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New data indicate that alcohol consumption among adults in the United States has begun relatively rapidly declining in the past 2 to 3 years. Additional surveillance is needed to determine whether these declines sustain over time; if they do, it may portend significant improvements to population health. New data are emerging, but by no means definitive, that alcohol consumption and binge drinking among adults in the United States (US) have begun a recent decline just in the past 2 to 3 years. News headlines have focused on a relatively small Gallup poll reporting that the percentage of Americans consuming any alcohol declined from 62% in 2023 to 54% in 2025 1, and among those who drink, average consumption also declined. National health survey sources are also beginning to document recent declines in consumption. Indeed, among adults 35 to 50 years old in Monitoring the Future, the prevalence of any past 12-month alcohol use has declined over the last 5 years, with the most noticeable decline in binge drinking—decreasing by more than 5 percentage points—and daily drinking 2. Additional survey data sources such as the National Household Survey on Drug Use and Health also suggest modest recent declines in alcohol use among adults 3. Several other countries, especially across the European Union, have also reported recent declines in consumption as well 4. These recent trends among adults in the United States reverse longer standing trends. While alcohol consumption has been declining among adolescents and young adults for over three decades 5, consumption among middle aged adults has generally been steady or accelerating 6, as has per capita consumption 7. Three years are not sufficient to know whether the downward trend in alcohol use in the United States is a blip or can be sustained, but regardless, the new data are promising. If these trends hold, they may produce population level improvements in health and mortality. The reasons why alcohol use has taken a sudden turn in the United States, and in other countries as well, can only be speculated. Certainly, macro-economic concerns about inflation and affordability may be influencing buyer behaviour. Beyond economic considerations, it is possible that the public are becoming more aware of the adverse health consequences of alcohol use, even in what has historically been considered ‘moderate’ amounts 8. Data from the Gallup poll point to Americans' increasing endorsement that even moderate alcohol consumption is detrimental for health 1. This could indicate that scientific evidence and data on the adverse consequences to health of alcohol use, even at low levels, which have been accumulating over decades 8, are penetrating the public sphere. Factors like the US Surgeon General's report on alcohol and cancer are high profile examples of scientific evidence on alcohol being communicated to the public 9. There may be other reasons (and likely not just one reason) for these changes. It is of course notable that this potential downturn directly follows the coronavirus disease (COVID) pandemic. Although alcohol sales 7 and alcohol-related mortality 10 increased during the pandemic, post-pandemic shifts in social interaction and work from home may be impacting occasions to drink. Yet available data indicate that drinking alone increased in the pandemic and remains elevated among some age groups 11; therefore, nights out with alcohol may have been replaced by nights in with alcohol. Some have speculated that the rise in cannabis (and related products such as cannabidiol and Δ-8) use among adults 12 is responsible for the decline in alcohol use as people may be substituting one substance for the other. However, most people who use cannabis also use alcohol, and it is difficult, if not impossible, to determine whether people who use cannabis without alcohol would have used alcohol had they not used cannabis, therefore, these hypotheses remain untested. Regardless of the reasons, if sustained, fewer people consuming alcohol in the United States will lead to lower levels of alcohol-related morbidity and mortality, especially among older individuals and those with heavy alcohol use patterns. Excessive alcohol consumption causes an estimated 178 000 deaths every year in the United States 10, which is likely an underestimate given the numerous organs and systems that repeated alcohol exposure affects across the human body. Although prolonged heavy alcohol use is long known to impact injury as well as many of the leading causes of mortality, consensus has now emerged that even at low levels, alcohol use substantially increases the risk of multiple chronic disease outcomes. Indeed, even at an average of one drink per day the risk of a death because of alcohol is 1 in 1000, and greater than 8.5 drinks per week on average, risks increase to 1 in 100 13. Sustained research that investigates the reasons why alcohol consumption is on the decline in the United States and other countries is needed to inform next steps for a prevention focused agenda. If alcohol use is declining because more people are hearing the message that moderate consumption is not health beneficial, then continued health education campaigns that provide people with accurate science on the risks and benefits of alcohol use may be effective in helping individuals make decisions about the role of alcohol in their diets. Even if alcohol use is declining because preferences are shifting to other substances, then coordinated public health activity to address and educate on health risks from substance use, including alcohol, should remain a priority. It is important to note that alcohol use disorder remains both prevalent and stigmatized. In 2024, an estimated 12% of Americans 12 years and older experienced alcohol use disorder 14. Even if these declines in alcohol use sustain, there will remain a corpus of individuals in need of evidence-based treatment and care to reduce or abstain from alcohol. Ensuring that medical professionals continue to screen for alcohol use disorders and refer to appropriate care when needed, and that they are knowledgeable about the current data on health consequences of consumption, will remain critical. Furthermore, these data indicate that there may be promising public support for a sustained effort to reform alcohol policy in some areas of the United States. It is well established in alcohol research across the globe that controlling the harmful consequences of alcohol to the public's health through measures such as increased alcohol pricing are among the most effective and cost-effective interventions to improve health 15. There has been resistance to increases in alcohol prices through measures such as taxation in the United States 16, and the functional tax on alcohol has eroded over time 17. Perhaps if Americans are becoming more conscientious consumers of alcohol, renewed efforts toward effective alcohol policy may be achievable. No matter the reason, continuing to monitor trends in alcohol use, heavy and frequent use, consequences of use both in acute and chronic conditions causally related to alcohol use, will be essential to further understanding whether the recent US trends are a blip on the radar or a sustained decrease. Given that alcohol remains among the largest contributor to preventable morbidity and mortality world-wide, understanding how we can effectively communicate health messages around alcohol will continue to be a critical public health activity. None. None. No data.
Katherine M. Keyes (Mon,) studied this question.