Whether someone reaches for a glass of red wine every day or gets drunk on spirits almost every weekend can depend on where they live.
The use of different types of alcohol is so deeply rooted in culture that habits in a given country have hardly changed in two decades, according to a study on drinking habits in Europe published in the specialist journal Addiction.
The analysis of data from the World Health Organization (WHO) also clearly shows how dangerous drinking alcohol is: In each of the countries analysed, alcohol was linked to numerous deaths and years of life lost. The study looked at the 27 countries in the European Union as well as Iceland, Norway and Ukraine.
Overall, Ukraine came out on top of the alcohol-consuming countries, followed, in various constellations by Lithuania, Latvia and Estonia.
Wine countries, hard liquor countries, beer countries
According to the table, alcohol causes particularly great harm in countries in Eastern Europe where spirits are frequently consumed. This applies much less to countries in Southern and Western Europe, where wine consumption is strong.
However, co-author Jürgen Rehm, who conducts research in Toronto and at the University Medical Centre Hamburg-Eppendorf and elsewhere, warns against the fallacy that wine is good and spirits are bad.
"In principle, 10 grams of alcohol is 10 grams of alcohol, regardless of whether someone drinks it as schnapps, wine or beer," says Rehm. The main reason for the large differences is the different life expectancies in European countries.
"The alcohol-related damage is based on the general mortality rate. This means that 1 litre of pure alcohol in different situations leads to different damage."
Alcohol is an important factor in tuberculosis deaths, for example, because alcohol damages both the innate and the acquired immune system. However, in a country like Germany, for example, tuberculosis hardly plays a role.
"If the living conditions in the countries analysed were much more similar, then the numbers of alcohol-related deaths would also be much more similar," Rehn said.
Total amount of pure alcohol not very different
In total, the research team identified six different types of drinking habits in Europe. The total amount of pure alcohol consumed did not differ much between the groups, ranging from 9.2 litres in the mainly wine-drinking southern European countries such as France, Italy and Greece to 12 litres in eastern European countries such as Estonia, Latvia and Lithuania, where both spirits and other alcoholic beverages are consumed.
Germany is one of the Central and Western European countries characterized by heavy beer drinking and comparatively low consumption of spirits, the study said. There are also countries with a lot of beer, a lot of spirits and frequent binge drinking, including Croatia, the Czech Republic and Poland.
In another category, there are many people who don't drink but there are also a lot of high-proof spirits consumed. These countries include Ukraine and Bulgaria. Finally, the study cites a group in which a particularly large number of people drink alcohol, often to the point of intoxication: Finland, Iceland and Ireland are among them.
Alcohol deeply rooted in culture - but that can change
These groups of countries were largely stable in the years 2000, 2010, 2015 and 2019, writes the international research team. "Europe continues to be a region with distinct drinking habits that appear to be deeply rooted in the culture and are therefore difficult to change."
However, one thing was striking: In 2000, there was an additional group in which relatively little alcohol was consumed - but that changed later. Four of these countries - Norway, Poland, Iceland and Sweden - had the strictest alcohol restrictions at the time, according to an analysis by the Organization for Economic Cooperation and Development (OECD). Between 2000 and 2010, all four countries relaxed their restrictions.
As drinking habits are still strongly linked to the burden of disease and mortality, the authors conclude that ways should be found to change learnt patterns. "Alcohol policies for this change are available and should be considered by all European countries."
