Aims: The aims of the article are (a) to estimate coverage rates (i.e. the proportion of ‘real consumption’ accounted for by a survey compared with more reliable aggregate consumption data) of the total, the recorded and the beverage-specific annual per capita consumption in 23 European countries, and (b) to investigate differences between regions, and other factors which might be associated with low coverage (prevalence of heavy episodic drinking [HED], survey methodology). Methods: Survey data were derived from the Standardised European Alcohol Survey and Harmonising Alcohol-related Measures in European Surveys (number of surveys: 39, years of survey: 2008–2015, adults aged 20–64 years). Coverage rates were calculated at the aggregated level by dividing consumption estimates derived from the surveys by alcohol per capita estimates from a recent global modelling study. Fractional response regression models were used to examine the relative importance of the predictors. Results: Large variation in coverage across European countries was observed (average total coverage: 36.5, 95% confidence interval [CI] [33.2; 39.8]), with lowest coverage found for spirits consumption (26.3, 95% CI [21.4; 31.3]). Regarding the second aim, the prevalence of HED was associated with wine- and spirits-specific coverage, explaining 10% in the respective variance. However, neither the consideration of regions nor survey methodology explained much of the variance in coverage estimates, regardless of the scenario. Conclusion: The results reiterate that alcohol survey data should not be used to compare or estimate aggregate consumption levels, which may be better reflected by statistics on recorded or total per capita consumption.

Little is known about possible changes in alcohol consumption distribution during the COVID-19 pandemic. We estimated how individual changes in alcohol consumption during the pandemic translated into changes in: (i) mean consumption; (ii) dispersion of consumption distribution; and (iii) prevalence of heavy drinkers. We employed data from two independent web-surveys of Norwegian adults collected between April and July 2020 and limited to those reporting past year alcohol consumption (N₁ = 15,267, N₂ = 1195). Self-reports of changes in drinking behavior were quantified, assuming change being relative to baseline consumption level. During the pandemic, we found a small increase (Survey 1) or no change (Survey 2) in estimated mean alcohol consumption (which parallels to total consumption). However, in both surveys, the dispersion of the distribution increased significantly (p < 0.001). For most respondents, an average modest decline in consumption was found. However, the small fraction with the highest baseline consumption increased their consumption substantially, and in effect, the proportion of heavy drinkers increased markedly (p < 0.001). In conclusion, quantifications of reported changes in alcohol consumption during the pandemic suggest that the upper 5 to 10% of the drinkers increased their consumption and hence the prevalence of heavy drinkers increased, despite little or no change in total alcohol consumption.

Evidence suggests that changes in alcohol consumption during the first months of the COVID-19 pandemic were unevenly distributed over consumer groups. We investigated possible inter-country differences in how changes in alcohol consumption are contingent on initial consumption (before or at the start of the pandemic), and how changes in consumption translate into possible changes in the prevalence of heavy drinking. We used data from the European Survey on Alcohol use and COVID-19 (ESAC) conducted in Czechia, Denmark, Finland, Germany, Norway, Poland, Spain, and the UK (N = 31921). Past-year alcohol consumption and changes in consumption were measured by AUDIT-C. Drinking habits were compared according to percentiles of pre-pandemic consumption levels, below versus above the 90th percentile. Across countries, drinkers in the highest 10% for pre-pandemic consumption increased their drinking during the pandemic, whereas absolute changes among those initially drinking below this level were modest. The percentage of people reporting >28 alcohol units/week increased significantly in seven of eight countries. During the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of the drinkers increased as did the prevalence of heavy drinkers, in contrast with a declining consumption in other groups in the sample.

To examine the prevalence of and trends in older adults’ (60–79 years) alcohol use in Norway between 1985 and 2019. Data stem from two repeated cross-sectional surveys in the Norwegian population: Statistics Norway’s Health and Living Conditions Surveys from 1985 (N = 7799), 1995 (N = 3518) and 2005 (N = 6487), and the Norwegian Institute of Public Health’s (NIPH) annual surveys on alcohol, tobacco and drug use from 2012/2013 (N = 4047), 2014/2015 (N = 4378), 2016/2017 (N = 4264) and 2018/2019 (N = 4330). The following measures were used to examine trends in alcohol use among women and men aged 60 and older: drinking status, drinking frequency, number of drinks per occasion, and frequency of heavy episodic drinking (HED). Between 1985 and 2019, there has been a substantial increase in the proportions of older adults in Norway who drink alcohol and who drink relatively often. The increase was particularly marked between 1985 and 2012/2013, and for elderly women. However, the majority of older adults drink small amounts of alcohol on typical drinking occasions, illustrating that the increased frequency of drinking is not accompanied by a corresponding increase in risky drinking. There has been a marked increase in alcohol use among older adults the past 30 years, particularly among older women, suggesting that the age and gender gap traditionally found in alcohol use in Norway is diminishing. Due to the lower alcohol tolerance among elderly, monitoring the changing trends in alcohol use in this group, as well as the possible consequences of these changes, is important.

Fall injuries account for a substantial part of the health burden among elderly persons, and they often affect life quality severely and impose large societal costs. Alcohol intoxication is a well-known risk factor for accidental injuries, but less is known about this association among elderly people. In this study, our aim was to assess whether risk of fall injuries among the elderly is elevated with an intoxication-oriented drinking pattern. We applied a population case-control design and data from persons aged 60 years and over in Norway. Cases comprised patients with fall injuries admitted to a hospital emergency department (n = 424), and controls were participants in general population surveys (n = 1859). Drinking pattern was assessed from self-reports of drinking frequency and intoxication frequency. Age and gender-adjusted association between fall injury and drinking pattern was estimated in logistic regression models. Fall injuries were considered alcohol-related if blood alcohol concentration exceeded 0.01% and/or the patient reported alcohol intake within six hours prior to injury. The risk of fall injuries was highly elevated among those reporting drinking to intoxication monthly or more often (OR = 10.2, 95% CI 5.5–19.0). Among cases, the vast majority of those with alcohol-related fall injuries (64 of 68) reported drinking to intoxication. A drinking pattern comprising alcohol intoxication elevated the risk of fall injuries among elderly people. As alcohol use is a modifiable risk factor, the findings suggest a potential to curb the number of fall injuries and their consequences by employing effective strategies to prevent intoxication drinking among the elderly.