Alcohol consumption during the COVID-19 pandemic in Europe: a large-scale cross-sectional study in 21 countries

Carolin Kilian1, Jürgen Rehm1,2,3,4,5,6,7  , Peter Allebeck8, Fleur Braddick9,10, Antoni Gual10,11 , Miroslav Barták12, Kim Bloomfield13, Artyom Gil7, Maria Neufeld1,2,14  , Amy O’Donnell15, Benjamin Petruželka12, Vladimir Rogalewicz12, Bernd Schulte16 & Jakob Manthey1,16,17 

the European Study Group on Alcohol Use and COVID-19 Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany,1 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,3 Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada,4 Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,5 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,6 I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia,7 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden,8 Clínic Foundation for Biomedical Research (FCRB), Barcelona, Mallorca, Spain,9 Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Mallorca, Spain,10 Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Mallorca, Spain,11 Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic,12 Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark,13 World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russia,14 Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK,15 Department of Psychiatry, Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany16 and Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany17

doi: 10.1111/add.15530



Aims To investigate changes in alcohol consumption during the first months of the COVID-19 pandemic in Europe as well as its associations with income and experiences of distress related to the pandemic.

Design Cross-sectional on-line survey conducted between 24 April and 22 July 2020.

Setting Twenty-one European countries.

Participants A total of 31 964 adults reporting past-year drinking.

Measurements Changes in alcohol consumption were measured by asking respondents about changes over the previous month in their drinking frequency, the quantity they consumed and incidence of heavy episodic drinking events. Individual indicators were combined into an aggregated consumption-change score and scaled to a possible range of —1 to +1. Using this score as the outcome, multi-level linear regressions tested changes in overall drinking, taking into account sampling weights and baseline alcohol consumption [Alcohol Use Disorder Identification Test (AUDIT-C)] and country of residence serving as random intercept. Similar models were conducted for each single consumption-change indicator.

Findings The aggregated consumption-change score indicated an average decrease in alcohol consumption of —0.14 [95% confidence interval (CI) = —0.18, —0.10]. Statisti- cally significant decreases in consumption were found in all countries, except Ireland (—0.08, 95% CI = —0.17, 0.01) and the United Kingdom (+0.10, 95% CI = 0.03, 0.17). Decreases in drinking were mainly driven by a reduced frequency of heavy episodic drinking events (—0.17, 95% CI = —0.20, —0.14). Declines in consumption were less marked among those with low- or average incomes and those experiencing distress.

Conclusions On average, alcohol consumption appears to have declined during the first months of the COVID-19 pandemic in Europe. Both reduced availability of alcohol and increased distress may have affected consumption, although the former seems to have had a greater impact in terms of immediate effects.


Keywords Alcohol consumption, coronavirus, COVID-19 pandemic, drinking, Europe, public health crisis, SARS-CoV-2.


Correspondence to: Carolin Kilian, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, Dresden, 01187, Germany. E-mail:

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