Tobacco and alcohol consumption

Tobacco and alcohol are major risk factors for at least two of the leading causes of premature mortality – cardiovascular diseases and cancer.

On average, about 18% of the adult population smoked on a daily basis in 2017 (Figure 7.13). Keeping measurement issues in mind, variations across OECD countries seem to be large. Smoking rates were lowest in Mexico and Iceland (less than 10% of the adult population) and highest in Greece, Hungary and Turkey (above 25%). Rates are higher among men than among women in nearly all OECD countries, with the exception of Sweden and Iceland where the gender gap is less than 1%. Apart from Austria and the Slovak Republic, all OECD countries experienced a marked decline in smoking rates over the past eighteen years. On average across the OECD, the rate decreased by more than one fourth, from 26% in 2000 to 18% in 2017. Particularly large reductions occurred in Ireland, the Netherlands and Norway. Among OECD partner countries, smoking rates tend to be low in Brazil (7%) and high in Indonesia and the Russian Federation (above 30%).

Alcohol consumption, as measured by recorded data on annual sales, stands at 8.8 litres of pure alcohol per adult, on average, across OECD countries, based on the most recent data available (Figure 7.14). The Czech Republic, France and Lithuania reported the highest consumption of alcohol with 11.5 litres or more per adult per year. Low alcohol consumption is recorded in Turkey and Israel, as well as in the emerging economies Indonesia and India, where religious and cultural traditions restrict the use of alcohol for some population groups. Although average alcohol consumption slightly declined in many OECD countries since 2000 – by about 0.7 litre per adult on average –, it has risen by two litres or more in Estonia, Latvia, Lithuania and Poland, as well as in key partner countries China and India. OECD analysis based on individual-level data show that men of low socioeconomic status are more likely to drink heavily than men of a high socioeconomic status, while the opposite is observed among women (OECD, 2015).

Adolescents establish addictions more quickly than adults and regular smoking and drinking is associated with poorer psychological, social and physical health outcomes, as well as poorer educational outcomes, violence, injuries, drug use and risky sexual behaviour (OECD, 2015). On average, one in eight 15-year-olds reported smoking at least once a week. Adolescent smoking rates ranged from less than 5% in Canada, Iceland and Norway to around 20% in France, Hungary and Italy (Figure 7.15). Boys reported significant higher rates in Finland, Israel, Lithuania and Russian Federation, while the opposite pattern prevailed in the Czech Republic and Luxembourg.

As for drunkenness, on average, one in five 15-year-olds reported that they had been drunk at least twice in their life. Rates ranged from 10% in Israel to above 35% in Denmark, Hungary and Lithuania (Figure 7.16). Boys are more likely to have been drunk than girls, particularly in Austria, Hungary, Israel, Italy, Latvia, Lithuania, Russian Federation and Switzerland. the United Kingdom is the only country where girls more frequently report drunkenness than boys.

Definition and measurement

The proportion of daily smokers is defined as the percentage of the population aged 15 years and over who report smoking every day. International comparability is limited due to the lack of standardisation in the measurement of smoking habits in health interview surveys across OECD countries.

Variations are observed in the surveyed age groups, the wording of questions, response categories and survey methodologies (e.g. in a number of countries, respondents are asked if they smoke regularly, rather than daily). Self-reported behaviours may also suffer from a social desirability bias that may potentially limit cross-country comparisons.

Alcohol consumption is defined as annual sales of pure alcohol in litres per person aged 15 years and over. However, the methodology to convert alcoholic drinks to pure alcohol may differ across countries. Official statistics do not include unrecorded alcohol consumption, such as home production, which may be more common in some countries than in others.

Tobacco and alcohol consumption rates for 15-year-olds by gender are taken from the 2013/14 Health Behaviour in School-aged Children (HBSC) study, which collects information on many socio-economic factors that affect health behaviour among children for 26 OECD countries. Indicators shown here by gender are the percentage of 15-year-olds who smoke at least once a week and those who have been drunk on two or more occasions.

Further reading

Inchley, J. et al. eds. Growing up unequal: Gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: International report from the 2013/2014 survey. Copenhagen, WHO Regional Office for Europe, 2016 (Health Policy for Children and Adolescents, No. 7), www.hbsc.org/publications/international.

OECD (2015), Tackling Harmful Alcohol Use: Economics and Public Health Policy, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264181069-en.

OECD (2017), Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris, http://dx.doi.org/10.1787/health_glance-2017-en.

Figure notes

Figure 7.13 and Figure 7.14: See Statlink for precise years.

Figure 7.15 and Figure 7.16: Data for Belgium were computed using population shares for Flemish (60%) and French (40%); data for the United Kingdom were computed using population shares for England (85%), Scotland (9%) and Wales (5%).

7.13. Marked decline in smoking rates among adults in most OECD countries
Percentage of population aged 15 years and over smoking daily, by gender, in 2000 and 2017 (or nearest years)
picture

Source: OECD Health Statistics 2018, https://doi.org/10.1787/health-data-en.

 StatLink http://dx.doi.org/10.1787/888933939522

7.14. Slight decline in alcohol consumption among adults in many OECD countries
Litres of pure alcohol per person aged 15 years and over, 2000 and 2016 (or nearest years)
picture

Source: OECD Health Statistics 2018, https://doi.org/10.1787/health-data-en.

 StatLink http://dx.doi.org/10.1787/888933939541

7.15. One in eight 15-year-olds smoke at least once a week
Percentage of 15-year-olds who smoke at least once a week, by gender, in 2013/14
picture

Source: Inchley, J. et al. eds. Growing up unequal: gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: international report from the 2013/2014 survey. Copenhagen, WHO Regional Office for Europe, 2016 (Health Policy for Children and Adolescents, No. 7), www.hbsc.org/publications/international.

 StatLink http://dx.doi.org/10.1787/888933939560

7.16. One in five 15-year-olds have been drunk at least twice in their life
Percentage of 15-year-olds who have been drunk on two or more occasions, by gender, in 2013/14
picture

Source: Inchley, J. et al. eds. Growing up unequal: gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: international report from the 2013/2014 survey. Copenhagen, WHO Regional Office for Europe, 2016 (Health Policy for Children and Adolescents, No. 7), www.hbsc.org/publications/international.

 StatLink http://dx.doi.org/10.1787/888933939579

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