Exposure variables: volume of consumption as well as drinking patterns

There is an association between total alcohol consumption, or in other words the volume of alcohol consumption, and several harmful outcomes (Babor et al., 2003; Rehm et al., 2004; WHO, 2004c). For more information see Volume of consumption and drinking patterns. Recognition of the link between drinking patterns and harmful outcomes has also grown (see Consequences for individuals and society).

Europeans heaviest drinkers in the world

The EU is the heaviest drinking region of the world, with on average 11 litres of pure alcohol being consumed per adult each year. This is over two-and-a-half times the rest of the world’s average (Anderson & Baumberg, 2006). The majority (over three quarters) of European citizens drink alcohol. Significantly more men than women drink alcohol and most drinkers drink at low risk levels (TNS Opinion & Social, 2007; Anderson & Baumberg, 2006). An estimated 15% (58 million in the EU-25: see Tabel 1) of those that consume alcohol are hazardous drinkers.

Table 1: Numbers^a of adults^b in the EU-25 at different drinking levels (source: Rehm et al., 2004, amended by Anderson & Baumberg, 2006).

^aestimates for 2001; ^b16+ years

Drinking patterns in Europe show north-south gradient

Within Europe drinking patterns traditionally show a north-south gradient. Leifman divided the EU-15 and Norway roughly into low, medium, and high consumption countries (Leifman, 2002b). The low consumption countries are the Nordic countries, the intermediate group is made up of central European countries and the high consumption group comprises Mediterranean countries. Beverage preference, drinking with meals, daily drinking and levels of consumption also show crude north-south gradients. Nordic countries traditionally show more detrimental drinking patterns. Drinking patterns are explained further in Different drinking patterns in Europe.

Converging trends in consumption levels and beverage preferences

Drinking levels, drinking patterns and beverage preferences are converging in Europe (Anderson & Baumberg, 2006). Trend in the total volume of alcohol consumed in European countries shows the convergence of per capita consumption over time. Despite remaining underlying differences between the different countries, the EU-15 alcohol consumption levels have been converging over the past four decades. Total alcohol consumption in the southern European countries, which was relatively high, has declined, while in the northern and mid-European countries total consumption, which was relatively low, has risen. As a result the differences in total consumption between the EU-15 countries have declined. Anderson & Baumberg have shown that the consumption levels of the EU-10 countries are currently closer to those of the EU-15 than ever before. However, substantial differences can still be observed between these countries.(Anderson & Baumberg, 2006).

Next to drinking levels, beverage preferences are also harmonizing. Traditional wine-drinking countries in the south are showing an increased level of beer and spirit consumption, while traditional beer and spirit-drinking countries in central and northern Europe are showing an increased level of wine-drinking. Additionally over the last few decades drinking patterns have been illustrating that a trend of increased youth drunkenness is developing in all European countries.