Published 26 Jun, 2024

Alcohol use is a leading risk factor for the global burden of disease through its association with injuries and chronic diseases such as cancer.1-2 Alcohol consumption is a known human carcinogen associated with cancers of the upper aerodigestive tract (oral cavity, pharynx, larynx, and oesophagus) and cancers of the colon, rectum, liver, and female breast,3-5 showing  dose-response relationships.6 In addition, the joint effect of alcohol consumption and behavioural risk factors such as smoking and obesity can further increase cancer risk.4,7,8 Alcohol is the most commonly used drug in Australia, where it is consumed in a wide range of social circumstances.9-10

In 2018, alcohol consumption was assessed to be the 5th leading risk factor contributing to the disease burden in Australia, accounting for 4.5% of the total burden. Alcohol use was attributed to 40% of the liver cancer burden in DALYs. Alcohol consumption contributed to the burden of 30 diseases and injuries, including alcohol use disorders, 8 types of cancer, chronic liver disease, and 12 types of injury— predominantly road traffic injuries and suicides & other self-inflicted injuries.11

Charts
  • Notes
    1. Since 1987, the National Health and Medical Research Council (NHMRC) has published evidence-based guidelines to help Australians reduce the risk of harm associated with drinking alcohol. The charts above cover the following periods:
    (a) From December 2020, the guideline advises "To reduce the risk of harm from alcohol-related disease or injury, healthy men* and women* should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day."
    (b) Previous to this, the guidelines (released in 2001 and summarised in 2009), advise "both men and women to drink no more than two standard drinks per day to reduce their health risks over a lifetime.
    Further information at: https://www.nhmrc.gov.au/health-advice/alcohol
    2. Error bars indicate 95% confidence intervals.
    *age 18 years and over.
    Table caption
    Proportion of adults exceeding the NHMRC lifetime risk alcohol guidelines by age and sex, 2001 to 2017-18 and 2020-21
  • Notes
    ·  Data sourced from ABS 2001 to 2017-18 NHS and 2001 to 2018-19 National Aboriginal and Torres Strait Islander Health Survey; error bars indicate 95% confidence intervals.
    ·  Persons aged 18 years and over.
    ·  Exceeding lifetime risk alcohol guideline is defined as an average alcohol consumption of more than two standard drinks per day.
    ·  Proportions have been age standardised to the 2001 Australian population to account for differences in the age structure of the population over time.


    Table caption
    Proportion of adults exceeding NHMRC lifetime alcohol risk guidelines by Indigenous status, 2001, 2011-13 and 2017-19 (age-standardised)
  • Notes
    • Data sourced from ABS National Health Surveys, 2011-12 to 2017-18.
    • Remoteness was classified according to the Australian Statistical Geography Standard (ASGS) Remoteness Areas, see 'About the data' for more details.
    • Rates are not age-standardised.
    • Error bars indicate 95% confidence intervals.
    Table caption
    Proportion of adults exceeding the NHMRC lifetime risk alcohol guidelines by sex and remoteness, 2011-12, 2014-15 and 2017-18 - Crude rates
  • Notes
    • Data sourced from ABS National Health Survey, 2011-12 to 1017-18.
    • The Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) was used to allocate participants to a SEIFA quintile based on their usual residence, see 'About the data' for more details.
    • Rates are not age-standardised.
    • Error bars indicate 95% confidence intervals.
    Table caption
    Proportion of adults exceeding the NHMRC lifetime risk alcohol guidelines by sex and socioeconomic status, 2011-12, 2014-15 and 2017-18 - Crude rates

Globally, an estimated 4.1% of all new cases of cancer in 2020 were attributed to alcohol consumption.3 In 2018 in Australia, alcohol use accounted for 4.5% of the total disease burden, 39.9% of DALYs attributed to liver cancer, 37.9% for nasopharyngeal cancer, and 37.5% for other oral cavity and pharynx cancers.11 The highest number and rate of ambulance attendances were related to alcohol intoxication between 2015 and 2021.10

The National Health and Medical Research Council (NHMRC) provides evidence-based guidance on reducing health risks associated with alcohol consumption.12 The previous 2009 NHMRC Guidelines stated that a healthy adult should drink no more than 2 standard drinks a day to reduce the risk of alcohol-related harm over a lifetime (Guideline I). From the 4th quarter of 2020, the NHMRC updated the Australian guidelines to reduce health risks from drinking alcohol. Guideline 1 now states that healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day to reduce the risk of harm from alcohol-related disease or injury. In this report, 2020 NHS data onwards have been provided alongside the 2020 guidelines update. Data from 2020 onwards should not be compared with prior data due to methodological differences.

In 2022, 26.8% of Australian adults (5.3 million people) consumed alcohol in excess of the 2020 NHMRC guideline for alcohol consumption that was set to reduce the lifetime risk of harm from alcohol-related disease or injury. Males (35.8%) were nearly twice as likely as females (18.1%) to exceed the guideline.13

Young adults aged 18–24 years were the most likely to exceed the guideline with over one in three (36.1%) doing so, followed by the corresponding proportion exceeding guidelines at ages 55-64 years (29.5%). 

This pattern was similar in males with the corresponding proportion exceeding the guidelines reported to be higher for ages 18-24 years (42.3%), followed by ages 55-64 years (40.5%).  In female, the highest proportion was reported for ages 18-24 years (28.9%), followed by ages 45-54 and 55-64 years (20.7% & 19.8%, respectively).13

The highest proportion consuming 5 or more standard drinks on any day in the last year at least monthly was reported for ages 18-24 years (33.7%) whereas the highest proportion consuming 10 or more drinks in the last week was reported for ages 55-64 years (24.6%).13

 

Remoteness and socioeconomic disadvantage

In 2022, the proportion of people exceeding the 2020 lifetime guideline varied across geographic regions, with a higher proportion applying to people living in Outer regional and Remote areas (excluding very remote areas) (30.9%) than the corresponding proportion for people living in Major cities (25.6%).13

In 2022, the proportion of people living in the least socioeconomically disadvantaged areas exceeding the lifetime risk guideline (30.6%) was higher than for people living in the most disadvantaged areas (21.8%).13

This measure shows the proportions of people aged 18 years and over who exceeded the guideline in alcohol consumption.

The 2020 Guidelines12 state:

Guideline 1: To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.

Guideline 2: To reduce the risk of injury and other harms to health, children and people under 18 years of age should not drink alcohol.

As for the 2020 Guidelines, persons aged 18 years and over who exceeded the Guideline are those who either consumed more than 10 standard drinks per week, or more than 4 standard drinks on a single day, or exceeded the guidelines for both components.

The 2009 lifetime risk guideline (guideline 1)12 recommended no more than 2 standard drinks per day (equivalent of 14 standard drinks per week). This guideline was assessed using average daily consumption of alcohol for persons aged 15 years and over, derived from the type, number and serving sizes of beverages consumed on the three most recent days of the week prior to interview, in conjunction with the total number of days alcohol was consumed in the week prior to interview.

Reports before 2020 had used this 2009 Guideline, whereas data from the 2020-21 NHS used the 2020 Guidelines. 

Data for adults aged 18 years and over in this report are sourced from the National Health Surveys, a series of Australia-wide health surveys conducted by the Australian Bureau of Statistics (ABS). Indigenous data were sourced from the National Aboriginal and Torres Strait Islander Health Surveys and Social Surveys, also conducted by the ABS.

In Australia, the AIHW National Drug Strategy Household Survey (NDSHS)14 and the ABS National Health Survey (NHS)15 have large sample sizes and collect self-reported data on tobacco smoking and alcohol consumption. Differences in scope, collection methodology, design and questions may lead to variations in estimates (e.g., data are collected for people aged 14 years and over for the NDSHS and people aged 18 years and over for the NHS).

 

Methodology

The 2022 National Health Survey (NHS) is regarded as comparable to the 2017-18 NHS and previous cycles. The 2020–21 NHS data should be considered a break in the time series from previous NHS collections and used for point-in-time analysis only. The survey was implemented during the COVID-19 pandemic with a changed process for data collection. 

Changes to the 2022 NHS compared to the 2017-18 NHS in alcohol consumption questions, included:16

  • The alcohol consumption module was updated to report consumption of common alcohol drink types instead of specific alcohol brands.
  • There was redesign of daily consumption questions into a matrix style to capture volume and number of drinks by alcohol type.
  • 12-month alcohol consumption questions were re-ordered to reduce respondent burden.
  • Outputs were updated to include new 2020 Alcohol Guidelines alongside the 2009 Alcohol Guidelines.
  • Improvements were made to collection of type and size of alcoholic drinks, including the use of new visual aids.
  • Addition of beer size description was added (e.g. pint, pot, schooner, etc) based on terms used in the respondent's State or Territory of residence, to improve identification of drink size.

Remoteness

The Australian Statistical Geography Standard (ASGS) Edition 3 was used to allocate participants to a remoteness area based on their place of usual residence.17 Data for 2004-05 used the 2001 ASGC, 2011-12 used the 2006 ASGC, 2014-15 data used the 2011 ASGC, and 2017-18, 2020-21 and 21-22 data used the ASGS 2016.

Socioeconomic status

The 2016 Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) was used to allocate participants to a SEIFA quintile based on their usual residence.18 For 2004-05 data, the 2004-05 IRSD was used, for 2011-12 and 2014-15 data, the 2011 IRSD was used, and for 2017-18, 2020-21 and 2021-22 data, the 2016 IRSD was used.

Data for socioeconomic status and remoteness are available for persons in general for 2022 (note: not yet available by sex).

 

Data sources: 

  • ABS National Health Surveys – 2001, 2004-05, 2007-08, 2011-12, 2014-15, 2017-18, 2020-21 and 2022.

 

Data

Australia Bureau of Statistics 2023. Alcohol consumption. Accessed May 2024;; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/latest-release

Australian Institute of Health and Welfare. National Drug Strategy Household Survey. Accessed May 2024; https://www.aihw.gov.au/about-our-data/our-data-collections/national-drug-strategy-household-survey

Australia Bureau of Statistics. National Health Surveys. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey

Australian Institute of Health and Welfare 2022. Alcohol, tobacco & other drugs in Australia. Accessed May 2025; https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/alcohol

Policy

National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC; 2020 Accessed May 2025; https://nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol

Australian Government, Department of Health. National Alcohol Strategy 2019-2028; Accessed May 2025; https://www.health.gov.au/resources/publications/national-alcohol-strategy-2019-2028

  1. Rehm J, Gmel GE Sr, Gmel G, et al. The relationship between different dimensions of alcohol use and the burden of disease-an update. Addiction. 2017 Jun;112(6):968-1001.
  2. Murray CJL, Aravkin AY, Zheng P et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396: 1223-1249.
  3. Rumgay H, Shield K, Charvat H, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. Lancet Oncol. 2021 Aug;22(8):1071-1080. 
  4. Cancer Australia. Lifestyle risk factors and the primary prevention of cancer. Sydney: Cancer Australia. Accessed May 2024; http://canceraustralia.gov.au/publications-and-resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer
  5. Pandeya, N., Wilson, L. F., et al. Cancers in Australia in 2010 attributable to the consumption of alcohol. Aust N Z J Public Health. 2015;39(5):408-13.
  6. Bagnardi, V., Rota, M., Botteri, E., et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015;112(3):580-93.
  7. Loomba R., Yang H.-I., Su J., et al. Synergism between obesity and alcohol in increasing the risk of hepatocellular carcinoma: a prospective cohort study. Am J Epidemiol 2013; 177: 333–342.
  8. Hashibe M, Brennan P, Chuang SC, et al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: Pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiology, Biomarkers & Prevention 2009; 1.
  9. Australian Institute of Health and Welfare 2020. National Drug Strategy Household Survey 2019. Drug Statistics series no. 32. PHE 270. Canberra AIHW. Accessed May 2025; https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/summary
  10. Australian Institute of Health and Welfare 2024. Alcohol, tobacco & other drugs in Australia. Web report. Accessed May 2024; https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/alcohol
  11. Australian Institute of Health and Welfare 2021. Australian Burden of Disease Study 2018: Interactive data on risk factor burden. Accessed May 2025; https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/contents/alcohol-use
  12. National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC. Accessed May 2024; https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol
  13. Australian Bureau of Statistics 2023. Alcohol consumption. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/latest-release
  14. Australian Institute of Health and Welfare. National Drug Strategy Household Survey. Accessed May 2024; https://www.aihw.gov.au/about-our-data/our-data-collections/national-drug-strategy-household-survey
  15. Australia Bureau of Statistics. National Health Surveys. Accessed May 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey
  16. Australian Bureau of Statistics. National Health Survey methodology. Accessed May 2024; https://www.abs.gov.au/methodologies/national-health-survey-methodology/2022#summary-of-content-changes
  17. Australian Bureau of Statistics. Remoteness Areas. Accessed May 2024; https://www.abs.gov.au/statistics/standards/australian-statistical-geography-standard-asgs-edition-3/jul2021-jun2026/remoteness-structure/remoteness-areas
  18. Australian Bureau of Statistics. Socioeconomic Indexes for areas (SEIFA) 2016. Accessed May 2024; https://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001

 

 

Summary

Men were about 2 times more likely than women to exceed the guideline (35.8% compared to 18.1%).

One in four Australians exceeded the 2020 lifetime risk guideline

In 2022, 26.8% of Australian adults (5.3 million people) consumed alcohol in excess of the 2020 NHMRC guideline for alcohol consumption that is thought to reduce the lifetime risk of harm. 

The proportion exceeding the guideline was highest at ages 18-24 years

(36.1%) and lowest in the 75+ year age group at 17.5%. 

People living in Outer Regional and Remote Australia and areas of least disadvantage were more likely to exceed the guideline than those in Major Cities and areas of most disadvantage.

(30.9% and 30.6% compared to 25.6% and 21.8%, respectively)

Related indicator
Alcohol consumption - no alcohol - adults
Apparent alcohol consumption

In this Measure

Topics

Aboriginal and Torres Strait Islander
Alcohol
Risk factors

Other measures in this indicator

Apparent alcohol consumption
Alcohol consumption - no alcohol - adolescents
Alcohol consumption - no alcohol - adults

Related measures

Apparent alcohol consumption
Alcohol consumption - no alcohol - adults