A quiet exception to a global Western trend
Over the past two decades, alcohol use among young adults has declined in many Western countries. In England, for example, nearly one in three young adults aged 16–24 now say they don’t drink at all—a figure that has almost doubled since 2005 (Ng Fat et al., 2018). Similar patterns have been observed in Australia, New Zealand, and the United States (Clark Goings et al., 2019; McCabe et al., 2021; Vieno et al., 2018). This trend could have important public health implications, given that consuming zero or near-zero levels of alcohol is the best way to minimize health loss, especially among youth (Bryazka et al., 2022; Zhao et al., 2023).
However, France—long known for its wine culture and close ties to the alcohol industry—tells a different story, as revealed in our recent study.
The study
Our study had two objectives: to track drinking trends among 18–30-year-olds in France from 2000 to 2021; and to compare the profiles of current, former, and never-drinkers.
We used cross-sectional survey data from the 2000, 2005, 2010, 2014, 2017 and 2021 editions of the French Health Barometer, a large national survey run every few years by Santé publique France (the national Public Health Agency) since 1992 (Santé Publique France). Its aim is to assess health behaviours and health and socio-demographic determinants, among representative samples of the metropolitan French population.
The results
We found no clear decline in drinking among young adults in France. In fact, rates of current drinkers remained remarkably stable across two decades. Moreover, additional analyses found no significant changes in the trend of at-risk drinkers during the same period. This finding also differs from other Western countries, where harmful alcohol use appears to have decreased between 1989 and 2015 (Visontay et al., 2020).
While overall trends haven’t changed much, we did see clear differences between those who drink and those who don’t. Compared to current drinkers, former- and never-drinkers were more likely to be women, have lower incomes, be unemployed, and have less formal education. They were more likely to be physically active, to practice a religion, and to avoid other substances like tobacco and cannabis.
France’s unique alcohol environment
Why hasn’t France followed the same downward trend as other countries? Our study doesn’t provide any answer to this thorny issue, but only allows for some cautious speculation.
While other countries have implemented strong public health campaigns—like the UK’s support for Dry January—France has been slower to act. To this day, the French government still does not support the Dry January campaign (Le « Dry January » aura bien lieu en 2024, toujours sans l’Etat, 2023). Similarly, a national alcohol prevention campaign, originally designed by Santé Publique France for the 2023 Rugby World Cup was abruptly cancelled by French authorities (Hallot, 2023). Government support for similar campaigns has been repeatedly blocked, often due to the powerful lobbying influence of the wine and alcohol industries.
This influence of the alcohol industry in France is particularly striking when examining the evolution of the Evin law, established in 1991, which originally intended to de-normalize and reduce alcohol use, reduce alcohol-related mortality and morbidity, and protect youth from alcohol advertising in France (République Française, 1991). Over the years, the Evin law has undergone several amendments and has been progressively weakened due to intense lobbying efforts from alcohol producers, especially from the wine industry (Millot et al., 2021). Consequently, the 2015 revised version of the Evin law was found to be ineffective in protecting young people from exposure to alcohol advertising in France (Jernigan et al., 2017), with almost 30% of 17-year-old French young adults reporting having been exposed to alcohol advertising almost every day in the past twelve month (Gallopel-Morvan et al., 2017).
What next?
Why is France out of step with other countries when it comes to youth drinking? And what can be done to change that?
We believe that more international comparative research is needed to explore what’s working elsewhere regarding alcohol use —and why it’s not happening in France. We also need to design public health campaigns that resonate with the economic, social, and cultural reality of young people.
For now, it is tempting to conclude that France’s desire to keep a foot rooted in the alcohol industry has resulted in a public health deadlock.
Written by Dr Julia de Ternay, psychiatrist and addiction specialist, Clinical Consultant and Lecturer at the University Addiction Department of Lyon (SUAL), Edouard Herriot Hospital, Hospices Civils de Lyon.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.