This report examines the implementation of alcohol tax and pricing policies in the WHO European Region as of 2022, assessing their impact on alcohol affordability and consumption, as well as their public health implications. It provides a comprehensive analysis of excise tax structures, minimum pricing policies and affordability trends across Member States. Findings indicate that while excise taxes are widely applied to beer and spirits, they remain low or non-existent for wine in many countries. Minimum pricing policies are limited, with only nine countries implementing them, often on specific products. Alcohol affordability is notably higher in European Union countries compared to the regional average, potentially undermining public health efforts. Case studies from Georgia, Germany and Portugal demonstrate that tax increases can lead to significant reductions in alcohol consumption and mortality. The report also addresses concerns regarding unrecorded alcohol, showing no automatic link between higher taxation and increased illicit alcohol consumption. These findings highlight the untapped potential of tax and pricing policies to reduce alcohol-related harm and support evidence-based policy-making in the Region, where such measures remain underutilized