Background Binge drinking may have played a central role in mortality fluctuations in the former Soviet Union (fSU). In Eastern Europe, binge drinking is more common in men than women and in men of lower socio-economic position (SEP). Yet intersections of these factors have rarely been addressed with sufficient power to detect social patterns in binge drinking amongst women. The aim of this study was to determine whether there are gender differences in the social patterning of binge drinking in the Czech Republic, Russia, Poland and Lithuania.

Methods Cross-sectional baseline data from the HAPIEE (Health, Alcohol and Psychosocial factors in Eastern Europe) study was used. The participants were men and women aged 45–69 years randomly selected from population registers in the Czech Republic, Russia, Poland and Lithuania. Logistic regression was used to examine the association between social factors (education, employment status, household amenities and deprivation) and binge drinking (>100g (men) and >60g (women) ethanol per occasion ≥1x/month) in each gender and country separately. Amenities score was derived from 18 (Lithuania) or 12 (other countries) individual questions on household items. ‘Few amenities’ was defined as a score in the lowest quartile for the participant’s country.

Tests for interaction between gender and each variable were carried out. Tests for interaction between country and each variable were also completed. Pooled data (all countries) was interpreted where there was no evidence of country heterogeneity.

Results There were 34,069 participants with complete data. Amongst men in all countries, all markers of low SEP were associated with increased odds of binge drinking (e.g. OR 1.22, 95% CI 1.10–1.35 for few amenities, fully adjusted model). In women, few amenities (OR 0.81, 0.70–0.94, fully adjusted model), and to a lesser extent low education level, were associated with decreased odds of binge drinking. The associations between social factors, gender and binge drinking were homogenous between countries (few amenities test for country heterogeneity p=0.72 men, p=0.51 women) with the exceptions of education and deprivation in women.

Conclusion In Russia and Eastern Europe binge drinking in men and women is socially patterned, but in contrasting ways. Men with lower SEP may binge drink due to social instability and poor coping mechanisms. Women with higher SEP may binge drink due to greater resources and exposure to, and adoption of, male drinking patterns through employment or higher education. Policy to tackle binge drinking should take into account its gender-specific social determinants.