Alcohol use

1. Key messages

European countries have the highest level of alcohol consumption in the world. Belgium, with an average consumption of 11 litres of pure alcohol per capita per year, is close to the mean European consumption, placing it among the countries with a high burden related to alcohol.
In 2013, 7.2% of the men and 4% of the women had a hazardous consumption of alcohol (more than 21 or 14 drinks per week respectively in men and women). The prevalence of hazardous consumption has decreased since 2004 in men, but not in women.
The prevalence of weekly Risky Single Occasion Drinking (RSOD, consumption of at least 6 glasses of alcohol at a single occasion) in Belgium is higher than the European average. Particularly worrying is the prevalence of RSOD in young men (15-24), that reaches 20%. This is a clear target for prevention strategies.

2. Background

Excessive alcohol consumption is responsible for 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 the European countries is largely above the world average. Reducing excessive alcohol consumption through appropriate strategies is a priority for public health.

At the international level, estimations of alcohol consumption are often based on sales data. While those average estimates are useful to assess long-term population trends, they do not allow identifying harmful drinking patterns. Survey-based data are more appropriate to describe problematic alcohol consumption, but self-reported measures are subject to under-reporting and social desirability bias.

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

  1. Hazardous alcohol consumption, referring to a weekly consumption exceeding 21 drinks containing the equivalent of 10 g of pure alcohol in men and 14 drinks in women;
  2. Weekly Risky Single Occasion Drinking (RSOD) or "binge drinking", referring to a consumption of 6 drinks or more in a single occasion, at least once a week.
  3. In the international comparisons, we present the average alcohol consumption per capita as estimated by the World Health Organization (WHO).

3. Hazardous drinking

Belgium

In 2013, the proportion of hazardous drinkers (more than 21 or 14 drinks on average per week respectively in men and women) was 6%. 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 suggest a much lower consumption in women. Hazardous drinking is worrying in young men (15-24 years) with an 8% prevalence, but the highest prevalence is observed in the 55-64 age group (12% for both sexes considered together).

Prevalence of alcohol hazardous drinking among the population aged 15 or older, by age group and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]

Time trend and differences by regions

At Belgian level, a decrease in the prevalence of hazardous alcohol consumption among men is observed from 12.3% in 2004 to 7.2% in 2013. This decrease from 2004 in men was observed in all three regions. In women, this decrease was smaller and not significant.

A slightly higher prevalence of hazardous alcohol consumption in men was observed in Wallonia in 2013 than in the other regions, but this difference was not significant after adjustment for age. In women, a significantly higher prevalence was observed in Brussels compared to the two other regions.

  • Men
  • Women

Prevalence of alcohol hazardous drinking in men aged 15 and older, by region and for Belgium, 1997-2013
Source: Health Interview Survey, Sciensano, 1997-2013 [1]

Prevalence of alcohol hazardous drinking in women aged 15 and older, by region and for Belgium, 1997-2013
Source: Health Interview Survey, Sciensano, 1997-2013 [1]

Differences by educational level

The patterns of hazardous alcohol drinking by educational level (EL) are opposite in men and women. They do not follow a gradient. Instead, in men, hazardous alcohol drinking is more frequent in the lower two than in the higher two ELs. In women, the pattern is reverse, with hazardous alcohol consumption more frequent among highly educated women compared to women with low ELs. The same gender pattern was also observed in all OECD countries [2].

Percentage of hazardous alcohol drinking in the population aged 15 and older, by sex and educational level, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]

4. Risky single occasion drinking

Belgium

The prevalence of weekly Risky Single Occasion Drinking (RSOD) was 8.5% in Belgium in 2013, while it was 8.1% in 2008. It is more frequent in men (12.5%) than in women (3.5%). The age group 15-24 years has the highest prevalence of RSOD (14%), followed by the 55-64 years (11.3%). The prevalence is particularly high in young men: almost 20% of the young men (15-24 years) declare a consumption of (at least) 6 glasses of alcohol at a same occasion, once a week or more. There are no differences by educational level.

Prevalence of weekly Risky Single Occasion Drinking (RSOD) in the population aged 15 or older, by age group and sex, Belgium, 2013
Source: Health Interview Survey, Sciensano, 2013 [1]

Changes and differences by regions

The prevalence of weekly RSOD remained almost stable between 2008 and 2013 at national level. In 2008, the prevalence of RSOD was significantly higher for men in Flanders (around 13%) than in the other regions, but the regional differences disappeared in 2013, as the weekly RSOD prevalence remained stable in Flanders but increased in Wallonia and Brussels (from 8.8% and 8.5% to 12% in both regions.

Among women, the prevalence in weekly RSOD remained stable in Flanders and Wallonia and increased in Brussels from 3.3 to 5.2% between 2008 and 2013.

  • Men
  • Women

Prevalence of alcohol weekly Risky Single Occasion Drinking in men aged 15 and older, by year and by region, Belgium, 2008-2013
Source: Health Interview Survey, Sciensano, 2008-2013 [1]

Prevalence of alcohol weekly Risky Single Occasion Drinking in women aged 15 and older, by year and by region, Belgium, 2008-2013
Source: Belgian Health Interview Surveys, 2008-2013 [1]

International comparison

The prevalence in weekly RSODs is higher in Belgium than the EU-15 average (for the 13 countries with available data), for both men (13 vs 10%) and women (3.8 vs 3.1%).

  • Men
  • Women

Prevalence of weekly Risky Single Occasion Drinking among men aged 15 or older, by country of residence, Europe, 2014
Source: Eurostat, 2014 [3]

Prevalence of weekly Risky Single Occasion Drinking among women aged 15 or older, by country of residence, Europe, 2014
Source: Eurostat, 2014 [3]

5. Total alcohol consumption per capita

The World Health Organization (WHO) European Region has the highest level of alcohol consumption in the world [4]. According to the WHO estimations for the period 2008-2010, the total consumption in Belgium was 11.0 liters of pure alcohol per capita, which was close to the EU-15 average (11.4 liters).

Total alcohol (recorded 3-year average + unrecorded) per capita consumption (in liters of pure alcohol) among population aged 15 or older, by country of residence, Europe, 2010
Source: GISAH, 2008-2010 [5]
Total alcohol (recorded 3-year average + unrecorded) per capita consumption (in liters of pure alcohol) among population aged 15 or older, by region of the world, 2010
Source: World Health Organization, 2014 [6]

6. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

Definitions

EU-15
The EU-15 corresponds to all countries that belonged to the European Union between 1995 and 2004: 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 because these countries have similar socioeconomic conditions.
Hazardous alcohol consumption
Hazardous alcohol consumption, or alcohol over consumption, is the percentage of men and women aged 15 years and older who reports consuming more than 30 g for men and 20 g for women daily, equivalent to 21 and 14 glasses per week respectively.
Total alcohol per capita consumption
The total alcohol per capita consumption is the recorded 3-years average and the unrecorded alcohol consumption per capita for the population aged 15 and over, expressed in litres 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 survey specific questions. More information can be found in http://www.who.int/substance_abuse/activities/gisah_indicatorbook.pdf?ua=1
Weekly Risky Single Occasion Drinking (RSOD)
Weekly risky single occasion drinking is the percentage of people aged 15 years and older who declares a heavy episodic drinking, defined as a consumption of (at least) 6 glasses of alcohol at a same occasion, at least once a week. Also frequently called "binge drinking".

References

  1. Health Interview Survey, Sciensano, 1997-2013. https://hisia.wiv-isp.be/SitePages/Home.aspx
  2. OECD, 2015. http://www.oecd-ilibrary.org/docserver/download/5js1qwkz2p9s-en.pdf?expires=1518691657&id=id&accname=guest&checksum=F8F823E57B77D9806509FD2DFA4CFC10
  3. Eurostat. http://ec.europa.eu/eurostat/fr/data/database
  4. World Health Organization, 2017. http://www.euro.who.int/__data/assets/pdf_file/0007/343744/2017-Alcohol-Fact-Sheet-FINAL.pdf?ua=1
  5. World Health Organization, GISAH, 2008-2010. http://apps.who.int/gho/data/node.gisah.A1032?lang=en&showonly=GISAH
  6. World Health Organization, Global status report on alcohol and health, 2014. http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1