Alcohol has historically, and continues to, hold an important role in social engagement and bonding for many. Social drinking or moderate alcohol consumption for many is pleasurable.
However, alcohol consumption – especially in excess – is linked to a number of negative outcomes: as a risk factor for diseases and health impacts; crime; road incidents; and for some, alcohol dependence. Globally alcohol consumption causes 2.8 million premature deaths per year.1
This entry looks at the data on global patterns of alcohol consumption, patterns of drinking, beverage types, the prevalence of alcoholism; and consequences, including crime, mortality and road incidents.
Data on other drug use can be found at our full entry here.
Drug Use disorders are often classified within the same category as mental health disorders — research and data on mental health can be found at our entry here.
Support for alcohol dependency
At the end of this entry you will find additional resources and guidance if you, or someone you know needs support in dealing with alcohol dependency.
The annual global average alcohol consumption is 6.4 liters per person older than 15 (in 2016). To account for the differences in alcohol content of different alcoholic drinks (e.g. beer, wine, spirits), this is reported in liters of pure alcohol per year.
To make the 6.4 liter average more understandable we can express it in bottles of wine. Wine contains around 12% of pure alcohol per volume2 so that one liter of wine contains 0.12 liters of pure alcohol. The global average of 6.4 liters of pure alcohol per person per year therefore equals 53 bottles of wine per person older than 15 (6.4l / 0.12l). Or to make it more memorable, around 1 liter of wine per week.
As the map shows, the average per capita alcohol consumption varies widely across the world.
We see large geographical differences: Alcohol consumption across North Africa and the Middle East is particularly low — in many countries, close to zero. At the upper end of the scale, alcohol intake across Europe is highest at around 15 liters per person per year in the Czech Republic, Lithuania, and Moldova. This equals around two bottles of wine per person per week.3
Only slightly behind the Eastern European countries are Western European countries – including Germany, France, Portugal, Ireland, and Belgium – at around 12 to 14 liters. Outside of Europe the only other country in this category is Nigeria.
The charts here show the share of adults who drink alcohol. This is first shown as the share of adults who have drunk alcohol within the last year and it is then broken down by sex.
The share of adults who drink alcohol is highest across Western Europe and Australia. It is highest in France: In 2010, close to 95 percent of adults in France had drunk alcohol in the preceding year.
Again, the prevalence of drinking across North Africa and the Middle East is notably lower than elsewhere. Typically 5-10 percent of adults across these regions drunk within the preceding year, and in a number of countries this was below 5 percent.
When we look at gender differences we see that in all countries men are more likely to drink than women.
This gender difference appears to be lowest in countries where the overall prevalence of drinking high. Where drinking prevalence is low-to-mid range, the prevalence of drinking in women tends to be significantly lower – often it is less than half the rate of men.
Data on the share who drink alcohol by gender and age group in the UK is available here.
Alcohol consumption – whilst a risk factor for a number of health outcomes – typically has the greatest negative impacts when consumed within heavy sessions.
This pattern of drinking is often termed ‘binging’, where individuals consume large amounts of alcohol within a single session versus small quantities more frequently.
Heavy episodic drinking is defined as the proportion of adult drinkers who have had at least 60 grams or more of pure alcohol on at least one occasion in the past 30 days. An intake of 60 grams of pure alcohol is approximately equal to 6 standard alcoholic drinks. The map shows the share heavy drinkers – those who had an episode of heavy drinking in the previous 30 days – of drinkers only (i.e those who have drank less than one alcohol drink in the last 12 months are excluded).
The comparison of this map with the previous maps makes clear that heavy drinking is not necessarily most common in the same countries where alcohol consumption is most common. In Madagascar, 65 percent of drinkers had a heavy session of drinking within the preceding month. Lithuania, Paraguay, Finland, Mongolia, Austria and Benin all had more than 50 percent of drinkers having a heavy session within the prior month.
In contrast, across most of Africa and South Asia this was the case for less than 5 percent of drinkers. Even within regions there are large differences between countries: in Italy, only 6 percent of drinkers had a heavy episode of drinking in contrast to nearly half in Ireland; 42 percent in Belgium one-third in the UK and France; and 20 percent in Spain.
Global trends on alcohol abstinence show a mirror image of drinking prevalence data. This is shown in the charts as the share of adults who had not drunk in the prior year, and those who have never drunk alcohol.
Here we see particularly high levels of alcohol abstinence across North Africa and the Middle East. In most countries in this region, more than 80 percent (often more than 90 percent) have never drunk alcohol.
Data on the share who don’t drink alcohol by gender and age group in the UK is available here.
The chart shows alcohol consumption since 1890 in a number of countries.
Across these high-income countries the annual average today lies between 5.6 liters in Japan and 10.4 liters in Austria.
A century ago some countries had much higher levels of alcohol consumption. In France in the 1920s the average was 22.1 liters of pure alcohol per person per year. This equals 184 one liter wine bottles per person per year.4 Note that in contrast to the modern statistics that are expressed in alcohol consumption per person older than 15 years, this includes children as well – the average alcohol consumption per adult was therefore even higher.
This chart shows the change in consumption of alcoholic beverages.
By default the data for Italy is shown – here the share of beer consumption increased and now makes up almost a quarter of alcohol consumption in Italy.
With the change country feature it is possible to view the same data for other countries. Sweden for example increased the share of wine consumption and therefore reduced the share of spirits.
Long-run data on alcohol consumption from the United States gives us one perspective of drinking since 1850. In the chart we see the average consumption (in litres of ethanol) of different beverage types per person in the USA from 1850 through to 2013.
Over this long time period we see that per capita drinking quantities have been relatively constant — typically averaging around 8 to 9 litres per year. Over the period 1920-1933, there was a ban on the production, importation, transportation, and sale of alcoholic beverages in the United States (known as the ‘National Alcohol Prohibition’). Since the statistics here reflect reported sales and consumption statistics, they assume zero consumption of alcohol over this time. However, there is evidence that alcohol consumption continued through black market and illegal sales, particularly in the sales of spirits. It’s estimated that at the beginning of Prohibition alcohol consumption decreased to approximately 30 percent of pre-prohibition levels, but slowly increased to 60-70 percent by the end of the period.5
As we see, following prohibition, levels of alcohol consumption returned to the similar levels as in the pre-prohibition period.
The charts show global consumption of beer, first in terms of beer as a share of total alcohol consumption, and then the estimated average consumption per person.
Both are measured in terms of pure alcohol/ethanol intake, rather than the total quantity of the beverage. Beer contains around 5% of pure alcohol per volume6 so that one liter of beer contains 0.05 liters of pure alcohol. This means that 5 liters of pure alcohol equals 100 liters of beer.
The charts show global consumption of wine, first in terms of wine as a share of total alcohol consumption, and then the estimated average consumption per person.
Both are measured in terms of pure alcohol/ethanol intake, rather than the total quantity of the beverage. Wine contains around 12% of pure alcohol per volume so that one liter of wine contains 0.12 liters of pure alcohol. This means that 3 liters of pure alcohol equals around 25 bottles of wine.
The charts show global consumption of spirits, which are distilled alcoholic drinks including gin, rum, whisky, tequila and vodka.
The first map shows this in terms of spirits as a share of total alcohol consumption. In many Asian countries spirits account for most of total alcohol consumption. In India it is over 90%.
The second map shows the estimated average consumption per person.
Both are measured in terms of pure alcohol/ethanol intake, rather than the total quantity of the beverage.
Does alcohol consumption increase as countries get richer? In the chart we see the relationship between average per capita alcohol consumption (in litres of pure alcohol per year) versus gross domestic product (GDP) per capita, across countries.
When we look at national averages in this way there is not a distinct relationship between income and alcohol consumption. As shown by clusters of countries (for example, Middle Eastern countries with low alcohol intake but high GDP per capita), we tend to see strong cultural patterns which tend to alter the standard income-consumption relationship we may expect.
However, when we looking at consumption data within given countries, we sometimes do see a clear income correlation. Taking 2016 data in the UK as an example we see that people within higher income brackets tend to drink more frequently. This correlation is also likely to be influenced by other lifestyle determinants and habits; the UK ONS also report that when grouped by education status, those with a university tend to drink more in total and more frequently than those of lower education status. There are also differences when grouped by profession: individuals in managerial or professional positions tend to drink more frequently than those in intermediate or manual labour roles.7
However, we also find correlates in drinking patterns when we look at groupings of income, education or work status. Although those in lower income or educational status groups often drink less overall, they are more likely to have lower-frequency, higher-intensity drinking patterns. Overall these groups drink less, but a higher percentage will drink heavily when they do.
The chart shows the average share of household expenditure which is spent on alcohol. Data on alcohol expenditure is typically limited to North America, Europe and Oceania. Alcohol expenditure typically ranges from 0.5 percent up to 7.7 percent (in Ireland) of household expenditure.
This shows the expenditure on alcohol in the United States, differentiated by where the alcohol has been purchased and consumed.
Alcohol is one of the world’s largest risk factors for premature death.
The Institute for Health Metrics and Evaluation (IHME) in its Global Burden of Disease study provide estimates of the number of deaths attributed to the range of risk factors.8 In the visualization we see the number of deaths per year attributed to each risk factor. This chart is shown for the global total, but can be explored for any country or region using the “change country” toggle.
The IHME estimates that in 2017 2.84 million people died prematurely as a result of indoor air pollution each year. To put this in perspective, this is 7-fold higher than the number of homicides globally (estimated to be 405,000 in 2017).
Alcohol consumption is a known risk factor for a number of health conditions and potential mortality cases. Alcohol consumption has a causal impact on more than 200 health conditions (diseases and injuries).
In the chart we see estimates of the alcohol-attributable fraction (AAF), which is the proportion of deaths which are caused or exacerbated by alcohol (i.e. that proportion which would disappear if alcohol consumption was removed). Across most countries the proportion of deaths attributed to alcohol consumption ranges from 2 to 5 percent. However, across a range of countries this share is much higher; across Eastern Europe (Russia, Ukraine, Belarus and Lithuania), nearly one-third of deaths are attributed to alcohol consumption.
Shown here is the rate of premature deaths caused by alcohol.
Globally the rate has declined from 43 deaths per 100,000 people in the early 1990s to 35 deaths in 2017.
The chart shows the age distribution of those dying premature deaths due to alcohol.
Globally almost three quarters are younger than 70 years. 28% are younger than 50 years.
It is possible to switch this data to any other country or region in the world.
Alcohol use disorder (AUD) refers to drinking of alcohol that causes mental and physical health problems.
Alcohol use disorder, which includes alcohol dependence, is defined the WHO’s International Classification of Diseases (available here).
At the end of this entry we provide a number of potential sources of support and guidance for those concerned about uncontrolled drinking or alcohol dependency.
A definite diagnosis of dependence should usually be made only if three or more of the following have been present together at some time during the previous year:
- (a) a strong desire or sense of compulsion to take the substance;
- (b) difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use;
- (c) a physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
- (d) evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill nontolerant users);
- (e) progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects;
- (f) persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.
The charts shown below present global data on the prevalence, disease burden and mortality cost of alcohol use disorders.
It’s estimated that globally around 1.4 percent of the population have an alcohol use disorder. At the country level, as shown in the chart, this ranges from around 0.5 to 5 percent of the population. In Russia, for example, the prevalence is 4.7 percent meaning that almost 1-in-20 have an alcohol dependence at any given time.
When we look at the variance in prevalence across age groups we see that globally the prevalence is highest in those aged between 25 and 34 years old (for which around 2.5 percent of the population have an alcohol use disorder). At the extreme of country-level figures, prevalence amongst Russians aged 30-34 years old is just under 10 percent. This means 1-in-10 Russians in this age group has an alcohol dependency.
Globally, 107 million people are estimated to have an alcohol use disorder. This breakdown can be viewed by gender for any country here; 70 percent globally (75 million) were male relative to 32 million females.
The scatter plot compares the prevalence of alcohol use disorders in males versus that of females. In 2017 — with the exception of Ukraine — the prevalence of alcohol dependence in men was higher than in women across all countries.
Deaths from alcohol dependence can occur both directly or indirectly. Indirect deaths from alcohol use disorders can occur indirectly through suicide. In our entry on Mental Health, we discuss the link between mental health and substance use disorders with suicide. Although clear attribution of suicide deaths is challenging, alcohol use disorders are a known and established risk factor. It’s estimated that the relative risk of suicide in an individual with alcohol dependence is around 10 times higher than an individual without.9
The chart shows direct death rates (not including suicide deaths) from alcohol use disorders across the world. In 2017, Belarus had the highest death rate with around 19 people per 100,000 individuals dying from alcoholism. For most countries this rate ranges from 1 to 5 deaths per 100,000 individuals.
It’s estimated that globally, around 185,000 people died directly from alcohol use disorders in 2017. The total estimated number of deaths by country from 1990 to 2017 are found here.
Global data on the prevalence and effectiveness of alcohol use disorder treatment is very incomplete. In the chart we see data across some countries on the share of people with an alcohol use disorder who received treatment. This data is based on estimates of prevalence and treatment published by the World Health Organization (WHO).
Do countries with higher average alcohol consumption have a higher prevalence of alcohol use disorders? In the chart we see prevalence of alcohol dependence versus the average per capita alcohol consumption. Overall there is not a clear relationship between the two, although there may be a slight positive correlation, particularly when viewed by region (e.g. in Europe). There is not, however, clear evidence that high overall consumption (particularly in moderate quantities) is connected to the onset of alcohol dependency.
Measuring the health impact by mortality alone fails to capture the impact that alcohol use disorders have on an individual’s wellbeing. The ‘disease burden‘ – measured in Disability-Adjusted Life Years (DALYs) – is a considers not only mortality, but also years lived with disability or health burden. The map shows DALYs per 100,000 people which result from alcohol use disorders.
DALY rates differentiated by age group can be found here.
Many of the risk factors for alcohol dependency are similar to those of overall substance use disorders (including illicit drug disorders). Further discussion on these risk factors can be found at our entry on Substance Use.
In the chart we show results from a study conducted published by Swendsen et al. (2010).10
In this study the authors followed a cohort of more than 5000 individuals, with and without a mental health disorder (but without a substance use disorder) over a 10-year period. Following the 10 year period they re-assessed such individuals for whether they had either a nicotine, alcohol or illicit drug dependency.11
The results in the chart show the increased risk of developing alcohol dependency (we show results for illicit drug dependency in our entry on Substance Use) for someone with a given mental health disorder (relative to those without). For example, a value of 3.6 for bipolar disorder indicates that illicit drug dependency became more than three time more likely in individuals with bipolar disorder than those without. The risk of an alcohol use disorder is highest in individuals with intermittent explosive disorder, dysthymia, ODD, bipolar disorder and social phobia.
The map shows the share of all road traffic deaths attributed to alcohol consumption over the national legal limit for alcohol consumption.
In South Africa and Papua New Guinea more than half of all traffic deaths are attributable to alcohol consumption.
In the US, Canada, Australia, New Zealand, Argentina, and many European countries alcohol is responsible for around a third of all traffic deaths.
In the countries shown in light yellow over 90% of road deaths are not related to alcohol consumption.
Shown in this map is the share of all crimes which are considered to be alcohol-related.
This includes two groups of criminal offenses: First, offenses in which the alcohol consumption is part of the crime such as driving with excess alcohol, liquor license violations, and drunkenness offenses. And second, all those crimes in which the consumption of alcohol is thought to have played a role of some kind in the committing of the offense – including assault, criminal damage, and other public order offenses.
The differences between countries are large: in some countries – including Iran, Chile, and Scandinavian countries – the share is well below 5%. In the UK on the other hand it is over 50%.
Whilst the World Health Organization (WHO) and most national guidelines typically quantify one unit of alcohol as equal to 10 grams of pure alcohol, the metric used as a ‘standard measure’ can vary across countries. Most countries across Europe use this 10 grams metric, however this can vary with several adopting 12 or 14 grams per unit.
In North America, a unit is typically taken as 14 grams of pure alcohol. In Japan, this is as high as 20 grams per unit.
Institute of Health Metrics & Evaluation (IHME), Global Burden of Disease (GBD)
- Data: Deaths, DALYs and prevalence of substance use disorders, by age and sex
- Geographical coverage: Global by country and region
- Time span: since 1990
- Available at: http://ghdx.healthdata.org/gbd-results-tool
World Health Organization (WHO) International Classification of Diseases (ICD)
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines (Vol. 1). World Health Organization.
- Data: Definitions and classifications of mental and substance use disorders
- Available at: ICD-10 Classification of Mental and Behavioural Disorders
World Health Organization (WHO) Global Health Observatory (GHO)
- Data: Prevalence of substance use disorders, trends in alcohol consumption
- Geographical coverage: Global by country
- Time span: Variable depending on datasets. Most inconsistent years post-2000
- Available at: http://www.who.int/gho/en/
Alcohol Rehab Guide
- Information: Guidance on the signs of alcoholism, unhealthy drinking behaviors, and support on where to go for help
- Geographical coverage: universal guidance; support options for the United States
- Available at: https://www.alcoholrehabguide.org/support/
Hello Sunday Morning
- Information: A social movement with the aim to reduce stigma around alcohol and to encourages people to consider their relationship with alcohol.
- Available at: HelloSundayMorning.org
- Information: List and contact details of a range of places for support on alcohol issues
- Geographical coverage: United Kingdom
- Available at: https://www.drinkaware.co.uk/alcohol-support-services/
Alcohol Help Center
- Information: Free guidance, support and discussion groups on concerns related to alcohol
- Geographical coverage: global
- Available at: http://www.alcoholhelpcenter.net/
- Information: Test to assess your drinking patterns relative to the US population
- Geographical coverage: Global; assesses relative to US drinking patterns
- Available at: What’s your drinking pattern?