The aim of this paper is to assess postwar differences and trends in alcohol- related mortality in the current European Union (minus Luxembourg plus Norway) on the basis of liver cirrhosis mortality and deaths with explicit mention of alcohol, primarily alcohol dependence, alcohol psychosis and alcohol poisoning (AAA). The question of the extent to which these indicators are comparable across Western European countries is also addressed. A marked north- south gradient was found for cirrhosis mortality, with the highest rates revealed in Southern Europe and the lowest in Northern Europe. However, this gradient weakened with the passage of time and the initially quite substantial regional differences declined during the latter part of the study period. Explicitly alcohol- related mortality (AAA), on the other hand, showed a reverse cross- national pattern with the highest rates in the north and the lowest in the south. A positive cross- national relationship was observed between cirrhosis and per capita consumption but this match was not improved by combining cirrhosis with explicitly alcohol- related causes. Nevertheless, within Southern, Central and Northern European countries the relationship between per capita consumption and AAA- mortality was positive. It is concluded that cirrhosis mortality is useful for making rough national comparisons in a Western European context whereas the validity of explicitly alcohol- related mortality is questionable. Cultural differences in recording practices and drinking patterns are discussed as possible determinants of geographical differences in AAA- mortality.
