Alcohol use is a major risk factor for disease and injuries worldwide, including chronic diseases such as cancer.1-2 Alcohol consumption is a known human carcinogen associated with cancers in the mouth, throat and oesophagus. It is also associated with cancers in other parts of the body. These include the colon and rectum, prostate, liver, skin, and female breast cancer.3-6 When combined with obesity and behavioural risk factors such as smoking, the risk of cancer increases even more.7,8 Alcohol is the most commonly used drug in Australia, where it is consumed in a wide range of social settings.9-10
In 2018, alcohol was the 5th leading risk factor contributing to disease in Australia. Alcohol use was responsible for 4.5% of the total disease burden in Australia. Alcohol use contributed to 40% of liver cancer burden (footnote), and to the burden of 30 diseases and injuries. These included alcohol use disorders, eight types of cancer, chronic liver disease, and twelve types of injury. Alcohol use especially contributed to the disease burden of road traffic accidents, suicides and self-inflicted injuries.11
Footnote: (measured in Disability Adjusted Life Years)
About this measure
In 2020, about 4.1% of all new cancer cases worldwide were linked to alcohol use.3 In Australia, alcohol was responsible for 4.5% of the total disease burden in 2018. It contributed to nearly 40% of the liver cancer burden and 37.5% of the disease burden for oral and throat cancers. Alcohol use contributed to nearly 38% of the disease burden for cancer of the upper throat and nasal cavity (nasopharyngeal cancer) (footnote).11 From 2015 to 2023, the highest numbers and rates of ambulance attendances was due to alcohol intoxication.10
About the data: 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 (equivalent of 14 standard drinks per week) to reduce the risk of alcohol-related harm over a lifetime (Guideline I). The 2009 single occasion risk guideline (guideline 2) recommended no more than 4 standard drinks on a single occasion. This guideline was assessed in the context of questions on the number of times in the last 12 months a person's consumption exceeded specified levels.
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.12 In this report, 2020 National Health Survey (NHS) and subsequent data have been provided alongside the 2020 guidelines update; hence, these data should not be compared with prior data due to methodological differences.
Footnote: (measured in Disability Adjusted Life Years)
Current status
In 2022, 21.7% of Australians aged 18 and over reported not drinking alcohol in the past year. This included people who had never drunk alcohol. Overall, more women (26.1%) than men (17.4%) reported not drinking.13
The proportion of adults aged 18 years and over who reported consuming no alcohol in the previous 12 months was higher among older Australians. The highest proportions were reported among people aged 65 years and over.
The proportions of Australians aged 65+ (all genders) reporting no alcohol consumption in the past year were:
- Ages 65-74 years: 23.7%
- Ages 75+years: 33.2%
Among women, the pattern remained consistent, with more women aged over 75 years reporting not drinking alcohol in the previous 12 months. The lowest rates of non-drinking reported in the previous 12 months was among women aged 18-24 years.13
The proportions of Australian women reporting no alcohol consumption in the past year were:
Ages 18-24 years: 18.9%
Ages 65-74 years: 29.3%
Ages 75+ years: 42.7%
Among men, the highest proportion of non-drinking was in men aged over 75 years. However, the next highest proportion of non-drinkers was men aged 25-34 years. Males aged 35-44 and 45-54 years were the least likely to report no alcohol consumption in the last 12 months (15.4% & 15.3%, respectively). 13
The proportions of Australian men reporting no alcohol consumption in the past year were:
Ages 25-34 years: 17.9%
Ages 35-44 years: 15.4%
Ages 45-54 years: 15.3%
Ages 75+ years: 23.8%.
Trends
Between 2001 and 2007-08, the proportion of adults not consuming alcohol varied and did not show a definite trend upwards or downwards. The proportion varied from16.8% in 2001, to 15.5% in 2004-2005 and 16.0% in 2007-2008.
The proportion of adults who reported not consuming any alcohol in the past 12 months increased from 16.0% in 2007-08 to 18.4% in 2020-21. This rate continued to rise, reaching 21.7% in 2022. The biggest increases were observed in ages 25-34 years (from 12.9% to 20.3%) and 35-44 years (from 14.1% to 20.3%).13,14
An increasing trend was similarly reported by the AIHW in the National Drug Strategy Household Survey (NDSHS) 2022-23 among people aged 14 years and over. In this age group, the proportion of people who reported never having had a full glass of alcohol increased from 9.3% (in 2001) to 14.9% (2022-23). The proportion of ex-drinkers increased from 7.1% to 8.2% over the same time period.10
Note: 2020 National Health Survey (NHS) and subsequent data have been provided alongside the 2020 guidelines update. These data should not be compared with prior data due to methodological differences.
About the data
This measure shows the proportions of people aged 18 years and over who reported consuming no alcohol in the previous 12 months (including those reporting that they never consumed alcohol).
Numerator: Number of persons who reported consuming no alcohol in the previous 12 months (including those reporting that they never consumed alcohol).
Denominator: Number of persons aged 18 years and over, including those who did not remember when they last consumed alcohol.13
Data for adults aged 18 years and over in this report were sourced from the National Health Survey (NHS) 2022 report.13 The National Health Survey is a series of Australia-wide health surveys conducted by the Australian Bureau of Statistics (ABS).
In Australia, the AIHW National Drug Strategy Household Survey (NDSHS)15 and the ABS National Health Survey (NHS)16 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 methodologically comparable to the 2017-2018 NHS and previous cycles. The 2020–2021 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 2017-2018 NHS in alcohol consumption questions, included:17
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.18 Data for 2004-2005 used the 2001 ASGC, 2011-2012 used the 2006 ASGC, 2014-2015 data used the 2011 ASGC, and 2017-2018, 2020-21 and 2021-2022 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.19 For 2004-2005 data, the 2004-2005 IRSD was used, for 2011-2012 and 2014-2015 data, the 2011 IRSD was used, and for 2017-2018, 2020-2021 and 2021-2022 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).
More details of technical notes can be found in reference 20.
Data sources:
ABS National Health Surveys – 2001, 2004-05, 2007-08, 2011-12, 2014-15, 2017-18, 2020-21 and 2022.
Data caveats:
Published NHS data for 2011-2012, 2014-2015 and 2017-2018, and microdata for 2011-2012 have been randomly adjusted to avoid the release of confidential data. Discrepancies may occur between sums of the component items and totals. 2020 National Health Survey (NHS) and subsequent data have been provided alongside the 2020 guidelines update; hence, these data should not be compared with prior data due to methodological differences.
References
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.
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.
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.
Cancer Australia. Lifestyle risk factors and the primary prevention of cancer. Sydney: Cancer Australia. Accessed Nov 2024; http://canceraustralia.gov.au/publications-and-resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer
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.
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.
Loomba R., Yang HI., 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.
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 Epidemiol Biomarkers Prev. 2009 Feb;18(2):541-50.
Australian Institute of Health and Welfare 2024. National Drug Strategy Household Survey 2022-2023. Drug Statistics series no. 32. PHE 340. Canberra AIHW. Accessed Nov 2024; https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey/contents/alcohol-consumption
Australian Institute of Health and Welfare 2024. Alcohol, tobacco & other drugs in Australia. Web report. Accessed Nov 2024; https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/alcohol
Australian Institute of Health and Welfare 2021. Australian Burden of Disease Study 2018: Interactive data on risk factor burden. Accessed Nov 2024; https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/contents/alcohol-use
National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC. Accessed Nov 2024; https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol
Australian Bureau of Statistics 2023. Alcohol consumption. Accessed Nov 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/latest-release#data-downloads
Australian Bureau of Statistics 2022. Alcohol consumption. Accessed Nov 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/alcohol-consumption/2020-21
Australian Institute of Health and Welfare. National Drug Strategy Household Survey. Accessed Nov 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 Nov 2024; https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey
Australian Bureau of Statistics 2023. National Health Survey methodology. Accessed Nov 2024; https://www.abs.gov.au/methodologies/national-health-survey-methodology/2022#summary-of-content-changes
Australian Bureau of Statistics 2023. Remoteness Areas. Accessed Nov 2024; https://www.abs.gov.au/statistics/standards/australian-statistical-geography-standard-asgs-edition-3/jul2021-jun2026/remoteness-structure/remoteness-areas
Australian Bureau of Statistics 2018. Socioeconomic Indexes for areas (SEIFA) 2016. Accessed Nov 2024; https://www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001
Australian Bureau of Statistics 2017. Data quality and technical notes. Accessed Nov 2024; https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4906.0.55.003main+features262016#Standard Error