By far the greatest proportion and level of expenditure on alcohol in Europe is found in Ireland, with each household spending nearly €PPP17008 on alcohol each year.9 This is three times the level of any other country, and over ten times as much as Greece (see Figure 3.4). More generally, expenditure is much lower in the wine producing countries than in the rest of the EU15, reflecting the relatively low price of alcohol in Southern Europe (see Chapter 9).

Studies from the United Kingdom  and Ireland indicate that one third of intimate partner violence occurs when the perpetrator is under the influence of alcohol. Violence against strangers is more likely to involve alcohol than is violence against intimate partners.

Just under half of this alcohol is consumed in the form of beer (44%), with the rest divided between wine (34%) and spirits (23%). Within the EU15, northern and central parts drink mainly beer, while those in southern Europe drink mainly wine (although Spain may be an exception). This is a relatively new phenomenon, with a harmonization visible over the past 40 years in the EU15.

Figure 4.1 Europe and the world’s drinking Sources: Global Status Report on Alcohol (WHO 2004); EU figures are taken from WHO Health for All Database and WHO Global Alcohol Database (as below). Averages are population-weighted.

Around 40% of drinking occasions in most of the EU15 are consumed with the afternoon/evening meal, although those in southern Europe are much more likely to drink with lunch than elsewhere. While the level of daily drinking also shows a north—south gradient, non-daily frequent consumption seems to be more common in central Europe, and there is evidence for a recent harmonization within the EU15.

Drinking to drunkenness varies across Europe, with fewer southern Europeans than others reporting getting drunk each month. This pattern is attenuated when ‘binge-drinking’, a measure of drinking beyond a certain number of drinks in a single occasion, is instead investigated, suggesting that there are systematic differences in either or both of people’s willingness to report being intoxicated or the length of a ‘single occasion’. The studies of binge-drinking also show occasional exceptions to the north-south pattern, in particular suggesting that

Sweden has one of the lowest rates of binge-drinking in the EU15. Summing up across the EU15, adults report getting drunk 5 times per year on average but binge-drink 17 times. This is equivalent to 40m EU15 citizens ‘drinking too much’ monthly and 100m (1 in 3) binge-drinking at least once per month. Much fewer data are available for the EU10, but that which exists suggests that some of the wine-drinking is replaced by spirits, the frequency of drinking is lower, and the frequency of binge-drinking higher than in the EU15.

While 266 million adults drink alcohol up to 20g (women) or 40g (men) per day, over 58 million adults (15%) consume above this level, with 20 million of these (6%) drinking at over 40g (women) or 60g per day (men). Looking at addiction rather than drinking levels, we can also estimate that 23 million Europeans (5% of men, 1% of women) are dependent on alcohol in any one year. In every culture ever studied, men are more likely than women to drink at all and to drink more when they do, with the gap greater for riskier behaviour. It is hard to find evidence that this gender gap has decreased for most aspects of drinking, although the gender gap in drunkenness is lowest in young adults. Although many women give up alcohol when pregnant, a significant number (25%-50%) continue to drink, and some continue to drink to harmful levels. Patterns in drinking behaviour can also be seen for socio-economic status (SES), where those with lower SES are less likely to drink alcohol at all.

Figure 4.2 Alcohol consumption in Europe, 2002 Sources: WHO Health for All database and WHO GBD study (Rehm et al 2004). * No estimate available for unrecorded consumption in Malta; APN update of WHO figures used for Slovakia; unrecorded consumption in Lux. is minus 2 litres due to tourist consumption. Lux is also high because many of its workers live in neighbouring countries.

Most countries show a rise in binge-drinking for boys from 1995/9 to 2003, and nearly all countries show this for girls (similar results are found for non-ESPAD countries using other data). This is due to a rise in binge-drinking and drunkenness across most of the EU 1995-9, followed by a much more ambivalent trend since (1999-2003). A narrowed gap between the EU10 and EU15 is also visible for binge-drinking and drunkenness, due to both the size of the changes and a continued rise in parts of the EU10, particularly for girls, and accompanied by rises in other aspects of consumption (e.g. last occasion consumption). Trends are more ambivalent for many other aspects of drinking, however, such as frequency of drinking and estimated total consumption. While there is, therefore, no evidence that young people’s use of alcohol has increased in the last decade, it does appear that there is a trend towards increased risky use, particularly in the EU10.