Alcohol use among U.S. adults declined for the first time since the COVID-19 pandemic began but remains above pre-pandemic levels, according to a USC-led study published Monday.
Researchers found that from 2022 to 2024, alcohol use declined by nearly 2%, while heavy drinking fell by more than 8%, according to the study published in Annals of Internal Medicine.
The declines were particularly pronounced among younger adults, with alcohol use among Gen Z dropping more than 5% and heavy drinking among millennials falling 17%.
However, researchers found a contrasting trend among adults ages 50 to 64. From 2018 to 2024, alcohol use among that group increased by nearly 4%, while heavy drinking rose by more than 36%.
“It’s encouraging to see alcohol use decline for the first time since the start of the pandemic,” said Dr. Brian P. Lee, a hepatologist and liver transplant specialist with Keck Medicine of USC. “However, use remains above pre-pandemic levels and certain groups continue to have concerning trends.”
Lee said the increase among older adults is particularly concerning because the risk of alcohol-related conditions, including liver disease, certain cancers and cardiovascular disease, increases with age.
“The encouraging national decline should not overshadow the fact that some groups continue to be at increased risk,” Lee said. “Heavy drinking among ages 50-64 is up by more than a third since 2018, a concerning trend because this age group faces some of the greatest risks of harm from alcohol, including cirrhosis and alcohol-related cancers.”
Researchers also found differences by gender. Men experienced a larger decline in overall alcohol use than women, 2.4% compared with 1.1%, while women had a larger decline in heavy alcohol use, 9% compared with 7.7%.
The study did not examine why younger adults reduced their alcohol consumption, although researchers said changing social attitudes toward drinking have been proposed as one possible explanation.
“These findings suggest that alcohol prevention efforts need to become more tailored to specific populations,” Lee said. “Different groups are showing different patterns of alcohol use, and understanding those differences could help us develop more effective prevention and treatment strategies.”
Researchers analyzed National Health Interview Survey data from 114,352 U.S. adults between 2018 and 2024.
Heavy drinking was defined under National Institute on Alcohol Abuse and Alcoholism criteria as five or more drinks per day or 15 or more drinks per week for men, and four or more drinks per day or eight or more drinks per week for women during the 12 months before the survey.
The findings build on a 2024 study led by Lee that found alcohol use increased during the COVID-19 pandemic and continued to increase during the following two years.
“The decline in alcohol use is a positive development, but we cannot assume alcohol-related harms will decline automatically,” Lee said. “Continued attention to screening, prevention and treatment will be critical, particularly among groups where alcohol use remains elevated.”
The research was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health.