The findings of this study suggest that challenges for prevention of acute alcohol-related harms in young people may be larger in countries where adolescents to a larger extent drink to intoxication. From a prevention point of view it also seems warranted to direct more future studies into the area of potential for preventing intoxication and drunkenness, not in the least among young people.

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.

Aim To (i) examine several factors associated with trends in heavy episodic drinking (HED) in Finland, Norway and Sweden, (ii) investigate similarities in these associations across the countries and (iii) analyse the contribution of these factors to the trend in HED and the differences across the countries. Design and Setting Observational study using five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from Finland, Norway and Sweden between 1999 and 2015. Participants A total of 18 128 male and 19 121 female 15‐ to 16‐year‐old students. Measurements Monthly HED, perceived access to alcohol, truancy, parental control, leisure time activities and daily smoking. The Cochran–Armitage test was used to examine linear time trends in HED. Logit regression models using the Karlson–Holm–Breen (KHB) method were fitted for each country separately, including all the independent variables together with time and adjusted for family status, parental education and gender. Findings In Finland, Norway and Sweden, perceived access to alcohol, truancy and daily smoking decreased significantly between 1999 and 2015 whereas risk perceptions, parental control and participation in sports increased in the same period. The confounding percentage of all the independent variables related to the trend in HED was 48.8%, 68.9% and 36.7% for Finland, Norway and Sweden, respectively. Decline in daily smoking (P < 0.001) and perceived access to alcohol (P < 0.001) were positively and increase in parental control (P < 0.001) negatively associated with the decline in HED in all three countries. Changes in truancy, going out with friends, and engaging in sports and other hobbies had little or no impact on the decline in HED or displayed no consistent results across the countries. Conclusions The decline in adolescent heavy episodic drinking in Finland, Norway and Sweden between 1999 and 2015 appears to be associated with a decline in adolescent daily smoking and perceived access to alcohol and an increase in parental control.

<b><i>Background:</i></b> In Europe, the COVID-19 pandemic triggered a range of restrictive measures, which may have impacted alcohol consumption. <b><i>Objectives:</i></b> We explored perceived changes in alcohol consumption, their association with sociodemographic characteristics and past year alcohol consumption, and self-reported reasons for change after CO­VID-19 restrictions in Norway. <b><i>Method:</i></b> A web-based survey was sent to Norwegians aged 18 years and older in June–July 2020. Respondents reporting any past year alcohol use (<i>n</i> = 1,200) were asked whether they drank less, approximately the same, or more after the COVID-19 restrictions compared to before and reasons for drinking less or more. <b><i>Results:</i></b> Almost a third (29.9%) reported they drank less, whereas 13.3% reported they drank more. Females, younger respondents, and Oslo residents were more likely to report both less and more drinking (<i>p</i> values between 0.001 and 0.029). Past year alcohol use was associated with less drinking (OR = 0.93; <i>p</i> &#x3c; 0.001) and more drinking (OR = 1.07; <i>p</i> &#x3c; 0.001). More drinking was also associated with living with child(ren) (<i>p</i> = 0.023) and high educational level (<i>p</i> = 0.029). The most frequently reported reasons for drinking less pertained to fewer social occasions and less on-premise drinking, whereas reasons for drinking more pertained to treating oneself to something good and fewer consequences of drinking more. <b><i>Conclusions:</i></b> After the COVID-19 restrictions were implemented, a substantial proportion of Norwegians changed their drinking behaviour.

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.