Tobacco and alcohol are major risk factors for at least two of the leading causes of premature mortality – cardiovascular diseases and cancer.
In 2021, an average of about 16% of the adult population smoked on a daily basis (Figure 7.13). However, variations across OECD countries are large. Smoking rates range from less than 8% of the adult population in Costa Rica and Iceland to over 25% in France and Türkiye. Rates are higher among men than among women in nearly all OECD countries, except for Norway. Apart from Luxembourg, the Slovak Republic and Türkiye, all OECD countries have experienced a marked decline in smoking rates over the past ten years. On average, the rate decreased by nearly 5 percentage points, from 21% in 2011 to 16% in 2021. Particularly large reductions occurred in Estonia, Ireland, Korea, Norway and Peru by 8 or more percentage points.
Alcohol consumption, measured by recorded annual sales, stood at 8.6 litres of pure alcohol per adult, on average across OECD countries in 2021 (Figure 7.14). Latvia and Lithuania reported the highest consumption of alcohol with 12 litres or more per adult per year. Low alcohol consumption is recorded in Türkiye and Israel, as well as in India and Indonesia and India, where religious and cultural traditions restrict the use of alcohol for some population groups. Average alcohol consumption has declined in many OECD countries since 2011 – by about 0.3 litres per adult on average – with the largest decline of over 2 litres recorded in Ireland and Lithuania. However, alcohol consumption has risen by 1 litre or more in Latvia and Mexico, as well as in Bulgaria and Romania.
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. On average, one in seven 15‑year‑olds reported smoking at least once a month, with girls being slightly more likely than boys to have reported smoking. Adolescent smoking rates ranged from around 4% in Iceland to over 25% in Hungary and Italy (Figure 7.15). Boys reported significant higher rates in Finland, while the opposite pattern prevailed in Hungary and Italy.
As for drunkenness, on average, almost one in five 15‑year‑olds reported that they had been drunk at least twice in their life. Rates ranged from 7% in Iceland to above 35% in Denmark and Hungary (Figure 7.16). Across the OECD on average, girls are slightly more likely to have been drunk than boys. Italy, Spain and the United Kingdom had girls reporting being drunk at a rate over 7 percentage points higher than their male counterparts, while Austria and Slovenia had more boys reporting drunkenness than girls (over 5 percentage points).
