Alcohol use

The ESPAD results indicate that although alcohol use and heavy drinking underwent some steady decrease over time, the prevalence alcohol use remains high among adolescents in Europe.

The 2019 ESPAD data indicate a widespread popularity of alcohol among European adolescents, with an average of over three-quarters (79%) of school students having used alcohol in their lifetime and almost half (47%) having used it in the last month (‘current use’).

However, trend data show some steady decreases, with levels now lower than in 2003 when both ‘lifetime use’ and ‘current use’ peaked at 91% and 63% respectively.

The prevalence of ‘heavy episodic drinking’ (five or more drinks on at least one occasion, in the last 30 days) reached its lowest level in the 2019 survey (35%), following a peak in 2007 (43%).

The overall temporal changes in the prevalence of current alcohol use, as well as heavy episodic drinking, between the previous survey and the 2019 survey are negligible, indicating that the downwards trend has levelled off and remains rather constant in 2019.

Although beverage preference varies across ESPAD countries, overall, in terms of prevalence rates and perception of availability, spirits have gained ground over beer. While the differences in beverage preference between countries may be explained by differences in drinking culture, lifestyle and personal factors, the 2019 ESPAD results show that the distribution of preferred beverages in adolescents diverges from the traditional characterisation of drinking cultures in Europe.

Changes in drinking regulations at national level may have contributed to the decline observed in alcohol use among young people. Among the further reasons hypothesised to have contributed to this phenomenon across Europe, is the possible loss of popularity and appeal of alcohol drinking as symbolic rite of passage to adulthood.

Teenagers continue to be broadly exposed to alcohol adverts, also on social media and this might partially explain the still high prevalence of alcohol use detected by ESPAD. The evidence of a strong influence of the exposure to alcohol advertising on adolescents has led to the suggestion that stronger measures counteracting the exposure to alcohol advertisements might act as an effective policy measure in the adolescent population.


Burdzovic Andreas, J. (2019), ‘Perceived harmfulness of various alcohol- and cannabis use modes: secular trends, differences, and associations with actual substance use behaviors among Norwegian adolescents, 2007-2015’, Drug and Alcohol Dependence 197, pp. 280-287, doi:10.1016/j.drugalcdep.2019.02.003.

Čermáková, I. and Podaná, Z. (2018), ‘Alcohol use by youth in the Czech Republic and Finland: an empirical test of Skog´s theory of the distribution of alcohol consumption’, Acta Universitatis Carolinae Philosophica and Historica 2, pp. 77-99, doi:10.14712/24647055.2018.5.

Chomynová, P. and Kážmér, L. (2019), ‘Leisure-time socializing with peers as a mediator of recent decline in alcohol use in Czech adolescents’, Journal of Substance Use 24 (6), pp. 630-637, doi:10.1080/1 4659891.2019.1640304.

Gomes de Matos, E., Kraus, L., Hannemann, T.-V., Soellner, R. and Piontek, D. (2017), ‘Cross-cultural variation in the association between family’s socioeconomic status and adolescent alcohol use’, Drug and Alcohol Review 36 (6), pp. 797-804, doi:10.1111/dar.12569.

König, C., Skriver, M. V., Iburg, K. M. and Rowlands, G. (2018), ‘Understanding educational and psychosocial factors associated with alcohol use among adolescents in Denmark; implications for health literacy interventions’, International Journal of Environmental Research and Public Health 15 (8), p. 1671, doi:10.3390/ ijerph15081671.

Kraus, L., Seitz, N.-N., Piontek, D., Molinaro, S., Siciliano, V., Guttormsson, U., Arpa, S., et al. (2018), ‘ “Are the times a-changin”? Trends in adolescent substance use in Europe’, Addiction 113 (7), pp. 1317-1332, doi:10.1111/add.14201.

Larm, P., Livingston, M., Svensson, J., Leifman, H. and Raninen, J. (2018), ‘The increased trend of non-drinking in adolescence: the role of parental monitoring and attitudes toward offspring drinking’, Drug and Alcohol Review 37 (Suppl. 1), pp. S34-S41, doi:10.1111/ dar.12682.

Markkula, J., Härkänen, T. and Raitasalo, K. (2019), ‘Drunken driving and riding with a drunken driver: adolescent types at higher risk’, Drugs: Education, Prevention and Policy 27 (3), pp. 213-220, doi:10. 1080/09687637.2019.1615867.

Noel, J. K. (2019), ‘Associations between alcohol policies and adolescent alcohol use: a pooled analysis of GSHS and ESPAD data’, Alcohol and Alcoholism 54 (6), pp. 639-646, doi:10.1093/alcalc/agz068.

Raitasalo, K., Simonen, J., Tigerstedt, C., Mäkelä, P. and Tapanainen, H. (2018), ‘What is going on in underage drinking? Reflections on Finnish European school survey project on alcohol and other drugs data 1999-2015’, Drug and Alcohol Review 37 (Suppl. 1), pp. S76-S84, doi:10.1111/dar.12697.

Raninen, J., Livingston, M., Karlsson, P., Leifman, H., Guttormsson, U., Svensson, J. and Larm, P. (2018), ‘One explanation to rule them all? Identifying sub-groups of non-drinking Swedish ninth graders’, Drug and Alcohol Review 37 (Suppl. 1), pp. S42-S48, doi:10.1111/ dar.12663.