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Alcohol-related harm is a major public health issue in the European Union. Alcohol use is responsible for some 255000 to 290000deaths each year across EUcountries (WHO, 2019; IHME, 2019). High alcohol consumption is associated with increased risk of heart diseases and stroke, liver cirrhosis, certain cancers and foetal alcohol disorders, but even moderate alcohol consumption increases the long-term risk of developing such diseases. Alcohol also contributes to morbidity and mortality through accidents and injuries, violence, homicide and suicide.

Measured through sales data, overall alcohol consumption stood at 10litres of pure alcohol per adult on average across EUcountries in 2018, down from 11litres in 2008 (Figure4.7). Latvia and Austria have the highest level of alcohol consumption, with over 12litres per adult, followed by the CzechRepublic, France, Bulgaria, Lithuania and Luxembourg, with over11litres per adult. Greece, Sweden, Italy and Malta have relatively low levels of consumption, below8litres of pure alcohol per adult.

Over the past decade, alcohol consumption has decreased in most EUcountries, with the largest reductions in Estonia, Greece and Lithuania (reductions of about 3litres per adult). It has slightly increased in Bulgaria, Latvia and Malta, although it remains well below the EU average in Malta.

Although overall alcohol consumption per capita is a useful measure to assess long-term trends, it is also important to consider drinking patterns across population groups to identify those who drink the most and are most at risk of alcohol-related disorders. Men consume about four times more alcohol than women on average across EUcountries (WHO, 2019). Beyond quantity, drinking frequency and intensity are also crucial to measure the extent of harmful consumption. In 2016, one-third (33%) of adults on average across EUcountries reported having had sixdrinks or more on a single occasion during the last month (Figure4.8). This proportion was three times higher among men than women (51% compared with 17%). Men and women in Lithuania, Luxembourg, Latvia, the CzechRepublic and Estonia were more likely to report episodic heavy drinking, with the proportion reaching over40%. Heavy drinking is on the rise in many countries among young adults and women especially. Men in lower socio-economic groups are also more likely to drink heavily than those in higher socio-economic groups, while it is the opposite for women (OECD, 2015).

Many European countries have implemented a range of policies to limit alcohol consumption, including taxation, restrictions on the availability of alcohol, bans on alcohol advertising, and public health campaigns (OECD, 2015). Recent innovative measures include minimum unit pricing, regulation of digital alcohol marketing, and alcohol labelling. Minimum pricing of alcohol units, introduced in Scotland in 2018, has been associated with a reduction in alcohol purchases, especially among households that bought the most alcohol (O’Donnell et al, 2019).

The confinement measures following the COVID-19 pandemic in the first half of 2020 had at least a temporary impact on people’s lifestyle and drinking habits. Different population groups reported either an increase or a decrease in alcohol use. In France and Belgium, the closure of bars and restaurants during the lockdown was associated with an overall reduction in alcohol consumption, especially among young adults. At the same time, other population groups (such as people aged35-50 and parents of young children) reported having drunk more than usual during the confinement period (Sciensano, 2020; Santé Publique France, 2020).