Alcohol use

1. Key messages

2. Hazardous drinking - adults

In Belgium, more men than women are hazardous drinkers

In 2018, in the whole population aged 15 years and over, the proportion of hazardous drinkers (more than 21 and 14 drinks per week respectively in men and women) was 5.9%. Twice as many men than women are considered to be hazardous drinkers. As the threshold for defining hazardous alcohol consumption in women is lower than in men, those results indicate a much lower consumption in women.

The highest prevalence is observed in the age group 55-64 and the lowest in the age group 75+.

Hazardous drinking has decreased in all regions except in Brussels, where it was the highest in 2018

The highest rate was observed in Brussels both for men and women, while it was the lowest in Flanders. In Belgium, the prevalence of hazardous alcohol consumption continues to decline. A decrease of 12% in men and 8% in women was observed between 2013 and 2018.

In men, the prevalence was the highest in Wallonia between 2004 and 2013, and the lowest in Brussels between 2004 and 2013. Since 2004 a continuous decrease of the prevalence in men was observed in Flanders and Wallonia, while in Brussels the decrease stopped in 2008 then markedly increased between 2013 and 2018, resulting in the highest prevalence of the three regions in 2018.

In women, the prevalence has been highest in Brussels in all HIS waves. A slight decrease was observed in Flanders, starting in 2001, with no clear trends in the other regions.

Education level does not clearly affect the prevalence of hazardous drinking

There is no clear difference by educational status in the age-standardized prevalence of hazardous drinking, meaning that hazardous drinking is somewhat evenly distributed among people with different educational status

3. Weekly heavy episodic drinking - adults

Young people (15-24 years old) are more likely to have weekly heavy episodic drinking

The prevalence of weekly heavy episodic drinking was 7.6% in Belgium in 2018. It was much more frequent in men (11.5%) than in women (3.9%). The age group 15-24 had the highest prevalence of weekly heavy episodic drinking (10.4%) followed by the 55-64 (9.2%) and the 25-34 (9%).

The prevalence of weekly heavy episodic drinking decreased for men and stayed stable for women in 2018 compared to 2013

In 2018, a slightly higher percentage of weakly heavy episodic drinking was observed in Flanders for men, in Brussels for women, but those differences were not statistically significant.

At Belgian level, after age-adjustment, the prevalence of weakly heavy episodic drinking decreased in men (-18%) and remained stable in women between 2013 and 2018.

In men, while the prevalence was significantly higher in Flanders in 2008, the difference between regions has narrowed and is no more significant. Between 2013 and 2018, a declining trend is observed in all three regions.

In women, in Flanders and Wallonia, the percentages remain stable around 4%; while Brussels witnesses a decrease but remained the region with the highest prevalences.

Education level does not clearly affect the prevalence of people having weekly heavy episodic drinking

There is no clear difference by educational status in the age-standardized prevalence of weekly heavy episodic drinking, meaning that weekly heavy episodic drinking is somewhat evenly distributed among people with different educational status

Belgium's average proportion of people engaging in weekly heavy episodic drinking is higher than the EU-15 average

The prevalence of weekly heavy episodic drinking is higher in Belgium than the EU-15 average, for both men (11,5% vs 8,4%) and women (3.9% vs 2.6%).

4. Problematic alcohol consumption - adults

More young people have a problematic alcohol use than elders

The prevalence of problematic alcohol use in the last 12 months was 7% in Belgium in 2018. It was higher in men (9.5%) than in women (4.7%). The prevalence of problematic alcohol consumption was the highest in the younger age group (9.8%) followed by the age group 25-44 and 45-54 (8.8%). The prevalence was similar in men and women in the age group 55-64.

Problematic alcohol use is highest among men in Wallonia and women in Brussels

The prevalence of problematic alcohol consumption in the past 12 months was the highest in Wallonia for men and in Brussels for women.

5. Total alcohol consumption per capita - adults

The total consumption of alcohol is lower in Belgium than the EU-15 average

According to the WHO estimations for 2019, the total consumption in Belgium was 10.8 liters of pure alcohol per capita (15+), which was lower than the EU-15 average (11.1 liters). The World Health Organization (WHO) European Region has the highest level (9.5 l) of alcohol consumption in the world (5.8 l).

In the world, Europe has the highest level of alcohol use

6. Weekly alcohol consumption – adolescents

In Belgium in 2022, 64% of 15-year-old adolescents in the Flemish Community and 62% in the French Community reported having ever consumed alcohol. Overall, a similar proportion of boys and girls in this age group had experimented with alcohol: 61% of girls in the French Community, 65% of girls in the Flemish Community, and 62% of boys in both communities [6].

In 2022, the prevalence of weekly alcohol consumption was highest among adolescents aged 17–18

The proportion of adolescents aged 13 to 18 who consumed at least one alcoholic drink per week was higher among the older age group. Among 17-18-year-olds, one in four girls reported consuming alcohol weekly. In this age group, 29% of boys in the French Community and 42% in the Flemish Community reported consuming alcohol weekly. Sex differences were only observed among those aged 15–18 in the Flemish Community, where boys reported more frequent weekly consumption than girls.

In 2022, weekly alcohol consumption prevalence was comparable between communities

In 2022, the proportion of boys and girls drinking alcohol weekly was similar across communities. Specifically, 15% of boys in the French Community and 17% in the Flemish Community reported consuming alcohol at least once a week. Among girls, 12% in the French Community and 11% in the Flemish Community reported weekly alcohol consumption.

Weekly beer, wine and mixed drink consumption has been declining since 2006

The weekly frequency of alcohol consumption has declined overall among adolescents since 2006, but recent trends show slight rebounds.

Among boys, weekly beer consumption fell until 2014 in both communities, then slightly increased in Flemish Community by 2022, while continuing to decline in the French Community. Weekly consumption of wine and mixed drink among boys followed a steady decline and then stabilized in 2022.

After a decline until 2014 among girls, beer and wine consumption rose again by 2022 in both communities. Mixed drink consumption decreased from 2006 to 2018 among girls.

In 2022, beer remained the most consumed alcoholic beverage among young people in both communities.

In 2022, weekly alcohol consumption was less frequent in the general education path in the Flemish Community

In the French Community, there was no significant difference in the proportion of adolescents who consumed alcohol weekly based on educational path. In the Flemish Community, fewer students in general education reported consuming alcohol weekly compared to those in technical or vocational education.

In 2022, a higher proportion of adolescents from the Flemish Community reported recent alcohol consumption compared to the EU-14 average

The 2022 HBSC International report revealed that in the EU-14 countries, 41% of 15-year-old boys and 44% of 15-year-old girls reported drinking alcohol at least once in the 30 days preceding the survey. In the French Community, prevalences were similar to the EU-14 average, while in the Flemish Community, they were higher than the EU-14 average.

7. Recent drunkenness – adolescents

In 2022, nearly two out of five adolescents aged 17-18 reported being drunk in the past month

Overall, the proportion of adolescents who had been drunk at least once in the month prior to the survey was higher among older adolescents. In the French Community, the proportion increased from around 10% at ages 13-14, to around 20% at 15-16, and nearly 40% at 17-18. In the Flemish Community, the prevalence was lower at 13-14 years (3.5% in boys and 3.2% in girls) and in girls aged 17-18 years (31%). More boys than girls had recently been drunk in the Flemish Community, while no significant sex differences were observed in the French Community.

In 2022, more young people in the French Community reported recent drunkenness than in the Flemish Community

In the French Community, 26% of boys and 27% of girls reported being drunk recently, compared to 21% for boys and 17% for girls in the Flemish Community. These differences were mainly due to a higher proportion of younger adolescents (aged 13–14) and girls who reported recent drunkenness in the French Community.

The proportion of adolescents who had been drunk recently increased in 2022

Among both sexes, the prevalence of adolescents aged 13-18 who had recently been drunk increased between 2018 and 2022 in both communities.

In the French Community in 2022, the prevalence was 1.5 times higher among boys and 2.3 times higher among girls compared to 2018. In the Flemish Community, the prevalence among boys was 1.1 times higher in 2022 than in 2018, and 1.2 times higher for girls.

In 2022, recent drunkenness was less frequent among students in general education in the Flemish Community

In the French Community, the proportion of adolescents who had recently been drunk did not differ significantly across educational paths. In the Flemish Community, students in general education reported lower levels of recent drunkenness compared to those in technical or vocational education.

In 2022 was recent drunkenness more frequent in Belgium than the EU-14 average

The prevalence of recent drunkenness among 15-year-olds was higher in both communities than the EU-14 average, for both boys and girls.

8. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

HBSC French Community

HBSC Flemish Community

Background

Excessive alcohol consumption leads to a considerable health burden: it is associated with mental disorders, liver cirrhosis, cancer, cardiovascular disease, as well as trauma, and is a leading cause of premature death. Alcohol consumption in European countries is well above the world average. Reducing excessive alcohol consumption through appropriate strategies is a priority for public health.

At the international level, estimates of alcohol consumption are often based on sales data. While these average estimates are useful to assess long-term population trends, they do not allow for the identification of harmful drinking patterns or age-specific consumption levels. Survey-based data are then more appropriate to describe problematic alcohol consumption, although self-reported consumption is subject to under-reporting and social desirability bias

In this report, we describe three survey-based indicators of excessive alcohol consumption and one indicator based on sales:

1. Hazardous alcohol consumption: weekly consumption exceeding 21 drinks containing the equivalent of 10 g of pure alcohol in men and 14 drinks in women;
2. Weekly heavy episodic drinking: consumption of 6 drinks or more in a single occasion, at least once a week;
3. Past year problematic alcohol consumption: people experiencing problematic drinking in the last 12 months defined by the CAGE instrument;
4. Average alcohol consumption per capita: estimations by the World Health Organization, used here for international comparisons.

For the adolescents, we focused on indicators of weekly and recent alcohol consumption, as well as recent drunkenness.

The HBSC survey collects data through questionnaires completed by students, drawn from a sample of schools that were randomly selected from the full-time education schools. The surveys provide information among adolescents aged 11 to 18 years. The data used for the French Community covers students from Wallonia and the Brussels-Capital Region, while the Flemish Community only includes schools from Flanders and not those from the Brussels-Capital Region [4-5]. For international level and socio-economic disparities, data are used from the most recent international reports published by the World Health Organization [6]. The indicators were assessed among adolescents aged 11, 13 and 15 years.

Definitions

Hazardous alcohol consumption - adults

Hazardous alcohol consumption, or alcohol overconsumption is defined as a consumption of pure alcohol exceeding 30 g for men and 20 g for women daily; it is equivalent to 21 and 14 standard drinks (of 10 g pure alcohol content) per week respectively.

Weekly heavy episodic drinking - adults

Weekly heavy episodic drinking is defined as consumption of at least 6 standard drinks (of 10 g pure alcohol content) on the same occasion, at least once a week.

Problematic alcohol consumption - adults

Problematic alcohol consumption is defined as 2 positive answers out of the 4 questions of the CAGE instrument and is predictive of alcohol dependence.

CAGE instrument - adults

The CAGE instrument is a widely used screening test for problem drinking and potential alcohol problems. The questionnaire contains four ‘yes-no’ questions and two positive answers are considered as a warning signal for potential problematic use of alcohol:
1. Have you ever felt the need to cut down on your drinking?
2. Have you ever been criticized concerning your drinking?
3. Have you ever felt guilty about drinking?
4. Have you ever felt the need to take a drink first thing in the morning (eye-opener) to steady your nerves or to get rid of a hangover?

Total alcohol consumption per capita - adults

The total alcohol per capita consumption is the recorded 3-years average and the unrecorded alcohol consumption per capita in the population aged 15 and over, expressed in liters of pure alcohol a year. Recorded alcohol consumption refers to official statistics (production, import, export, and sales or taxation data. Unrecorded consumption refers to alcohol which is not taxed and is outside the usual system of governmental control. This can be estimated thanks to specific survey questions. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/465

Weekly alcohol consumption - adolescents

Adolescents were asked about the frequency with which they consumed beer, wine, strong spirits (brandy, cocktail, whisky, …), soda mixes with alcohol (Bacardi Breezer®, Smirnoff Ice®, …), or other alcoholic beverages. Weekly alcohol consumption refers to drinking at least one of these beverages at least once per week.

Recent alcohol consumption - adolescents

Adolescents were asked how many times they had consumed alcohol in the last 30 days. Response options ranged from “never” to “30 (or more) days”. Recent alcohol consumption is defined as the proportion of adolescents who had consumed alcohol one day or more in the last 30 days.

Recent drunkenness - adolescents

Adolescents were asked how many times in the last 30 days they had consumed so much alcohol that they got drunk. Response options ranged from “never” to “more than 10 times”. Recent drunkenness was defined as the proportion of adolescents who reported having been drunk at least once in the last 30 days.

EU-15/EU-14

The EU-15 corresponds to all countries that belonged to the European Union between 1995 and 2022: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom. We compare the Belgian health status to that of the EU-15 rather than the one of EU-28 because this historical construction has more socio-economic similarity than EU-28. From 2020 onwards, we compare data between 14 countries, i.e. the countries listed above excluding United Kingdom, which is no longer part of the European Union.

References

1. Health Interview Survey, Sciensano, 1997-2018. https://www.sciensano.be/en/projects/health-interview-survey
2. Eurostat. http://ec.europa.eu/eurostat/fr/data/database
3. World Health Organization, GISAH, 2019. http://apps.who.int/gho/data/node.gisah.A1036?lang=en&showonly=GISAH
4. Service for Health Information, Promotion, and Education, Université libre de Bruxelles. 2022. Health behaviour in School-aged Children (HBSC) survey in the French community, funded by the Office for Birth and Childhood (ONE), the Walloon Region (AVIQ) and the Brussels Region (Cocof). https://sipes.esp.ulb.be.
5. Health Promotion Research Group of Ghent University (UGent). 2022. The Health Behaviour in School-aged Children (HBSC) study in the Flemish Community, under the coordination of the Regional Office of the World Health Organization (WHO) for Europe, funded by the Flanders Agency for Care and Health. https://www.jongeren-en-gezondheid.ugent.be/
6. World Health Organization (WHO) Regional Office for Europe. 2022. Spotlight on adolescent health and well-being. Findings from the 2021/2022 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. International report. 2020. https://www.euro.who.int/en/health-topics/Life-stages/child-and-adolescent-health/health-behaviour-in-school-aged-children-hbsc/publications/2020/spotlight-on-adolescent-health-and-well-being.-findings-from-the-20172018-health-behaviour-in-school-aged-children-hbsc-survey-in-europe-and-canada.-international-report.-volume-2.-key-data

Please cite this page as: Sciensano. Determinants of Health: Alcohol use, Health Status Report, 21 October 2025, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/determinants-of-health/alcohol-use