Recognizing the harm caused by the products and practices of the alcohol industry to Spanish society, the government has released the first ever comprehensive report on alcohol consumption and harm in the country. The report collects existing data in one place and aims to provide analysis and high quality information necessary to develop a multi-sectoral approach to prevent and reduce alcohol harm in Spain. The report is to be updated regularly to continuously provide the most recent information.

The Spanish government has released the first ever report on alcohol. Recognizing the harm caused by the products and practices of the alcohol industry to people and communities in Spanish society, this ground-breaking report aims to bring together in a comprehensive document the existing information published by the Government Delegation for the National Plan on Drugs (DGPNSD). The report incorporates elements from the information systems of the Spanish Observatory on Drugs and Addictions (OEDA), and information from other relevant and reliable sources. In this way the Spanish government aims to provide analysis and high quality information necessary to develop a multi-sectoral approach to prevent and reduce alcohol harm in Spain.

Currently, alcohol use is the fourth leading risk factor regarding Disability-Adjusted Life Years (DALYs) in Spain, ranking second in women and fifth in men.

  • Alcohol consumption caused 15,489 annual deaths between 2010-2017,
    • 74% of those in men, and
    • 55.7% being premature deaths (before reaching 75 years of age).

Summary of data shared in the report

Underage alcohol consumption

The Survey on Drug Use in Secondary Education in Spain 2018 (ESTUDES, for Spanish abbreviations) reports that alcohol consumption is widespread among secondary education students:

  • 77.9% of the students reported alcohol consumption sometime in their life (76.3% of males and 79.4% of females),
    • 77.5% in last 12 months (74.1% of males and 77.5% of females), and
    • 58.5% in last 30 days (57.2% of males and 59.8% of females).
  • The prevalence of consumption for these time periods is higher in girls than in boys.
  • The age for the first alcohol use is 14 years on average for both sexes.

The number of students reporting alcohol intoxication and binge alcohol use – characterized as five or more glasses of alcoholic beverages in one occasion (about two hours) – increased in 2018.

Out of the total number of students who had used alcohol during the last month,

  • Half of them (55.5%) reported binge alcohol use, almost half, reported an alcohol intoxication episode, with the percentage being higher in girls than in boys (46.5% of girls compared to 42.3% of boys).
  • In the group of minors (14-17 years of age), 47.1% of the boys and 52.3% of the girls have been alcohol intoxicated at some time in their lives.

The European ESPAD survey reports in 2019,

  • The prevalence of alcohol consumption in students aged 15 and 16 years was 78% sometime in their life and 47% within the last 30 days. Both values were similar to the European average.
  • However, the prevalence of binge alcohol use in the last 30 days was above the European average, being 17% in Spain compared to the European average of 13%.

The practice of “botellón” which is shared consumption of potent alcoholic beverages on public roads or in open public spaces is a specifically harmful practice. It is still prevalent despite being illegal. Girls between the age of 14 to 17 years engaged in this practice even more than boys. But by age 18, boys did “botellón” more than girls. The prevalence of alcohol intoxications and binge alcohol use was substantially higher in the group who practiced “botellón”.

Mixed alcoholic beverages or RTDs were the most used alcoholic beverage type by students (29%), with a higher consumption observed in girls. Alcohol harms among students are also linked more to RTDs. These ready to drink alcoholic beverages are the most used alcohol product by both boys and girls who reported alcohol intoxication, binge alcohol use or “botellón”.

Students find it very easy to access alcohol, with 94.9% students regardless of whether they were of legal age or not reporting they obtain alcohol easily.

A total of 60.3% of minors accessed alcohol directly by themselves (42.4%) or through other minors (17.9%).

94.9%
Spanish students including minors find it easy to access alcohol
Students find it very easy to access alcohol with 94.9% students regardless of whether they were of legal age or not reporting they obtain alcohol easily.

The students’ recognition of the risks of alcohol is very low. However, alcohol harm is high. Out of those who have been intoxicated with alcohol once in the last month, 16.9% admitted having been involved in a fight or assault and 30.6% have had unprotected sex.

Alcohol consumption in the general population

According to the Spanish Household Survey on Alcohol and Drugs 2019/2020 (EDADES for its Spanish abbreviation), alcohol consumption is widespread among the general population aged 15 to 64 years:

  • 93% of the population had consumed alcohol at some time in their lives,
    • 77.2% in the past year,
    • 63% in the past month, and
    • 8.8% reported daily alcohol consumption.
  • Alcohol use in the past year among men is highest in the 25 to 34 age group (86.1%).
  • In women the highest alcohol consumption level was in the 15 to 24 age group (76.7%).
  • Alcohol intoxication and binge alcohol use showed an upward trend. They were more widespread in men than in women across all age groups and were more prevalent in the younger age groups.
63%
Spaniards between 15 to 64 years have consumed alcohol in the past month
According to the Spanish Household Survey on Alcohol and Drugs 2019/2020, 63% of the population between 15 to 64 years have consumed alcohol in the last month.

Alcohol consumption by older adults (over 64 years)

According to the Survey on Alcohol and Drugs and Other Addictions in People over 64 years of age in Spain, 2019/2020 (ESDAM for its Spanish abbreviation), in the population over 64 years of age, alcohol consumption is less widespread than in the population aged 15 to 64 years and is higher among men.

Alcohol use changes in this age group. Older people in Spain have a higher level of daily consumption, higher wine consumption, but less intensive consumption, such as binge alcohol use, alcoholic intoxication and high-risk alcohol use. The differences in consumption by sex are greater in this older population, as men’s consumption in the past year was almost double that of women.

COVID-19 impact on alcohol use

The report states that it was still too early to know the long-term impact of COVID-19 on population alcohol use.

However, according to the results of the national population-based telephone survey conducted to ascertain COVID-19 impact in 2020, alcohol consumption and intoxication declined in both sexes and in all age groups.

The data tallies with the decrease in the total volume of sales of alcoholic beverages recorded in 2020 compared to 2019.

High-risk alcohol consumption

According to the results of the EDADES 2019/2020 survey,

  • 5.2% of the population aged 15 to 64 years presented a pattern of high-risk alcohol consumption estimated on the basis of the AUDIT scale (≥8 points in men and ≥6 in women), with a greater extent among men (6.7%) than among women (3.7%).
  • Prevalence is higher among younger people and in men. However, in the 15 to 24 age group differences between men and women are narrowing.

According to information from the latest edition of the EDADES Survey 2019/20,

  • An estimated 18.6% of the population aged 15 to 64 years has an alcohol use level above the threshold for low risk average alcohol intake in Spain, set at 10 grams/day (1 SD/d) in women and 20 grams/day (2 SD/d) in men.
18.6%
Spanish population consumes alcohol above the low-risk threshold
According to the results of the EDADES 2019/2020 survey, an estimated 18.6% of the population aged 15 to 64 years consumes alcohol above the threshold for low risk consumption in Spain.

The alcohol burden in Spain

  • 27,209 Spaniards were admitted to Regional Addiction Care Networks for treatment of alcohol use disorder or dependence in 2019.
  • Alcohol was responsible for 35.2% of treatment admissions and is present in the majority of poly-consumption patterns.
  • In 2019, 40.3% of emergencies associated to other drug use involved alcohol as well. Data is only collected on alcohol when it is present with another drug under the hospital emergencies related to the consumption of psychoactive substances reporting protocol. Therefore, this is probably an underestimation.
  • According to the new national registry of Emergencies health episodes being deployed in Spain as part of the National Specialized Care Activity Register (RAE-CMBD for its Spanish abbreviation), there were 9,964 episodes with a diagnostic code related to alcohol intoxication in 2019 reported from 8 of the 19 Spanish regions. Again men and those under 24 years are at highest risk.
  • In terms of deaths caused by alcohol, the Specific Register of Mortality due to acute reaction to psychoactive substances, alcohol is only recorded when it appears with another psychoactive drug. Even then alcohol is one of the substances most present among the deceased, detecting its presence in 39.7% of cases (38.7% in men and 43.6% in women).

In the period 2010-2017, alcohol caused an estimated 15,489 deaths per year in Spain.

73.8% of deaths were among men and 55.7% of them were premature deaths (in persons under 75 years of age).

15,489
Deaths per year caused by alcohol in Spain
In the period 2010-2017, alcohol caused an estimated 15,489 deaths per year in Spain.

The report notes that harm caused by alcohol products is directly linked to alcohol consumption. The report emphasizes that there is no safe level of alcohol consumption.

The report by the Spanish government aims to provide useful information for all actors involved in preventing and reducing harm caused by the products and practices of the alcohol industry. The report is to be updated regularly to continuously provide the most recent information.


Sources

Ministry of Health Spain:

Spanish Alcohol Report 2021 Consumption and consequences. Summary Report” [PDF]

Spanish Alcohol Report 2021” [Spanish, PDF]