Key Takeaway:
- The U.S. alcohol use decline reached nearly 2% from 2022 to 2024, while heavy drinking fell more than 8%.
- Gen Z and millennials led the decline, with heavy drinking among millennials dropping 17%.
- Alcohol use among adults ages 50 to 64 rose, including a more than 36% increase in heavy drinking since 2018.
U.S. adults’ alcohol use declined from 2022 to 2024, with younger adults showing some of the largest drops, while drinking among adults ages 50 to 64 remained elevated, a new study finds.
Alcohol Use Falls After Pandemic Rise
The study, published in the Annals of Internal Medicine, analyzed cross-sectional data from more than 114,000 respondents to the National Health Interview Survey from 2018 through 2024.
The U.S. alcohol use decline saw the share of adults reporting any alcohol use in the previous year fall by nearly 2% from 2022 to 2024, while heavy alcohol use dropped by more than 8%, according to the study. Alcohol use declined among both men and women, although the size of the decline differed by measure.
The findings mark the first decline in alcohol use since the increase associated with the COVID-19 pandemic. However, drinking levels in 2024 remained above those recorded in 2018.
Dr. Brian P. Lee, a hepatologist and liver transplant specialist at Keck Medicine of USC and the study’s lead author, said the change offers a reason for cautious optimism.
“Seeing this first decline gives you something to hope for as a doctor,” Lee said, adding that one change does not necessarily establish a sustained trend.
Younger Adults Lead The Decline
Adults ages 18 to 29, identified in the study as Generation Z, recorded the largest decline in alcohol use, with a drop of more than 5% from 2022 to 2024.
Heavy drinking among adults ages 30 to 49, a group that includes millennials, fell by 17% during the same period. The findings add data to an ongoing discussion about changing drinking patterns among younger generations.
Lee said the study did not examine why the U.S. alcohol use decline occurred among younger adults. He pointed to possible social factors, including greater awareness of alcohol-related health risks and the rise of the sober-curious movement.
He and Dr. Jagpreet Chhatwal, director of the Institute for Technology Assessment at Massachusetts General Hospital, also noted that some people may be substituting alcohol with other substances, including cannabis.
“Alcohol relates to cultural norms and societal peer pressure,” Lee said, describing how changes in drinking habits among a small group could spread through a wider peer group.
Chhatwal, who was not involved in the study, called the change encouraging but cautioned that overall drinking levels remain high.
“This is an encouraging trend — at least there’s a change in direction,” Chhatwal said.
Middle-Aged Adults Remain A Concern
The study found a different pattern among adults ages 50 to 64. Any alcohol use in that group increased by 4% from 2018 to 2024, while heavy drinking increased by more than 36%.
Lee said the trend is concerning despite the U.S. alcohol use decline, because alcohol-related conditions, including liver disease, can become serious during middle age. He has also observed younger patients with alcohol-related liver disease and patients requiring liver transplants during the years following the pandemic.
“We’re seeing the biggest increases in heavy drinking in exactly the group that we’re worried the most about in terms of their health related to alcohol,” Lee said.
Chhatwal said behavioral interventions can help people reduce drinking, but maintaining those changes can be difficult.
Lee encouraged people concerned about alcohol-related health problems to discuss screening and alcohol use with their doctors. He said such conversations can help people understand potential risks without judgment.
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