Tour de booze: alcohol facts and trends across the globe
December 16, 2013
Note from the editor: This is the second of a four-part series exploring drug trends around the world. Check back soon for part three, which examines opioid and opiate use.
Anyone who watches the show "Intervention" -- or reality TV in general -- might think the United States has a bit of a drinking problem. According to the U.S. Centers for Disease Control and Prevention, alcohol is a popular American pastime despite its link to a number of harmful health issues, like liver disease or unintentional injuries. In fact, the National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration reveals that 18.3 million Americans 12 and up needed alcohol abuse treatment (such as counseling) in 2012.
Furthermore, the Century Council reports that in 2010, 31 percent of all traffic-related deaths were caused by excessive drinking, though one should note that the number of overall drunk driving fatalities actually decreased by 52 percent between 1982 and 2010. Nonetheless, most Americans of legal drinking age imbibe at least periodically, and they are not alone in this.
As the Social Issues Research Centre (SIRC) reports, alcohol has been an important part of human cultures since the Neolithic period, or about 4000 B.C., and plays a key role in most societies today. Still, drinking trends vary from one nation to the next, and statistics alone can be deceiving. For instance, the SIRC notes that a country's alcohol-related problems are not necessarily linked to its average per capita consumption: France consumes much more alcohol than Ireland but has far fewer indices of problem drinking. Just where does the U.S. fit in on this global scale? The following alcohol profiles of six nations across the globe can offer some perspective.
The U.S. is a diverse nation and drinking habits tend to vary based on region and culture, but according to the World Health Organization, adult drinkers (defined by the WHO as 15 years and older) consumed an average of 14.43 liters in pure alcohol per year from 2003 to 2005. Beer tends to be the drink of choice, accounting for 53 percent of alcohol consumed in 2005. Spirits accounted for 31 percent, and wine 16 percent. Thirteen percent of U.S. men age 15 to 85 were defined as heavy episodic drinkers in 2004, compared to only 3.4 percent of women. Not surprisingly, nearly three times more men suffered from alcohol use disorders that year: 5.48 percent versus 1.92 percent. This may all sound bad, but on a global scale, problematic alcohol use is actually fairly tempered in the U.S. The WHO assigns each nation a "patterns of drinking score," which rates its degree of dangerous drinking on a scale of 1 to 5 -- with 5 being the most risky. In 2005, the U.S. scored a 2, which suggests that though its citizens enjoy alcohol, they do so fairly responsibly.
To get a sense for what type of drinking behaviors would earn a nation a patterns of drinking score of 5, look no further than Russia. According to the WHO, adult drinkers consumed, on average, 26.71 liters per year in pure alcohol from 2003 to 2005 -- nearly double that of the U.S. About 6 percent of Russian women were considered heavy episodic drinkers in 2003, compared to a whopping 22 percent of males. Perhaps the most alarming statistic is that one in five men in Russia and surrounding countries die from alcohol-related causes. This may come as a surprise considering over 10 percent were defined as lifetime abstainers in 2003, meaning they've never had a drop. The vast bulk of alcohol consumed in Russia is spirits, with vodka being the drink of choice.
The World Bank reports that while alcohol abuse is a mostly global problem, it is especially prevalent in poorer nations. Ecuador certainly fits that bill. The nation's yearly per capita consumption of pure alcohol among adult drinkers from 2003 to 2005 averaged a hefty 29.87 liters. Bucking the trend, women actually tend to drink much more than men: 33.43 liters compared to 22.78 liters per year. Nonetheless, alcohol abuse disorders afflict a far greater percentage of males: 6 percent versus 1 percent of women. Despite these statistics -- and a patterns of drinking score of 4 -- nearly 57 percent of Ecuadorians are lifetime abstainers, suggesting that the comparatively small share of drinkers tend to go overboard. According to CNN, an inexpensive, but highly potent drink called Zhamir, made from sugar cane, is among the nation's most favored drinks.
As CNN notes, China's economic expansion has made it a major consumer of oil and other raw materials, and, it seems, alcohol. It's often used in a celebratory or ceremonial manner, like at a wedding or when closing a business deal, and the WHO indicates most of what is consumed is spirits. Still, average consumption among drinkers from 2003 to 2005 was about 10.6 liters of pure alcohol per year, less than the U.S. About a tenth of men are labeled as heavy episodic drinkers versus just .3 percent of women. CNN notes that while Shanghai billionaires have been known to spend more than $10,000 on bottles of wine, many Chinese citizens prefer to stick to "fiery" grain-based liquors like Baijiu.
Australia has a reputation for being a drinking nation, notes CNN, and one might say it has embraced that label wholeheartedly. Former Prime Minister Bob Hawke once appeared in the Guinness Book of World Records for downing 2.5 pints of beer in just 2.5 seconds. But despite feats like this, Australian drinkers consume less than Americans, averaging 11.89 liters of pure alcohol per year between 2003 and 2005. The WHO has assigned Australia a pattern of drinking score of just 2. According to CNN, social custom can make drinking in Australia an expensive affair since one must abide by the rules of "the shout." That means when you accept a drink as part of a round, you are obligated to "shout" (or buy) everyone else a drink in return. Beer remains the most popular drink. Wine is increasing in popularity, but is still often consumed in conjunction with beer.
One would reasonably assume that Germans are the biggest beer drinkers in Europe, but it's the Czechs that take that title according to CNN. In fact, Czech drinkers consume among the most alcohol overall in Europe, imbibing 19.54 liters per year, on average, from 2003 to 2005. The WHO reports that in 2003, more than a third of Czech men and 6 percent of women were heavy drinkers, and less than 6 percent of all Czechs were lifetime abstainers. Still, only 4.4 percent of males and 0.58 percent of females had an alcohol use disorder in 2004, less than Americans. This juxtaposition has earned the Czech Republic a patterns of drinking score of 3.
Setting limits: how nations address alcoholism
If profiles like these tell us anything, it is that even countries with relatively minimal alcohol consumption can still struggle with alcohol abuse -- some just struggle more than others. How nations deal with the problem varies and some choose to embrace it for what it is. According to Times Live, Amsterdam recently revealed that it actually hires local alcoholics to clean its streets, then paid them in beer. Generally, however, nations set strict age and alcohol consumption limits, and according to WHO, may even levy hefty taxes to discourage sales. Organizations like the WHO and World Bank maintain detailed records on alcohol use (and abuse) statistics, legal drinking ages and other key regulations for most nations.
"Action needed to reduce health impact of harmful alcohol use," World Health Organization, February 11, 2011, http://www.who.int/mediacentre/news/releases/2011/alcohol_20110211/en/index.html
"Alcohol and Public Health: Data, Trends, and Maps," Centers for Disease Control and Prevention, August, 2013, http://www.cdc.gov/alcohol/data-stats.htm
"Amsterdam pays alcoholics in beer to clean streets," Times Live, November 19, 2013, http://www.timeslive.co.za/world/article10413118.ece
"Drunk Driving Fatalities - National Statistics," The Century Council, 2010, http://www.centurycouncil.org/drunk-driving/drunk-driving-fatalities-national-statistics
"Global Status Report on Alcohol and Health 2011," World Health Organization, http://www.who.int/substance_abuse/publications/global_alcohol_report/en/index.html
Management of Substance Abuse: Country profiles 2011, World Health Organization, 2011, http://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/en/index.html
"Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings," Substance Abuse and Mental Health Services Administration, October 2013, http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/
"Risking your health: causes, consequences, and interventions to risky behavior," World Bank, November 19, 2013, Damien de Walque, http://documents.worldbank.org/curated/en/2013/10/18486155/risking-your-health-causes-consequences-interventions-prevent-risky-behaviors
"Social and Cultural Aspects of Drinking," Social Issues Research Centre, http://www.sirc.org/publik/drinking3.html
"World's 10 best drinking nations," CNN, Barry Neild, March 15, 2013, http://www.cnn.com/2013/03/15/travel/best-drinking-nations/
"Worldwide alcohol trends," World Health Organization, March 15, 2011, http://www.who.int/mediacentre/multimedia/podcasts/2011/alcohol_20110315/en/