Alcohol use declines but remains above pre-pandemic levels

1. In this cross-sectional study, both any and heavy alcohol use among US adults decreased from 2022 to 2024 but remained at or above prepandemic levels.

2. Absolute reductions in use of any alcohol were most prominent among males, Generation Z, and White participants.

Evidence Rating Level: 3 (Average)

Study Rundown: Alcohol-related mortality accelerated during the COVID-19 pandemic and continued to rise immediately afterward. Although a 2025 survey reported the first decline in alcohol consumption since the pandemic, these findings required validation. This study aimed to assess trends in alcohol use since 2022 and differences across demographic subgroups. Among more than 110,000 adults, the prevalence of both any and heavy alcohol use declined between 2022 and 2024. Reductions in any alcohol use were observed across most subgroups and were particularly pronounced among males, Generation Z, and White participants. Heavy alcohol use also declined, with notable reductions among adults aged 30 to 49 years, Millennials, White and non-Hispanic participants, and urban residents. Despite these declines, alcohol use in 2024 remained at or above 2018 prepandemic levels. From 2018 to 2024, any alcohol use increased among adults aged 50 to 64 years and participants living in the western United States, while heavy alcohol use increased among adults aged 50 to 64 years and Hispanic participants. Generalizability may be limited by self-reported outcomes and underrepresentation of military personnel and institutionalized adults. Overall, these findings suggest that although alcohol consumption has declined since its pandemic-era increase, alcohol use among U.S. adults remains elevated compared with prepandemic levels.

Click to read this study in the Annals of Internal Medicine

Relevant Reading: Trends in Alcohol Use After the COVID-19 Pandemic: A National Cross-Sectional Study

In-Depth [cross-sectional study]: This cross-sectional study aimed to assess whether alcohol use decreased between 2022 and 2024 and to evaluate differences across demographic subgroups. Serial cross-sectional data from the National Health Interview Survey (NHIS) from 2018 to 2024 were used to assess alcohol consumption among US adults. Outcomes included past-year prevalence of any and heavy alcohol use, with heavy use defined as ≥5 drinks on any day or ≥15 drinks per week for males and ≥4 drinks on any day or ≥8 drinks per week for females. The study included 114,352 respondents (24,965 in 2018; 30,829 in 2020; 26,806 in 2022; 31,752 in 2024). Compared with 2022, the 2024 national prevalence of any alcohol use decreased by 1.24% (95% confidence interval [CI], -2.46% to -0.02%), while heavy alcohol use decreased by 0.52% (95% CI, -1.00% to -0.05%). Reductions in any alcohol use were observed across most subgroups, particularly males (-1.76% [95% CI, -3.31% to -0.21%]), Generation Z (-3.96% [95% CI, -6.98% to -0.95%]), and White participants (-1.45% [95% CI, -2.83% to -0.06%]). Heavy alcohol use also declined across several subgroups, including adults aged 30 to 49 years (-1.67% [95% CI, -2.94% to -0.40%]), Millennials (-1.19% [95% CI, -2.08% to -0.30%]), White participants (-0.78% [95% CI, -1.37% to -0.17%]), non-Hispanic participants (-0.68% [95% CI, -1.21% to -0.15%]), and urban residents (-0.57% [95% CI, -1.08% to -0.06%]). Despite these declines, both outcomes remained at or above 2018 prepandemic levels. From 2018 to 2024, any alcohol use increased among adults aged 50 to 64 years (+2.53% [95% CI, +0.42% to +4.64%]) and Western residents (+3.30% [95% CI, +0.01% to +6.58%]). Heavy alcohol use also increased among adults aged 50 to 64 years (+2.08% [95% CI, +1.16% to +2.99%]) and Hispanic participants (+1.47% [95% CI, +0.54% to +2.39%]). Overall, alcohol use declined from 2022 to 2024 but remained at or above prepandemic levels.

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