Report on Alcohol in the Czech Republic 2023

This is a summary of the report, which has been published in full in Czech only. The full report is available on the Czech version of this website under the title Zpráva o alkoholu v České republice 2023.

Summary of the Report on Alcohol in the Czech Republic 2023

Public health impacts of alcohol use

Alcohol consumption is a significant factor of the overall health burden. In developed countries, including the Czech Republic, it is a major cause of morbidity and premature mortality.
The effects of alcohol use are associated with more than 30 diagnoses and alcohol is a cause of approximately 200 other diseases. Alcohol consumption is also a frequent cause of other harms such as accidents, injuries, and domestic violence.
The most harmful forms include heavy episodic drinking (binge drinking) and long-term daily drinking, with the amount of alcohol consumed playing a significant role.
Any amount of alcohol poses a risk of negative impacts. Therefore, no amount of alcohol can be recommended as beneficial or considered safe.
Risky or harmful alcohol consumption is defined based on the average dose of alcohol consumed, i.e., consumption of ≥40 g ethanol/day for men and ≥20 g/day for women, or ≥60 g/day for men and ≥40 g/day for women, which corresponds to 3-5 standard drinks per day for men and 1.5-3 standard drinks for women.
In the Czech Republic, 1 beer (0.5 l), 1 glass of wine (2 dl) or 1 "shot" of spirits (5 cl) is considered a standard drink. One standard drink contains 10-20 g of ethanol.
Heavy episodic drinking is usually defined as the consumption of ≥60 g of pure alcohol, or 5 or more standard drinks on one occasion.
The Czech Republic is one of the countries with the highest average per capita alcohol consumption. Annual consumption averages 10 litres of ethanol per capita, which is equivalent to approximately 22 g per capita/day, including children and the elderly.

Alcohol policy

Alcohol policy in the Czech Republic is part of the integrated addictions policy, which combines the topics of legal and illegal substances and behavioural addictions since 2014. Responsibility for developing alcohol policy rests with the government. The Government's coordinating and advisory body on addiction issues is the Government Council for Addiction Policy Coordination of (GCCAP).
The main strategic document is the National Strategy for the Prevention and Reduction of Harm Associated with Addictive Behaviours 2019-2027 and its Action Plan for the period 2023-2025, which also includes specific objectives and defines activities for the alcohol sector.
International recommendations for effective policies to reduce the negative impacts of alcohol consumption include (1) increasing the price of alcohol through excise taxes and pricing policies, (2) reducing the availability of alcohol, (3) banning or extensively restricting alcohol advertising, (4) providing screening, brief interventions and treatment, and (5) measures against drink-driving. Some of these international recommendations are not consistently implemented in the Czech Republic.
The system of excise taxation of alcoholic beverages varies according to the type of beverage. For spirits it is based on the content of ethanol, for beer it is based on the degree (content of malt) and for wine and similar beverages it is based on the volume. Beer from small-scale breweries and fruit spirits from small distilleries have a reduced tax rate. Still wine has a zero rate of excise duty.
Alcohol advertising is regulated by law in the Czech Republic, with an emphasis on the protection of minors and the prohibition of associating alcohol with increased performance, success, or positive effects.
Alcohol marketing and sponsorship is mainly linked to sport, recreational setting and cultural events. In recent years, hidden advertisement and influencing, to which children may also be exposed, has become a problem.

Alcohol supply and the alcohol market

The availability of alcoholic beverages in the Czech Republic is very high. In line with the legislation, alcohol can be sold at any time and almost everywhere - in food stores, snack bars, public transport and petrol stations.
Home production of spirits is prohibited by law, while beer or wine can be produced at home in the volume of up to 2 000 litres per household. The Czech specificity is the so-called grower distilleries, where growers may produce a limited amount of fruit spirit made from their own fruit.
There are legal restrictions on the sale of alcohol in the Czech Republic. It is forbidden to sell alcohol to minors, as well as distant (Internet) sale in case when the age of the buyer cannot be verified. The sale of toys that look like alcoholic beverages is also prohibited. Alcohol may not be sold or served in health care facilities, schools, children's facilities or at events for minors. The law also regulates the occasional sale of alcohol and defines restrictions at public events.
Municipalities may, through generally binding ordinances, prohibit the consumption of alcohol, restrict or prohibit the sale and provision of alcohol in public places, and restrict the operation of restaurants and bars.
All packages of alcoholic beverages must indicate the ethanol content. For products produced in the Czech Republic, the indication of the ingredients is mandatory. Warning of the risks and harm caused by alcohol on packaging is not compulsory.
In the Czech Republic, 100-150 million litres of ethanol are consumed annually. Approximately 48% of the total amount of ethanol consumed is consumed in beer, 28 % in spirits and 24 % in wine. In recent years, 8-10 % of the ethanol consumed in spirits has been produced in distilleries.

Alcohol consumption among children and young people

Prevalence of alcohol use and risky use among children and adolescents has been declining in the long term, but still the prevalence of use among youth, as well as the rates of risky use, remains high.
Overall, 24% of 11-year-olds, 44% of 13-year-olds and 73% of 15-year-olds have used alcohol, with around half of them reporting drinking alcohol in the last 30 days. Repeated binge drinking (i.e., use at least 2 times in their lifetime) was reported by less than 1% of 11-year-olds, 5% of 13-year-olds and almost 23% of 15-year-olds (HBSC 2022 study).
In the 15-19-years-old group, 83-87% of students had drunk alcohol in the last 12 months, and 62-66% in the last month. Drinking excessive amounts of alcohol on one occasion (i.e., 5 or more drinks) in the last 30 days was reported by 39-47% of students, and 12-20% of adolescents consumed excessive amounts of alcohol once a week or more frequently (ESPAD 2019, UPOL 2021).
A significant decline in alcohol consumption among adolescents occurred between 2010-2015, with a continued but slower decline thereafter. Available studies suggest a levelling out of the differences between boys and girls and confirm that the transition from primary to secondary school is an important turning point in terms of exposure to addictive substances.
Subjectively perceived availability of alcohol has declined in recent years, but still remains at relatively high levels. A positive trend in recent years refers to increasing perception of the riskiness of heavy alcohol consumption.
There are subgroups of children and adolescents who report higher experiences with alcohol use, e.g., socio-economically disadvantaged children and children in institutional care.

Alcohol use in the adult population

The prevalence of alcohol use in the adult population of the Czech Republic is high. About 7-10% of adults drink alcohol daily or almost daily. Drinking excessive amounts of alcohol on one occasion (so called binge drinking) with a frequency of at least once a week or more is reported by 12-13% of adults.
Between 2014 and 2020, the prevalence of daily alcohol consumption increased, but the proportion of men drinking daily has been decreasing over the last two years. Among women, the rate of daily drinking has been stable for a long time, and after the decline that occurred in the context of the COVID-19 pandemic, the prevalence of daily drinking among women has returned to 2019 levels.
Long-term trends show a relatively stable prevalence of frequent heavy/binge drinking. Since 2019, the prevalence of frequent binge drinking is declining among men and among respondents in the 25-44 age group.
In the Czech Republic, 7-9% of the population fall into the category of risky alcohol consumption, with a further 8-10% falling into the category of harmful alcohol consumption (i.e., 15-19% of adults in the Czech Republic fall into the category of being at risk). After extrapolation to the adult population aged 15+, NAUTA 2022 study estimates of risky and harmful alcohol consumption reach approximately 1.3 million people (CI: 1.1-1.6 million), of whom 730 thousand (CI: 610-840 thousand) show signs of harmful drinking.
A survey among medical practitioners indicated that problem alcohol consumption is estimated to affect 175-230 000 people.
Up to 60% of women in the Czech Republic consume alcohol during pregnancy, with almost 19% of pregnant women consuming alcohol regularly or in a risky form.
There are vulnerable or at-risk population groups which report higher prevalence of alcohol use than the general population. These include, for example, people living in social exclusion, homeless people, or those with experience of imprisonment. For these people, alcohol contributes to exacerbating socio-economic disadvantage.
Tolerant attitudes of Czech population are among the explanations of the high level of alcohol consumption in the Czech Republic - 31% of people currently perceive regular alcohol consumption as acceptable. Czechs are also relatively tolerant to alcohol advertising - only 25% of the population would ban advertising for spirits, 13% for wine and 12% for beer.

Health consequences of alcohol consumption

The number of cases of death attributable to alcohol reaches 6-7 thousand per year, which represents 6% of the total mortality in the Czech Republic (10% for men and 2% for women). The largest proportion of total alcohol-related deaths is seen in older age groups, with the highest relative alcohol burden in the 35-44 age group (26% of total mortality in men and 17% in women).
In 2-3 thousand cases of death per year, alcohol is the main or only cause of death; in 2022, there were 2 409 deaths, of which 1 827 were due to alcoholic liver disease and 505 due to alcohol intoxication.
In 2022, 4.8 thousand accidents caused by alcohol were reported (i.e., 4.8% of the total number of accidents). In these accidents, 46 persons were killed (i.e., 10.1% of all fatalities).
In the Czech Republic, 13-14 thousand hospital admissions for diseases entirely attributable to alcohol are reported annually, of which around 8 thousand are for alcohol dependence (about 60%), 4 thousand for alcoholic liver disease (30%) and 1 thousand for alcoholic pancreatitis (8%). In 2022, 15 510 hospital admissions for alcohol-related injury were reported (1% of all hospital admissions).

Social consequences and correlates of alcohol use

Recent estimates of the total social costs related to alcohol consumption reach 50-57 billion CZK, i.e., 0.7-1.2% of GDP.
The largest share of the costs (54 %) is related to the indirect costs of lost productivity due to morbidity and premature mortality, and health care costs (23 %).
The total cost of substance use disorder treatment is estimated at CZK 1,287 million, of which CZK 836.9 million were costs related to treatment of alcohol-related disorders.
Household expenditure on alcohol and tobacco corresponded to 3% of consumption expenditure in 2022 (similar in 2019), of which 2% was on alcohol and 1% on tobacco products.
Alcohol is associated with domestic violence. It is estimated that up to 2/3 of all domestic violence cases in the country are alcohol related. The victims are mostly women. Heavy drinking increases the risk of aggressive behaviour. In addition to physical violence, alcohol increases the likelihood of sexual violence, as well as intense psychological violence.
Available research shows a clear relationship between homelessness and substance use. Drinking rates are related to length of time on the streets. Alcohol was a common cause of divorce, loss of housing and/or work, but further increases in rates of alcohol consumption occurred as a result of the fall into homelessness itself.
The majority of clients of addiction services is in a poor socio-economic situation, most often in financial difficulties (insufficient income, debt), housing (homelessness, threat of losing their housing) and employment (unemployment, inability to work).

Alcohol-related crime

Primary alcohol-related crime includes the offence of serving (providing) alcohol to minors (persons under 18 years), the offence of endangering under the influence of an addictive substance and the offence of drunkenness.
In 2022, 247 offences of supplying alcohol to a minor were recorded, 96 offences were cleared and 69 people were convicted of this offence. There has been a marked increase in this crime over the long term.
In 2022, 8,290 offences of endangering under the influence of a substance and drunkenness were registered, of which 5,833 were alcohol-related (70%).
Secondary alcohol crime includes crimes committed under the influence of alcohol. In 2022, 10,699 crimes were reported as alcohol-impaired, 13% of all crimes solved. The number of alcohol-impaired crimes and their share of total crime have been declining over the long term.
Alcohol-related economically motivated crime is regularly surveyed in a questionnaire study of sentenced prisoners. Theft or other illegal conduct with the motive of obtaining funds for alcohol was reported by 13% of inmates in the 2022 study.
In 2022, 1,037 alcohol-related offences were recorded in the context of public health. The most common offence involved the sale or supply of an alcoholic drink to a person under 18 years of age, accounting for 42% of the total number of offences.

Alcohol prevention programmes

Alcohol prevention targeting children and young people, which includes the prevention of alcohol consumption, is part of a broader framework of risk behaviour prevention. Programmes aimed solely at preventing alcohol use among children and young people are therefore not implemented.
Programmes in schools have most often focused on the prevention of bullying and aggression, prevention of cyberbullying and prevention of crime. Alcohol prevention was the focus of 6.5% of programmes.
Numerous public websites in the Czech Republic are dedicated to reducing consumption and the negative effects of alcohol use and providing information where to address to get help.
Since August 2019, the National Quitline 800 350 000 also integrates the topic of alcohol.
A significant campaign aimed at reducing (risky) alcohol consumption in the country is Dry February. In addition to the February event itself, it is dedicated year-round to reducing alcohol consumption in the country and promoting the destigmatisation of addiction.
In April 2022, the campaign Don't Beer the Kids was launched, targeting parents of children to encourage more responsible approach to serving (non-)alcoholic beer to children.
Alcohol producers and distributors are also running media campaigns. The effectiveness and purpose of these campaigns are questionable, as they are primarily part of marketing strategies and corporate social responsibility image building.

Brief interventions and treatment of alcohol users

Brief interventions in primary care in the Czech Republic are mainly targeted at addictive substances such as tobacco, alcohol, and illicit drugs. The level of implementation of brief interventions in practice is relatively low, even though it is mandatory by law to provide them.
Brief interventions for at-risk or heavy alcohol users are performed by approximately half of the physicians. Approximately one third of people (37%) are asked about their alcohol consumption when visiting a doctor, and 8% are advised to stop or cut down their alcohol consumption.
Alcohol dependence treatment in the Czech Republic is primarily abstinence-oriented, taking place both in outpatient and residential settings. The typical model of residential treatment is the so-called Apolinar model, i.e., treatment with a structured programme comprising various therapeutic activities with elements of psychotherapy and physical activities, with possible pharmacological support.
There are approximately 250-300 addictology programmes of various types in the Czech Republic, among them 55-60 low threshold contact centres, 50 outreach programmes, 90-100 outpatient treatment programmes 30-40 residential programmes and 35-45 aftercare programmes.
Approximately 25-35 thousand alcohol users are in contact with addictology programmes annually, of which the largest part (about 27 thousand persons) are in psychiatric care (20-23 thousand in outpatient care and about 7-8 thousand in inpatient care).
There are 17 therapeutic communities for the treatment of addiction in the Czech Republic with an estimated capacity of 300 clients. The Government Office subsidises 10 therapeutic communities, which treat approximately 100 alcohol users per year.
There are 42 registered aftercare programmes, of which 23 are residential. The services of the programmes subsidised by the Government Office (21 programmes) were used by 1,087 clients with addictive behaviour, of whom 42 % were alcohol users.
Addiction services are also available to alcohol users in prisons. Alcohol users make up to 5-40% of the clientele of addiction programmes in prisons. An estimated dozens of alcohol users are treated in prison each year.
Self-help organizations also provide help to alcohol users. Alcoholics Anonymous organization is active in 50 cities. There are currently 65 AA groups in the country. New organisations and informal groups based on self-help and participatory activities are also emerging.
In the last decade, the private segment of services has been developing. These programmes are not part of the network of publicly funded services and their clients are not reported in the information systems on clients of addiction services.
Sobering-up stations are a specific type of facility. In 2022, there were a total of 18 sobering-up stations in the country providing services to 24.1 thousand people. However, there is a lack of continuity of these stations with the system of addiction services in the Czech Republic.

Harm reduction services for alcohol users

Alcohol users are also clients of low-threshold harm reduction programmes primarily intended for people using illicit drugs. In 2022, 39.8 thousand substance users were in contact with these programmes, of whom 2.9 thousand were alcohol users (7.4%).
Harm reduction interventions aimed at reducing or controlling alcohol consumption are not widespread in addressing problem alcohol use or dependence in the country.
Programmes based on controlled alcohol distribution are an innovative approach. This is a method used especially for people who are in an unfavourable social situation. In the Czech Republic, the so-called wet centre in Brno operates on this principle, and a centre in Olomouc is being prepared for opening.
Specific programmes aimed at reducing the risks of alcohol use operate in recreational settings, providing counselling, HR material or breath tests for alcohol.
Harm reduction elements in the field of alcohol can also be provided by sobering-up stations.