globally, 27.1 percent of cancer deaths in women and 18.9 percent in men over age 50 were linked to the their drinking habits, according to the study’s findings, which were published in the Lancet medical journal. Researchers investigated the health effects of alcohol consumption in 195 countries between 1990 and 2016—using data from 694 studies to find out how common drinking was and from 592 studies to determine health risks. The study, which received funding from the Bill & Melinda Gates Foundation, also analyzed whether moderate levels of drinking could have health benefits—which previous studies have indicated.

Although researchers found low levels of drinking could offer some protection against heart disease, and maybe from diabetes as well, these positives were far outweighed by the harmful impact of alcohol. For younger people, the biggest causes of death linked to alcohol were tuberculosis (1.4 percent), road injuries (1.2 percent) and self-harm (1.1 percent). The study shows that one in three, or 2.4 billion people around the world, drink alcohol. That works out to a quarter of women and 39 percent of men. Denmark has the most drinkers—95.3 percent of women and 97.1 percent of men. “Alcohol poses dire ramifications for future population health in the absence of policy action today. The widely held view of the health benefits of alcohol needs revising, particularly as improved methods and analyses continue to show how much alcohol use contributes to global death and disability. Our results show that the safest level of drinking is none,” the study says.