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.