Why has alcohol consumption declined in countries of southern Europe?

Addiction (1997) 92 (Supplement 1), S21± S31

SECTION 1: ALCOHOL, SOCIETY AND CULTURE

Why has alcohol consumption declined incountries of southern Europe?

ANTONI GUAL & JOAN COLOM1

Alcohol Unit, Generalitat de Catalunya, Hospital ClõÂ nic &1Drugs Agency, Health

Department, Generalitat de Catalunya, Barcelona, Spain

Abstract

Alcohol consumption seems to be decreasing in the traditional wine countries of southern Europe. This paper

describes the evolution of alcohol consumption over the last 30 years in France, Greece, Italy, Portugal and

Spain. For this purpose, data on alcohol production and per capita alcohol consumption in southern Europe

are examined, and their reliability discussed. To analyse alcohol-related mortality, liver cirrhosis death rates

are also reviewed. Since 1980 overall alcohol production has increased by 10%, while wine production has

decreased by 13%. The consumption of pure alcohol equivalent per capita has continually decreased, from a

peak of 14 litres per year in 1974 to 10.4 litres in 1992. The reduction is dramatic for wine (42.3%) and

slight for spirits (4.7%), while beer consumption has grown by 36.6%. These data seem to con ® rm a

European trend towards the homogenization of drinking patterns. Marketing factors, public health policies,

the evolution of prices and taxation, European Union agricultural policies, a growing awareness of public

opinion about the toxicity of alcohol and competition from non-alcoholic drinks are all factors that may

partially explain these observed changes.

Introduction

In seeking to de® ne what is meant by southern

Europe, both geographical and cultural factors

should be considered. One approach would be to

count as southern European countries those that

touch the Mediterranean Sea, but this would

exclude Portugal, which is undoubtedly in south-

ern Europe. Conversely, this de® nition includes

the residents of the northern regions of France as

southern Europeans, which they are not. Since

no clear criteria can be de® ned, we have chosen

as southern European countries those that touch

the Mediterranean and can be considered wine

producers and countries with a wine culture.

This includes Portugal, although it does not

touch the Mediterranean, but excludes the wine-

producing regions of southern Germany. Turkey

is also excluded since it is not a wine culture

country.

To know if alcohol consumption has

decreased, comparable longitudinal data is

needed. In this group of countries such data are

not always available for research. In particular,

data are unobtainable or unavailable in Albania,

Bosnia and Herzegovina, Croatia, Slovenia, the

former Yugoslav Republic of Macedonia or

Yugoslavia. Therefore, our analysis will include

® ve countries: France, Greece, Italy, Portugal

and Spain. These ® ve countries have a good deal

in common. As both wine producers and mem-

Correspondence to: Antoni Gual, Unitat d’ Alcohologia de la Generalitat de Catalunya, Hospital ClõÂ nic, Villarroel136, 08036 Barcelona, Spain. Tel: 1 34 32 27 55 48; e-mail: [email protected]

Submitted 10th July 1996 ; initial review completed 24th July 1996 ; ® nal version accepted 23rd October 1996.

0965 ± 2140 /97/03S021 ± 11 $9.50 Ó Society for the Study of Addiction to Alcohol and Other Drugs

Carfax Publishing Company

S22 Antoni Gual & Joan Colom

Table 1. Comparison between countries (1993)

Country France Greece Italy Portugal Spain

Area(km2) 543 965 131 957 301 286 91 985 504 750Population 57 527 000 10 346 000 56 960 000 9 860 000 39 048 000GDP per capita

121 739 7 124 17 405 7 597 12 252

Cars2 420 178 474 207 445Television3 95% 99% 99% 98% 99%Life expectancy

476.8 77.0 77.5 74.9 76.7

Source: European Marketing Pocket Book 1995. 1Gross domestic product in US$ thousands, 1993;2per 1000 inhabitants;

3percentage of families with the speci® ed consumer durable in 1991;

4in years,

data from 1990.

Table 2. Wine and beer consumption in recent years, according to different sources (in litres per capita)

Wine Beer

Country Source 1989 1992 % change1

1989 1992 % change1

France WDT2

74.1 64.5 2 13 40.8 40.9 0

Eurostat 73.2 64.5 2 12 40.5 40 2 1Greece WDT 29.9 31/5 5 38.4 40 4

Eurostat 33.3 25.3 2 24 38.8 40 3Italy WDT 62.5 60.4 2 3 21.9 25.9 19

Eurostat 69.7 61.6 2 12 21.7 23.6 9Portugal WDT 53 55 4 63.8 65.3 2

Eurostat 53 57 8 57.3 65.6 14Spain WDT 36.9 39.1 6 71.1 70.5 2 1

Eurostat 46 43 2 7 72.5 70.5 2 3Southern Europe3 WDT 58.0 54.9 2 5 45.2 44.1 2 3

Eurostat 62.3 55.9 2 10 45.1 43.0 2 5

1Percentage change from 1989 to 1992; 2World Drink Trends;

3data calculated weighting alcohol consumption inlitres per capita by the population of each country.

bers of the European Union (EU) they share the

same beverages, taxes, policies to reduce vine-

yards, etc. Although a selected group these ® ve

countries, with over 170 million people, clearly

represent the drinking trends in this part of the

world.

To treat these ® ve countries as a whole it must

be assumed that they share some social, cultural

and economic homogeneity, yet they have ® ve

different languages, ® ve different cultures and

® ve different economies. Table 1 shows large

differences in the broad economic indicators. For

instance, France is ® ve times bigger than Greece,

has ® ve times more people and its gross domestic

product per capita is three times bigger; so,

although we will study these southern European

countries as a whole, national differences should

be outlined and kept in mind.

The second problem is how to obtain reliable

data on alcohol consumption. The ® rst dif® culty

is the source of data. As Hupkens et al. (1993)

point out: `... international research based on data

gathered on an individual level is scarce ...

Comparative research is mainly based on con-

sumption data per head of the population ...

These studies allow only a rough impression of

the differences in alcohol consumption between

countries.º

Relying on per capita alcohol consumption

data alone is dangerous. In southern Europe,

alcohol consumption seems to differ depending

on who collects the data. Table 2 presents data on

wine and beer consumption from two different

sources: World Drink Trends (1994 edition) and

Eurostat (1995). It is surprising how data can be

so similar in some cases and completely different

in others. Certainly, further research should be

done before we accept these data as correct.

Alcohol consumption decline in S. Europe S23

In recent years, World Drink Trends has

become the standard source of data for anyone

studying world alcohol consumption. Certainly,

collecting such a huge amount of information is

a tremendous job, but users should remember

that the reports form part of a series of pocket

books based on economics, and that this particu-

lar book is sponsored by the Produktschap Voor

Gedistilleerde Dranken (Commodity Board for

the Distilled Spirits Industry).

The World Drink Trends data show the total

consumption of alcoholic beverages for each

country. Per capita consumption is then just an

extrapolation. At the same time these data are

surprisingly volatile over time. Data in the 1992

and 1994 editions of the World Drink Trends

(W DT) raise some questions about our ® ve

countries.

· In Italy, alcohol consumption in 1981 was

13.0 litres of pure alcohol per capita, accord-

ing to the W DT 1992 edition. Surprisingly, the

data for the whole 10-year period have been

revised in the W DT 1994 edition, lowering

Italy’ s alcohol consumption in 1981 to 11.7

litres. Although it is clearly acceptable to revise

recent data, it is not so acceptable to revise

10-year-old data, particularly without expla-

nation.

· While data on spirits consumption in Greece

do not appear in the 1992 W DT edition, the

1994 edition presents retrospective data going

back to 1976. As a result, alcohol consump-

tion in Greece has suddenly and retrospec-

tively ª increasedº by an average of 2.5 litres of

pure alcohol per capita over the last 15 years.

For example, alcohol consumption in 1990

was 5.9 litres of pure alcohol per capita in the

W DT 1992 edition and has grown to 8.6 litres

in the 1994 edition.

· Simpura (1995) has recently outlined the

problems caused by not knowing what conver-

sion factors have been used to convert the

volume of alcoholic drinks consumed into

pure alcohol equivalent. Data on spirits are

already presented in litres of pure alcohol,

while beer and wine consumption are

expressed in litres of each type of drink. Since

there are signi® cant differences in the alcoholic

contents of wines and beers this is important

information from the public health point of

view, even though it may be irrelevant for

economic analysis.

Table 3. Annual production of ethyl alcohol of agricultural

origin in the European Union (thousands of hectolitres of pure

alcohol)

Country 1984 1991 % change

France 4 296 4 993 16Greece 320 283 2 12Italy 2 914 2 655 2 9Portugal 87 105 21Spain1 2 723 3 353 23Southern Europe2 10 340 11 389 10Rest of EU

32 11 2 632 31

EU4 12 351 14 021 14

Source: Eurostat.1Data for 1984 were not available

and have been substituted with those of 1985; 2includesFrance, Greece, Italy, Portugal and Spain;

3does not

include Sweden, Finland, Austria and the GermanDemocratic Republic; 1991 data have been replaced bythose for 1990 for Germany., Ireland and the Nether-lands;

4does not include Sweden, Finland, Austria and

the German Democratic Republic.

Table 4. Annual production of spirits in the European

Union (in thousands of hectolitres of pure alcohol)


France 2 200 2 880 31Greece 150 150 43Italy 900 750 2 17Portugal1 88 101 15Spain 1 070 966 2 10Southern Europe2 4 363 4 847 11Rest of EU3 4 889 6 437 32EU

49 252 11 284 22

Source: Eurostat. 1Includes wine spirits; 2includesFrance, Greece, Italy, Portugal and Spain;

3does not

include Sweden, Finland, Austria and the GermanDemocratic Republic; 1992 data have been replaced bythose for 1990 for Germany;

4does not include Sweden,

Finland, Austria and the German Democratic Republic.

Table 5. Annual production of wine in the European Union

(in thousands of hectolitres)


France 79 953 61 500 2 23Greece 4 500 4 067 2 10Italy 72 648 67 700 2 7Portugal 8 489 9 200 8Spain 39 219 36 700 2 6Southern Europe

1204 809 179 161 2 13

Rest of EU2 16 399 13 587 2 17EU

3221 208 192 748 2 13

Source: Eurostat. 1Includes France, Greece, Italy,Portugal and Spain;

2does not include Sweden, Finland

and Austria; 1993 data have been replaced by those for1992 for Belgium and the United Kingdom; 3does notinclude Sweden, Finland and Austria.


Table 6. Evolution of alcohol consumption in southern Europe (litres of pure alcohol

per capita per year)

SouthernYear France Greece Italy Portugal Spain Europe

1961 17.7 5.3 12.3 12.2 7.0 12.431962 17.2 5.0 12.5 9.3 10.6 12.961963 18.0 3.8 12.7 13.9 10.5 13.471964 17.6 4.8 12.4 13.3 10.7 13.311965 17.3 5.0 12.8 13.9 11.2 13.511966 17.3 5.1 13.1 13.9 12.9 13.861967 17.1 4.9 13.3 12.0 11.1 13.461968 16.7 4.9 13.7 12.0 11.4 13.531969 16.5 5.2 13.7 12.7 11.6 13.581970 16.2 5.3 13.7 9.9 11.6 13.311971 16.1 5.3 13.6 14.3 11.5 13.491972 16.0 5.4 13.6 11.7 12.4 13.511973 16.2 5.1 13.9 12.0 13.7 13.971974 15.9 5.2 13.8 14.0 14.1 14.061975 16.1 5.3 12.8 13.3 14.2 13.781976 16.2 8.3 12.4 14.1 13.7 13.791977 15.8 8.7 12.0 12.3 13.0 13.281978 15.4 8.8 12.7 10.4 14.0 13.501979 15.1 9.2 12.7 10.8 13.6 13.361980 14.9 10.2 13.0 11.0 13.6 13.471981 14.4 9.8 11.7 11.6 13.0 12.751982 14.4 8.9 11.4 12.1 12.7 12.561983 14.0 9.6 11.5 13.4 12.8 12.621984 13.5 9.5 11.2 12.7 11.5 12.001985 13.3 8.9 10.6 13.1 11.6 11.751986 13.2 7.3 10.0 11.2 11.6 11.311987 13.0 8.1 9.6 10.9 11.8 11.191988 12.6 8.3 9.4 9.9 11.1 10.791989 12.8 8.4 9.1 10.4 10.8 10.721990 12.7 8.6 9.2 10.1 10.8 10.711991 11.9 8.6 9.1 11.6 11.0 10.561992 11.8 8.5 8.9 10.7 10.9 10.381993* 11.5 9.2 8.6 10.4 10.0 10.00

Source: World Drink Trends, 1994 edn; *estimated values.

· Alcohol-free and low alcohol beers (up to a

maximum of 1.2% volume of alcohol) are

counted as beer in the W DT 1994 edition.

Light beers are not mentioned and it is unclear

whether they have been included. We believe

that low alcohol beers should be considered

separately.

These are just some of the reasons for our

reluctance to accept data from the alcohol indus-

try as the only source of reliable data. Another

reason is that, in the foreword to the W DT 1992

edition, Dr Verhoek, Secretary General of the

Produktschap voor Gedistilleerde Dranken states

clearly: ª There is no correlation between alcohol

consumption in a country and alcohol misuse

there. People who use this book on that basis are

® ghting the wrong battle.º This is the best rea-

son to ask for new and independent data on

alcohol consumption. Perhaps alcohol consump-

tion is decreasing in most western countries.

What is certain is that this is exactly the message

that the alcohol industry wants to give to

European politicians and to people concerned

with alcohol-related problems.

W hat is the evidence?

Although our real interest is in individual alcohol

consumption, alcohol production trends provide

a ® rst approximation. Table 3 offers data about

the annual production of ethyl alcohol of agricul-

tural origin, and Table 4 gives data about the

annual production of spirits. Both tables show


Table 7. Evolution of spirits consumption in southern Europe (litres of pure alcohol per

capita)

SouthernYear France Greece Italy Portugal Spain Europe1

1961 2.17 1.2 1.091962 2.26 1.3 2.3 1.671963 2.38 1.5 1.8 1.671964 2.44 1.6 0.5 2.1 1.821965 2.49 1.4 0.6 2.5 1.871966 2.52 1.5 0.5 3.0 2.021967 2.50 1.6 0.5 2.3 2.021968 2.15 1.6 0.5 2.3 1.781969 2.22 1.7 0.4 2.5 1.871970 2.30 1.8 0.5 2.3 1.891971 2.18 1.8 0.9 2.5 1.921972 2.23 1.9 1.0 2.6 2.001973 2.36 2.2 0.9 2.6 2.141974 2.39 2.1 0.8 2.6 2.111975 2.42 1.8 0.9 2.7 2.051976 2.34 2.8 1.9 0.9 2.8 2.241977 2.37 3.0 2.0 0.7 2.9 2.301978 2.46 2.7 1.9 0.9 3.0 2.321979 2.53 3.0 2.0 1.0 3.1 2.421980 2.52 3.5 1.9 0.9 3.2 2.431981 2.31 2.9 1.4 0.8 3.2 2.151982 2.42 3.2 1.4 0.8 3.0 2.161983 2.38 2.9 1.3 0.8 3.0 2.101984 2.22 2.7 1.3 0.8 2.8 1.991985 2.33 2.8 1.3 0.8 2.8 2.031986 2.34 2.7 1.2 0.8 2.9 2.021987 2.40 2.5 1.2 0.8 2.9 2.021988 2.47 2.8 1.2 0.8 2.8 2.041989 2.60 2.9 1.1 0.8 2.8 2.061990 2.51 2.7 1.0 0.8 2.7 1.961991 2.49 2.7 1.0 0.8 2.7 1.951992 2.63 2.7 1.0 0.8 2.7 2.001993* 2.49 2.8 0.9 0.8 2.5 1.88

Source: World Drink Trends, 1994 edn;1Calculated weighting the per capita

consumption of each country by its population in 1993 ; *estimated values.

the same pattern: in the last 10 years, alcohol

production has increased by around 10% in

southern Europe, while the increase has been

higher (around 30%) in the rest of the European

Union. On the other hand, data on wine pro-

duction (Table 5) show a clear decrease (13%)

in all wine-producing countries. A decrease is

also evident in Germany, even with the inclusion

of the former German Democratic Republic.

Wine production in the rest of the European

Union is almost irrelevant. Unfortunately, no

longitudinal data on beer production are avail-

able from Eurostat (1995).

Production, of course, does not mean con-

sumption, which is clearly our main concern.

Using the per capita alcohol consumption data

in the W DT 1994 edition, we have calculated the

per capita alcohol consumption for southern

Europe (each country’ s consumption being

weighted according to its population). Table 6

shows data for all ® ve countries alone and

together, to give a clear idea of both overall and

individual trends over the last 30 years; the table

shows a systematic decrease in alcohol consump-

tion over the last 30 years in southern Europe.

This trend follows the pattern of France, the

highest consumer. Italy shows a similar pattern,

but with a peak in consumption during the

1970s. Spain and Portugal increased their con-

sumption into the late 1970s, while Greece fol-

lowed a similar evolution a little later, reaching a

peak in consumption in the early 1980s. This


Table 8. Evolution of beer consumption in southern Europe (litres of pure beer per capita)

SouthernEurope

Litres of Litres of pureYear France Greece Italy Portugal Spain beer

1alcohol

2

1961 37.2 5.3 6.1 4.9 13.3 17.67 0.881962 37.8 4.9 7.4 4.3 15.2 18.35 0.921963 36.5 5.3 8.1 4.4 18.4 19.23 0.961964 40.9 4.9 8.3 5.5 21.6 21.49 1.071965 39.2 6.8 8.6 5.5 23.4 21.55 1.081966 40.4 8.7 9.8 7.0 25.4 23.24 1.161967 40.8 9.6 10.4 8.4 30.4 24.60 1.231968 40.0 9.2 10.7 8.9 32.9 25.01 1.251969 40.7 8.8 11.0 10.0 32.0 25.18 1.261970 41.3 9.4 11.3 13.3 38.5 26.74 1.361971 41.9 10.5 11.0 13.7 35.8 26.74 1.341972 40.3 11.5 12.0 16.6 36.0 26.84 1.341973 44.5 13.3 15.7 27.7 42.6 31.69 1.581974 44.2 16.6 14.8 33.0 44.3 32.19 1.611975 44.9 14.8 12.8 32.7 47.0 32.25 1.611976 48.7 14.9 14.1 29.3 47.9 33.90 1.701977 46.2 19.5 13.9 31.0 46.9 33.19 1.661978 45.3 21.2 14.9 39.0 52.1 34.97 1.751979 45.5 26.1 16.7 38.7 53.7 36.34 1.821980 44.3 26.3 16.7 37.9 53.4 35.78 1.791981 44.0 29.8 17.9 43.8 55.2 37.05 1.851982 43.7 29.5 20.6 37.4 56.9 37.83 1.891983 43.7 29.0 20.9 38.5 58.4 38.30 1.921984 41.2 31.2 19.0 35.4 59.0 36.94 1.851985 40.1 33.2 21.9 38.1 61.0 38.28 1.911986 40.4 34.8 23.2 38.8 62.0 39.17 1.961987 38.9 35.9 23.3 47.0 66.8 40.36 2.021988 39.2 39.0 23.4 53.1 68.7 41.47 2.071989 40.8 38.4 21.8 63.8 71.1 42.62 2.131990 41.5 39.8 25.1 65.1 71.9 44.28 2.211991 40.5 40.0 24.9 67.4 71.0 43.84 2.191992 40.9 40.0 25.9 65.3 70.5 44.06 2.201993* 40.1 42.6 25.1 80.3 75.7 45.77 2.29

Source: World Drink Trends, 1994 edn; 1calculated weighting the per capita consumption ofeach country by its population in 1993 ;

2calculated assigning to all beers a 5% alcoholic content

by volume; *estimated values

tendency to decrease seems quite steady in

France and Italy, but Greece, Portugal and

Spain have only stabilized their alcohol con-

sumption since 1989.

How can we explain this overall decrease in

alcohol consumption? When we look at the type

of alcoholic beverages consumed, it is obvious

that beer and wine are responsible for most of

the change. Tables 7, 8 and 9 show data for

spirits, beer and wine, respectively. These tables

clearly con® rm that alcohol consumption has

decreased because of the decrease in wine con-

sumption. That is, to be speci® c, spirits con-

sumption is almost stable in all countries, except

in Italy and Spain where a slow decrease in their

consumption is evident, beer consumption is

increasing fairly fast in all countries but France,

and wine consumption has clearly fallen in

recent years in the whole of southern Europe.

W hat are the explanations?

Several factors are responsible for these changes.

First we discuss each factor in turn, and then we

will show how they interact (Fig. 1).

M arketing factors

The last 20 years have been characterized by the


Table 9. Evolution of wine consumption in southern Europe (litres of wine per capita)

SouthernEurope

Litres of Litres of pureYear France Greece Italy Portugal Spain wine1 alcohol2

1961 126.1 41.9 108.2 99.3 52.5 96.98 10.671962 121.1 39.5 108.3 76.0 63.5 96.34 10.601963 127.3 29.5 107.6 114.0 64.8 100.12 11.011964 120.8 37.9 103.8 104.0 62.8 96.19 10.581965 117.6 39.2 110.1 108.6 63.0 97.65 10.741966 116.8 38.7 110.6 108.9 66.5 98.35 10.821967 115.3 36.7 111.4 92.3 61.0 95.76 10.531968 115.3 36.7 116.0 91.8 62.1 97.49 10.721969 112.4 40.0 114.9 98.5 62.5 96.89 10.661970 109.1 40.0 113.7 72.5 61.5 93.62 10.301971 108.0 40.0 112.7 105.7 60.0 94.61 10.411972 106.9 40.0 110.9 82.4 67.0 93.81 10.321973 105.5 37.0 109.3 80.4 75.0 94.35 10.381974 104.1 36.5 109.2 96.0 77.0 95.23 10.461975 103.7 38.0 103.9 89.8 76.0 92.83 10.211976 101.3 39.8 98.0 97.8 71.0 89.55 9.851977 102.1 39.6 93.5 83.9 65.0 86.11 9.471978 96.3 42.0 91.0 63.0 70.0 83.41 9.181979 92.8 40.5 90.0 65.9 65.0 80.91 8.901980 91.0 44.9 92.9 68.7 68.7 81.64 8.981981 89.0 44.9 86.2 71.7 59.0 77.67 8.541982 88.0 35.3 82.0 78.4 57.0 75.35 8.291983 85.0 44.1 82.6 89.1 57.0 75.73 8.331984 82.0 43.9 81.0 84.2 48.0 71.89 7.911985 79.7 37.3 75.0 87.0 48.0 68.94 7.581986 76.4 23.7 69.0 70.8 47.0 63.89 7.031987 75.1 31.8 66.0 64.3 46.0 62.32 6.861988 74.3 29.9 63.7 54.0 40.6 59.35 6.531989 74.1 29.9 62.5 53.0 36.9 57.99 6.381990 73.1 32.6 62.5 45.5 37.4 57.60 6.341991 67.0 32.4 62.1 62.0 39.8 56.90 6.261992 64.5 31.5 60.4 55.0 39.1 54.90 6.041993* 63.5 35.2 58.0 46.8 31.3 51.73 5.69

Source: World Drink Trends, 1994 edn;1calculated weighting the per capita consumption of each

country by its population in 1993 ; 2calculated assigning to all wines an 11% alcoholic content byvolume; *estimated values

extensive growth of advertising. However, while

spirits and beers have regularly been advertised

to consumers through all forms of the mass

media, wine has appeared only occasionally in

television spots or any other kind of advertising.

New beverages

Colas, sodas, fruit juices and mineral waters

were almost unknown 30 years ago in most

southern European countries. These ª new

drinksº clearly challenge the status of wine as the

only drink available. Much more investment has

gone into advertising them. The case of beer is

different since some of the new beverages are

light and low alcohol beers. Data from the

United Kingdom indicate that the penetration of

such beers in the market doubled from 1986 to

1993 (The Drink Pocket Book, 1994). One could

perhaps argue that beer consumption is increas-

ing because of these new beers (as they are

included in the W DT statistics).

Public health policies

In the last 15 years, awareness has grown in

southern Europe of the harm done by alcoholic

drinks. Because of this, new rules have been

0

10

61Year

Advertising New drinks Public healthpolicies

Economic factorsCrisis EU policies

Publicopinion

Litr

es o

f pur

e al

coho

l per

cap

ita

2

4

6

8

12

14

16

63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93


Figure 1. Factors in¯ uencing alcohol consumption in southern Europe ( 5 wine; 7 beer; 6 spirits).

implemented that limit the availability of

alcoholic drinks (through a minimum drinking

age, and banning them in the work-place, etc.)

as well as the hours and places where advertising

can be shown. Only 20 years ago, no real limits

were set for any kind of alcoholic drinks. For

instance, a television spot recommending a

forti® ed wine for children was quite popular in

Spain. Public health policies have been almost

exclusively directed at spirits, having almost no

effect on beer and a very weak one on wine.

Economic factors

Two factors come under this heading: the econ-

omic recession and the in¯ uence of the

European Union alcohol policies.

The economic recession in the late 1980s

probably helped to decrease alcohol consump-

tion in the same way that prosperity helped to

increase it. Data from the early 1990s also sug-

gest that, in countries with weaker alcohol poli-

cies, alcohol consumption stopped dropping

when the recession ended.

The European Union alcohol policies have

probably affected wine production very selec-

tively. Greece, Portugal and Spain had to accept

dramatic cuts in their wine production, in order

to enter the European Union. These policies

have also had a direct effect on prices and tax-

ation.

Price and taxation

Price is always a major factor in all goods.

Alcohol is no exception. There are several exam-

ples in the literature about the elasticity of

alcohol price (Edwards et al., 1994). In the case

of Spain, for example (Table 10), the price of

wine in constant pesetas increased by 23.09%

from 1985 to 1992, while that of beer increased

just 13.80%. On the other hand, the real price of

¯ avoured sodas has remained almost stable (a

3.06% increase); so, at least in Spain, price is

one of the factors that clearly contributes to the

decrease in wine consumption. Further analysis

should be done to establish how much of this

increment is attributable to taxation. Unfortu-

nately, alcohol taxation policies have rarely been

considered a ª useful lever for public healthº

(Edwards et al., 1994) in southern European

countries.

Public opinion

Traf® c accidents, especially among young driv-

ers, have convinced people of the dangers of

alcohol. Heroin dependence has also increased

the public’ s concern about drugs. In southern

European countries this has probably helped

people to see wine and spirits as drugs and not as

healthy drinks. Beer still seems to be considered

as less dangerous.


Table 10. Price evolution of alcoholic and non-alcoholic drinks in Spain

Years 1985 1986 1987 1988 1989 1990 1991 1992

PriceA

Wine 62.59 73.03 72.03 83.46 105.53 105.42 114.60 117.87Beer 79.74 90.60 95.91 105.34 116.36 123.89 131.93 138.84Sodas1 34.59 37.83 40.11 44.04 47.49 51.62 57.41 61.97

Sodas2 70.58 75.71 80.08 87.89 94.63 100.84 109.01 111.29Price

B

Wine 62.59 67.00 62.78 69.55 82.45 76.95 79.03 77.04Beer 79.74 83.12 83.40 87.78 90.91 90.43 90.99 90.75Sodas

134.59 34.71 34.88 36.70 37.10 37.68 39.59 40.50

Sodas2

70.58 69.46 69.63 73.24 73.93 73.61 75.18 72.74% ChangeC

Wine 0.00 7.05 2 6.29 10.78 18.54 2 6.67 2.71 2 2.52Beer 0.00 4.24 0.34 5.26 3.56 2 0.52 0.61 2 0.26Sodas1 0.00 0.34 0.50 5.22 1.09 1.56 5.08 2.30

Sodas2 0.00 2 1.59 0.25 5.18 0.94 2 0.44 2.14 2 3.25% Change

D

Wine 0.00 7.05 0.31 11.12 31.72 22.94 26.27 23.09Beer 0.00 4.24 4.59 10.09 14.00 13.41 14.10 13.80Sodas

10.00 0.34 0.83 6.10 7.26 8.93 14.46 17.10

Sodas2 0.00 2 1.59 2 1.34 3.77 4.75 4.29 6.52 3.06

Source: Encuesta Continua de Presupuestos Familiares (1985± 92).APrice in real pesetas;

BPrice in constant pesetas;

C% change from the previous year in constant pesetas; D% change from 1985 in constant pesetas; 1Non-¯ avouredsodas;

2¯ avoured sodas.

Homogenization

In general, Europe is tending progressively

towards a homogenization of life-styles. For

example, lunch in southern Europe is losing its

central role as a family meal, which reduces wine

consumption. When talking about alcoholic bev-

erages one must distinguish between qualitative

and quantitative homogenization. On one hand,

countries that have experienced the greatest

decreases were the higher consumers; on the

other hand, there are fewer differences in the

types of beverage consumed throughout Europe,

with a clear tendency to a beverage mix of 50%

beer, 35% wine and 15% spirits (Edwards et al.,

1994). In southern European countries this

homogenization means drinking less wine and

more beer, which ® nally leads to a decrease in

alcohol consumption.

Obviously, all these factors in¯ uence each

other. Beer has partially replaced wine, because

its lower alcohol content has allowed beer pro-

ducers to advertise more widely. Conversely,

changes in public opinion and in the policies

limiting the consumption and advertising of spir-

its have considerably reduced the effect of adver-

tising them. Wine has probably experienced a

dramatic fall in its consumption because of poor

marketing strategy. Note that the beer and spirits

markets are controlled by no more than 10

multi-national enterprises, while the wine market

is full of very small producers. This means that

multi-nationals can easily decide how to invest in

promoting their beverages, while small producers

have never been able to work out and fund a

coherent strategy for their product.

It is not clear if changes in wine and beer

consumption are substitution or addition phe-

nomena. They may be both. On one hand, beer

consumed during meals clearly replaces wine.

On the other hand, the weekend consumption of

beer is a new pattern of alcohol consumption,

and should be considered an addition.

In short, marketing pressures have stimulated

beer and spirits consumption while public health

policies have concentrated on curbing spirits

consumption. The ® nal result is a decrease in

alcohol consumption because beer partially

replaces wine, while spirits remain almost stable.

W hat are the consequences?

Analysing the evolution of alcohol-related mor-


Table 11. Cirrhosis and chronic liver disease (death rates per 100 000 population)

France Greece Italy Portugal Spain

Year M1

F2

M F M F M F M F

1980 Ð Ð Ð Ð Ð Ð Ð Ð 32.1 13.01981 Ð Ð Ð Ð 47.3 19.8 Ð Ð 31.4 12.41982 37.8 15.2 Ð Ð 45.3 19.7 Ð Ð 30.8 12.11983 36.8 15.2 15.5 5.5 46.7 20.8 47.7 17.0 30.2 12.01984 35.4 14.0 13.7 6.2 45.9 20.7 44.5 16.5 30.7 11.51985 32.7 13.1 15.8 6.5 44.8 20.7 44.1 16.2 31.1 12.51986 30.9 12.4 14.7 5.7 42.0 19.7 42.1 16.6 30.4 12.21987 29.2 11.5 14.3 6.1 39.0 19.4 41.6 15.5 29.4 12.31988 27.8 12.0 12.3 5.2 38.4 19.2 40.5 14.9 29.5 11.91989 26.4 11.3 12.5 5.6 36.9 19.0 34.8 13.4 29.6 12.41990 25.1 10.7 13.6 5.5 34.8 19.2 36.6 13.2 28.9 11.91991 23.9 10.6 13.2 6.0 Ð Ð 40.6 14.2 Ð Ð1992 Ð Ð Ð Ð Ð Ð 40.6 15.1 Ð Ð

Source: World Health Statistics Annual 1986 ± 93. 1M 5 male; 2F 5 female.

bidity and mortality in southern Europe is far

beyond the scope of this paper. Nevertheless, we

must refer brie¯ y to the evolution of liver cir-

rhosis in southern Europe, since the literature

indicates that a decrease in alcohol consumption

leads to a decrease in the mortality rates attribu-

table to liver cirrhosis. Table 11 shows clearly

how dramatically those rates have fallen in

France and Italy, the countries that had the

highest liver cirrhosis death rates and the highest

alcohol consumption per capita. Table 12 shows

the statistical correlation between alcohol con-

sumption and cirrhosis death rates. All countries

clearly show a strong and signi® cant correlation

except Greece. Further epidemiological research

should show if this is a causal correlation.

Conclusions

Why has alcohol consumption declined in south-

ern Europe? The question has no single answer,

but some facts are clear.

· Independent data on per capita alcohol con-

sumption are lacking. Data on individual

drinking patterns and their evolution over time

are a must if we want to explain general

trends.

· Alcohol consumption has decreased steadily

and slowly since the late 1970s. This decrease

relates clearly to the small decrease in spirits

consumption, the marked increase in beer

consumption and the clear fall in wine con-

sumption.

· Greece, Portugal and Spain seem to have sta-

bilized their alcohol consumption since the

early 1990s. No decrease has been observed in

those countries in recent years.

· A clear decrease in liver cirrhosis death rates

over the last 10 years seems to con® rm that

there is a direct correlation between per capita

alcohol consumption and liver cirrhosis death

rates.

This is just a ® rst look at an exciting theme.

We have considered most of the factors that

in¯ uence alcohol consumption in southern

Europe. The next step should be to develop an

econometric analysis of the demand for alcoholic

and non-alcoholic beverages. This would facili-

tate the economic analysis of the different

options available for designing effective alcohol

policies (Lehto, 1995).

Table 12. Statistical correlation

between per capita alcohol consumption

and cirrhosis death rates in men

(1980± 92)

Pure alcohol

France 0.9487**Greece 0.2189Italy 0.9654**Portugal 0.8377*Spain 0.7825*

Source: World Health Statistics

Annual 1986 ± 93 (cirrhosis deathrates) and World Drink Trends, 1994,edn (per capita alcohol consump-tion). 1-tailed signi® cance: *0.01;**0.001.


On one hand, the alcohol market moves thou-

sands of millions of ECUs, generates important

bene® ts for private enterprise and, through tax-

ation, contributes considerably to the budgets of

the governments of all western countries. On the

other hand alcohol consumption causes many

alcohol-related problems, which cost modern

societies huge amounts of money. Intensive

research should be done in both areas to enable

governments to elaborate ª a national alcohol

policy aimed at reducing alcohol-related prob-

lemsº (Walsh, 1982).

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Why has alcohol consumption declined in countries of southern Europe?

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