The prevalence of alcohol use among US adults may have declined from 2022 to 2024 but remained at or above prepandemic levels.

Investigators conducted a serial cross-sectional study using National Health Interview Survey data from 2018, 2020, 2022, and 2024. The survey used complex sampling to generate nationally representative estimates for US adults. The investigators included 114,352 respondents: 24,965 in 2018, 30,829 in 2020, 26,806 in 2022, and 31,752 in 2024.

The investigators assessed the prevalence of any and heavy alcohol use within the year of each survey. Heavy drinking was defined according to National Institute on Alcohol Abuse and Alcoholism criteria as at least 5 drinks on any day or at least 15 drinks per week for men and at least 4 drinks on any day or at least 8 drinks per week for women.

From 2022 to 2024, the national prevalence of any alcohol use decreased by 1.24 percentage points, while heavy alcohol use decreased by 0.52 percentage points. The changes were described as absolute reductions of approximately 1% and 0.5%, respectively.

Any alcohol use declined by 3.96 percentage points among adults born from 1997 to 2012 vs. 1.76 percentage points among men and 1.45 percentage points among White adults. The largest reduction in any alcohol use occurred among adults born from 1997 to 2012.

Heavy alcohol use declined by 1.67 percentage points among adults aged 30 to 49 years and 1.19 percentage points among those born from 1981 to 1996. Reductions were also observed among non-Hispanic adults and urban residents. Point estimates suggested larger reductions in alcohol use among men vs. women and younger vs. older adults, although some subgroup estimates were less precise because of smaller sample sizes.

Despite the declines from 2022, alcohol use had not fallen below prepandemic levels. Any and heavy alcohol use in 2024 remained at or above their 2018 prevalence. Those aged 50 to 64 years had increases of 2.53 percentage points in any alcohol use and 2.08 percentage points in heavy alcohol use from 2018 to 2024. Hispanic adults had a 1.47-percentage-point increase in heavy alcohol use over the same period.

The study had several limitations. Alcohol consumption was self-reported and may have been underestimated, although the survey used methods intended to improve reporting accuracy and reduce social desirability bias. Smaller samples reduced the precision of estimates for some racial and urban subgroups, precluding definitive conclusions about differences between those groups. The survey also included only nonmilitary, noninstitutionalized adults and may not fully represent the entire US adult population.

The findings suggest a national shift toward lower reported alcohol use since 2022. “The impact on alcohol-related morbidity and mortality remains to be seen,” wrote lead study author Divya Ayyala-Somayajula, MD, of Thomas Jefferson University, and colleagues.

The study was supported by the National Institute on Alcohol Abuse and Alcoholism. Full disclosures of the study authors can be found in the study.

Source: Annals of Internal Medicine