The socioeconomic profile of alcohol use in Europe: findings from 33 European countries

Background
Alcohol’s detrimental health effects do not affect everyone equally but accumulate in people with low socioeconomic status (SES). Using data from the 2021 Standard European Alcohol Survey, we explore gender- and SES-specific consumption patterns, and COVID-19 related changes in consumption across Europe.

Methods
Cross-sectional population-based survey data from 54,354 adults from 33 European countries plus Spain-Catalonia were analysed. Five alcohol indicators were of interest: prevalence of past-year alcohol use; and, among past-year alcohol users, prevalence of monthly/more frequent risky-single-occasion-drinking (monthly+ RSOD); prevalence of high-risk alcohol use (40+/60+ grams pure alcohol daily for women/men); mean daily grams of pure alcohol consumed; and self-reported consumption changes during COVID-19. Alcohol indicators were age-standardised and decomposed by gender and SES (education attainment), and analysed using regression models with location-specific random intercepts.

Results
Across jurisdictions, past-year alcohol use, monthly+ RSOD, and high-risk drinking were all commonly reported, with distinct gender-specific socioeconomic profiles. While high-SES men and women were generally more likely to report past-year alcohol use, monthly+ RSOD and high-risk drinking were more prevalent among currently drinking low/mid-SES compared to high-SES men. No such SES differences in risky drinking were observed among women, however, female alcohol users with high SES reported higher mean daily drinking levels. High-SES women but not men were more likely to both increase and decrease their drinking during COVID-19 compared to their low/mid-SES counterparts.

Conclusion
High consumption levels and distinct socioeconomic profiles among men and women highlight the need for effective alcohol policies to reduce health inequalities in Europe.