Open Access Highly Accessed Research article

Drinking behaviours and blood alcohol concentration in four European drinking environments: a cross-sectional study

Karen Hughes1*, Zara Quigg1, Mark A Bellis1, Ninette van Hasselt2, Amador Calafat3, Matej Kosir4, Montse Juan3, Mariangels Duch3 and Lotte Voorham2

Author Affiliations

1 Centre for Public Health, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK

2 Trimbos-instituut, Da Costakade 45, 3521 VS Utrecht, Netherlands

3 European Institute of Studies on Prevention (IREFREA), Rambla 15, 07003 Palma de Mallorca, Spain

4 Institute for Research and Development 'Utrip', Trubarjeva cesta 13, SI-1290, Grosuplje Ljubljana, Slovenia

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BMC Public Health 2011, 11:918  doi:10.1186/1471-2458-11-918

Published: 12 December 2011



Reducing harm in drinking environments is a growing priority for European alcohol policy yet few studies have explored nightlife drinking behaviours. This study examines alcohol consumption and blood alcohol concentration (BAC) in drinking environments in four European cities.


A short questionnaire was implemented among 838 drinkers aged 16-35 in drinking environments in four European cities, in the Netherlands, Slovenia, Spain and the UK. Questions included self-reported alcohol use before interview and expected consumption over the remainder of the night. Breathalyser tests were used to measured breath alcohol concentration (converted to BAC) at interview.


Most participants in the Dutch (56.2%), Spanish (59.6%) and British (61.4%) samples had preloaded (cf Slovenia 34.8%). In those drinking < 3 h at interview, there were no differences in BAC by gender or nationality. In UK participants, BAC increased significantly in those who had been drinking longer, reaching 0.13% (median) in females and 0.17% in males drinking > 5 h. In other nationalities, BAC increases were less pronounced or absent. High BAC (> 0.08%) was associated with being male, aged > 19, British and having consumed spirits. In all cities most participants intended to drink enough alcohol to constitute binge drinking.


Different models of drinking behaviour are seen in different nightlife settings. Here, the UK sample was typified by continued increases in inebriation compared with steady, more moderate intoxication elsewhere. With the former being associated with higher health risks, European alcohol policy must work to deter this form of nightlife.