Public health successes and missed opportunities

Regional trends in total adult per capiTA alcohol
consumption
Monitoring alcohol exposure
Fig. 10 summarizes the trends in different subregions within the WHO European Region and for the Region as a whole
between 1990 and 2014. 10 There are clear differences in trend: consumption in the WHO European Region in the past 25
years has decreased by about 11%, with almost all of the decrease occurring since 2007. The economic recession may have
played a role there, as during recession overall less money is spent on alcoholic beverages, despite a potential increase
in the number of unemployed people (58,59). (For the relationship between unemployment and alcohol consumption, see
(60).) Such an effect would be most relevant for countries with a lower income, such as those in the eastern part of the
WHO European Region.
The decrease in alcohol consumption in the WHO European Region has also been fuelled primarily by an almost linear
decrease in the countries of the EU over the period (approximately –18% based on the 1990 level). Countries in the centralwestern
EU region around Germany showed a very similar pattern as the EU as a whole (–22%). Within the EU, consumption
in the Mediterranean countries decreased the most (–34% for all Mediterranean countries). This decrease in alcohol
consumption in Mediterranean countries actually started earlier than 1990, and is primarily the result of a decrease in wine
consumption in the traditional wine-drinking countries of France, Greece, Italy, Portugal and Spain (61–63).
Fig. 10. Trends in adult per capita alcohol consumption in the WHO European Region and selected subregions,
1990–2014
Litres of pure alcohol
18
16
14
12
10
8
6
4
2
EU
Central-western EU
Mediterranean
South-eastern WHO
European Region
Central-eastern EU
Eastern WHO
European Region
WHO
European Region
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
However, not all regions of the EU showed a decrease in alcohol consumption. The central-eastern part of the EU had
almost stable consumption over the observation period. The eastern WHO European Region in 1990 had consumption
levels that were below that of the EU and Mediterranean countries, and now their consumption exceeds the consumption
in these regions by far: in 2014, the eastern WHO European Region had 3.1 (28%) and 6.6 (85%) litres per capita higher
consumption than the average of the EU and Mediterranean countries, respectively. While in most parts of the WHO
European Region alcohol consumption is higher than the global average (see below for a quantification), this is not the
case for its south-eastern part. Alcohol consumption levels are markedly lower here, in part because a considerable
proportion of the population is from the Muslim faith (52). The sharp increase to 1991 in the south-eastern part followed
by a decrease in 1992 is partly due to the different composition of the region in these years and the methodology of using
three-year averages. 11
10
While the emphasis of this report is on the country level, and thus the majority of figures concern all countries in comparison with neighbouring countries,
the next section gives some regional trends. There is some overlap between regions, as the regions were selected based on geography, economic wealth and
drinking tradition (see above for details).
11
The time series for countries like Turkmenistan and Uzbekistan start in 1991, as they became independent in that year. Moreover, for many countries in this
region, the data source changed in 1990 (for data sources for each country and year, see (1)), resulting in some changes between 1990 (average 1989–1991, i.e.
one year with a different data source) and 1991 (average 1990–1992; all years from the same data source).
11