Alcohol use in Ukraine: evidence of polarisation during wartime (2023–2024 comparative analysis)

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.