Alcohol use in Ukraine: evidence of polarisation during wartime (2023–2024 comparative analysis)
Abstract
Background: Alcohol consumption is one of the major risk factors contributing to premature mortality in Ukraine. Emerging evidence suggests increasing polarisation in drinking behaviours—simultaneous expansion of both abstinence and high-risk consumption—potentially intensified by the prolonged stressors of war. This study examines shifts in alcohol use patterns between 2023 and 2024.
Methods: We analysed data from two nationally representative telephone surveys conducted in 2023 (n = 2,015) and 2024 (n = 2,028) among adults aged 18+ in Ukraine, implemented with WHO support. Indicators included prevalence, frequency, heavy episodic drinking (HED), socioeconomic differences, and self-reported behavioural changes.
Results: Current alcohol consumption remained stable (77.4% in 2023; 78.0% in 2024), with approximately one in five adults abstaining. However, key indicators point to intensifying polarisation. The proportion of active drinkers (monthly or more often) increased from 50.8% to 57.3%, while HED rose from 49.2% to 54.2%. Average daily alcohol intake decreased (8.5 g to 7.3 g), suggesting a shift toward more frequent but not necessarily higher-volume consumption. A larger share of respondents reduced or stopped drinking (22–28%) than those who increased or initiated consumption (8–11%). Socioeconomic inequalities reinforce polarisation. Individuals with higher socioeconomic status are more likely to drink, whereas those with lower socioeconomic status consume higher volumes and exhibit riskier patterns. Nearly half of drinkers (48%) report consumption of unrecorded alcohol.
Conclusions: Alcohol use in Ukraine demonstrates polarisation: stable overall prevalence masks growing divergence between abstainers and high-risk drinkers. War-related stressors appear to amplify both protective and harmful coping behaviours. Public health strategies should include both ‘quick buys’ and universal approaches to targeted, equity-focused interventions to address high-risk consumption.
Key messages: • Alcohol use in Ukraine is becoming more polarised, with increasing heavy episodic drinking alongside stable abstinence.
• Differentiated, equity-focused public health strategies are needed to address high-risk consumption and structural drivers.
Related
- Conducting a RCT during wartime in Ukraine: methodological implications and lessons learnt
- Wartime HPV vaccine introduction in Ukraine: strategy, results and lessons
- Dual and polyuse of nicotine and tobacco products among adolescents in wartime Ukraine
- Pilot trial of a transdiagnostic intervention for war-affected men with alcohol misuse in Ukraine
- Comparative Strain Trajectories After Septal Myectomy, Alcohol Septal Ablation, and Myosin Inhibitor Therapy.
BibTeX
@article{skipalskyi2026alcohol,
title = {{Alcohol use in Ukraine: evidence of polarisation during wartime (2023–2024 comparative analysis)}},
author = {A Skipalskyi and O Alimenko and O Zaporozhska and M Neufeld},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.016},
url = {https://doi.org/10.1093/eurpub/ckag169.016},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Alcohol use in Ukraine: evidence of polarisation during wartime (2023–2024 comparative analysis)
AU - A Skipalskyi
AU - O Alimenko
AU - O Zaporozhska
AU - M Neufeld
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.016
UR - https://doi.org/10.1093/eurpub/ckag169.016
AB - Background: Alcohol consumption is one of the major risk factors contributing to premature mortality in Ukraine. Emerging evidence suggests increasing polarisation in drinking behaviours—simultaneous expansion of both abstinence and high-risk consumption—potentially intensified by the prolonged stressors of war. This study examines shifts in alcohol use patterns between 2023 and 2024. Methods: We analysed data from two nationally representative telephone surveys conducted in 2023 (n = 2,015) and 2024 (n = 2,028) among adults aged 18+ in Ukraine, implemented with WHO support. Indicators included prevalence, frequency, heavy episodic drinking (HED), socioeconomic differences, and self-reported behavioural changes. Results: Current alcohol consumption remained stable (77.4% in 2023; 78.0% in 2024), with approximately one in five adults abstaining. However, key indicators point to intensifying polarisation. The proportion of active drinkers (monthly or more often) increased from 50.8% to 57.3%, while HED rose from 49.2% to 54.2%. Average daily alcohol intake decreased (8.5 g to 7.3 g), suggesting a shift toward more frequent but not necessarily higher-volume consumption. A larger share of respondents reduced or stopped drinking (22–28%) than those who increased or initiated consumption (8–11%). Socioeconomic inequalities reinforce polarisation. Individuals with higher socioeconomic status are more likely to drink, whereas those with lower socioeconomic status consume higher volumes and exhibit riskier patterns. Nearly half of drinkers (48%) report consumption of unrecorded alcohol. Conclusions: Alcohol use in Ukraine demonstrates polarisation: stable overall prevalence masks growing divergence between abstainers and high-risk drinkers. War-related stressors appear to amplify both protective and harmful coping behaviours. Public health strategies should include both ‘quick buys’ and universal approaches to targeted, equity-focused interventions to address high-risk consumption. Key messages: • Alcohol use in Ukraine is becoming more polarised, with increasing heavy episodic drinking alongside stable abstinence. • Differentiated, equity-focused public health strategies are needed to address high-risk consumption and structural drivers.
SN - 1101-1262
SN - 1464-360X
ER -