Declining alcohol consumption in Australia: implications for public health

Alcohol consumption in Australia (and many other western countries) has been declining over the past ten years. Currently, as a nation we are drinking a litre less of pure alcohol per year, per person than we did in 2007 (1).  In particular, young people are drinking less, and they are said to be responsible for driving this decline in national consumption (2). However, we recently found that people of all ages are increasingly modifying their drinking.

Using National Drug Strategy Household Survey (NDSHS) data from 2001-2013, we found that rates of quitting drinking (in the previous twelve-month period) went up from 4.3 per cent to 6 per cent, and the rates of reducing the frequency or quantity of drinking went up from around 24 per cent to 29 per cent. In 2013, nearly half of the drinkers surveyed (43.4 per cent) reported quitting or reducing their drinking in the past 12 months.

Consistent with earlier research, we also found that adolescents and younger adults were more likely than older groups to report quitting and reducing their drinking. The reasons for doing so also differed significantly across age groups.

Health was the most common reason reported by the sample for modifying their drinking. However, older respondents were much more likely than younger respondents to report quitting or reducing drinking for health reasons. Younger respondents, on the other hand, were much more likely than older respondents to report being motivated by lifestyle, social, taste and enjoyment reasons (3).

What might explain these trends?

It is very likely that more than 15 years of concerted public health efforts have influenced the social and cultural position of alcohol in Australia. The late 1990s and early 2000s saw a significant increase in alcohol and other recreational drug use. Consequently, over the past 15 years, significant political and economic resources have been directed towards alcohol-related prevention, education and health promotion.

In particular, the popularity of health as the main reason for modifying drinking suggests that one of the factors that might be influencing national drinking patterns is growing awareness of the negative health effects of alcohol. Alcohol is linked to more than 200 disease conditions including cancer (4) and through public health efforts, this message may be getting through to more people. Furthermore, the risk of alcohol to the developing brain (5) is more widely publicised and understood.

More broadly, public health has successfully promoted the notion of healthier lifestyles. Perhaps as a consequence, more of us are joining programs such as Dry January or Feb Fast, which advocate not drinking for a month (6). Short-term abstinence programs such as Hello Sunday Morning, which can be undertaken at any time (7) are also gaining popularity. Such programs encourage us to reflect on the role of alcohol in our lives and the importance of periods of abstinence for health.

In our study, the importance of socially-informed reasons such as believing in moderation, being concerned about violence, wanting to avoid drunkenness, and not enjoying getting drunk, suggest a shift in how young people view alcohol and drinking. In particular, this suggests a change in social norms that limit the acceptability of heavy or frequent drinking.

What should be done by policymakers to further encourage this trend and support others to reduce their consumption?

It is important to note that while declining drinking represents a positive public health trend, millions of Australians are still drinking in ways that put them at risk of short and long-term harm. In particular, older Australians, particularly Generation X and Baby Boomers, are continuing to drink at harmful levels (2).

In addition, despite an overall drop at the population level, alcohol-related harm, as observed by emergency service responses, continue to increase (8). As such, it is important that as public health workers we do not take our foot off the pedal.

Our findings indicate that in order to be effective, health promotion messages might resonate differently with younger and older drinkers. It appears that health-related messages appear particularly salient for older populations and a focus on the pleasures of moderation, avoiding violence and ways to enjoy leisure time without intoxication are more meaningful for younger people.

Ultimately, while the current decreases in consumption are promising, there is much more work to be done as the harm from alcohol continues to increase. In particular, a health promotion focus on older drinkers, who are not decreasing their consumption like their younger cohorts, is warranted. It is a particular challenge for public health going forward to affect change with older drinkers whose alcohol practices are clearly more deeply embedded in every day practice.

References

1. Australian Bureau of Statistics. (2017). Apparent Consumption of Alcohol, Australia. Retrieved from Canberra.
2. Livingston, M., Raninen, J., Slade, T., Swift, W., Lloyd, B., & Dietze, P. (2016). Understanding trends in Australian alcohol consumption: an age–period–cohort model. Addiction, 111, 1590-1598.
3. Pennay, A., Callinan, S., Livingston, M., Lubman, D. I., Holmes, J., MacLean, S., . . . Dietze, P. (2018). Patterns in reduction or cessation of drinking in Australia (2001-2013) and motivation for change. Alcohol and Alcoholism, early online.
4. World Health Organization. (2018). Global status report on alcohol and health. Retrieved from Geneva:
5. Bonomo, Y., Coffey, C., Wolfe, R., Lynskey, M., Bowes, G., & Patton, G. (2001). Adverse outcomes of alcohol use in adolescents. Addiction, 96(10), 1485-1496.
6. de Visser, R. O., Robinson, E., & Bond, R. (2016). Voluntary temporary abstinence from alcohol during “Dry January” and subsequent alcohol use. Health Psychology, 35(3), 281-289.
7. Pennay, A., MacLean, S., & Rankin, G. (2016). Hello Sunday Morning: Alcohol, (non)consumption and selfhood. International Journal of Drug Policy, 28, 67-75.
8. O’Giel, R., Gao, C., Rehm, J., Gmel, G., & Lloyd, B. (2016). Temporal changes in alcohol?related mortality and morbidity in Australia. Addiction, 111(4), 626-634.