Alcohol-related harm and drinking behaviour

This indicator explores whether alcohol-related harm and drinking behaviour has changed over time.


Last updated: 27/01/2021

Effective clinical care
Primary and community care Public health


Excessive alcohol consumption can have harmful health consequences in the short term but also in the long term, through conditions such as liver disease, stroke and some cancers. Alcohol-related hospital activity and deaths are potentially avoidable burdens to the health service.

The latest data presented here are from 2019, before the onset of the coronavirus (Covid-19) pandemic. Initial data from surveys carried out during the pandemic suggests that higher risk drinking increased during the national lockdown.

How have alcohol-related deaths changed over time in the UK? 26/02/2020

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The alcohol-related death rate varies considerably across the UK. Scotland has had the highest alcohol-related death rate since the time series began in 2001, while England has had the lowest. In 2018, the rate was 20.8 deaths per 100,000 people in Scotland, compared with 10.7 deaths per 100,000 people in England. The alcohol-related death rate in Wales was 13.1 deaths per 100,000 people. Data for Northern Ireland were not published in 2018.

Alcohol-related death rates in England and Wales were significantly higher in 2018 compared with 2001, increasing by 20% in England and 30% in Wales over the time period.

In contrast, the alcohol-related death rate in Scotland was significantly lower in 2018 than it was in 2001, falling by 20%. The launch of a Scottish National Alcohol Strategy in 2002 may have contributed to the downward trajectory in alcohol-related deaths over the subsequent decade. However, since 2012 rates have begun to increase again. In 2018, Scotland introduced the world’s first minimum unit price for alcohol and published the Alcohol Framework 2018: Preventing Harm to address high numbers of alcohol-related deaths.

How do alcohol-related deaths differ by gender? 26/02/2020

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In England, the alcohol-related death rate in males is more than twice the rate in females. In 2018, there were 14.8 deaths per 100,000 males compared with 6.9 deaths per 100,000 females. Since 2001, the rate of alcohol-related deaths in males has increased by 20%, but fluctuated over time. It reached a high of 15.5 deaths per 100,000 males in 2008. The rate of alcohol-related deaths in females has increased by 23% since 2001, reaching a peak of 7.4 deaths per 100,000 females in 2017. To put these figures into context, in 2018 there were 3,830 alcohol-related deaths in males and 1,868 in females.

How have alcohol-related admissions to hospital changed over time? 26/02/2020

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Alcohol misuse is estimated to cost the NHS £3.5 billion per year and society as a whole £21 billion annually. Monitoring alcohol-related hospital admissions supports the national ambition to reduce harm set out in the Government's Alcohol Strategy.

The rate of hospital admissions that were primarily due to alcohol consumption has remained broadly stable over time. However, in 2018/19 the rate increased to 850 alcohol-related admissions per 100,000 males and 500 admissions per 100,000 females. This may be due to alcohol becoming increasingly affordable and accessible.

How has the proportion of people who drank heavily in the past week changed over time? 27/01/2021

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The Health Survey for England conducts annual face-to-face interviews where people are asked about the maximum amount of alcohol they drank on any day in the last week. Data prior to 2006 is not shown due to changes in the methodology used to convert drinks to units of alcohol.

Between 2006 and 2019, the proportion of adults who drank more than 8 units (men) or 6 units (women) on any day in the past week fell for all age groups between 16 and 54 years old. The largest decrease occurred in people aged 16-24, from 29% drinking heavily in 2006 to 15% in 2019.

Over the same time period, the proportion of adults aged 55-64 who drank heavily in the week prior to interview fluctuated around 16%. For those aged 65-74, heavy drinking increased from 6% in 2006 to 10% in 2018, and for those aged 75 and over it increased from 1.8% to 3.2%.

Overall, the 25-34 age group reported drinking the most heavily in 2019, with 22% exceeding 8/6 units on any day in the last week. By comparison, only 3.2% of people aged 75 and over reported heavy drinking.

How has the proportion of children who have had an alcoholic drink changed over time? 27/01/2021

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Young people who start drinking alcohol at an early age tend to drink more often than those who start drinking later, and are more likely to develop alcohol problems in adolescence and adulthood. The Government’s Alcohol Strategy sets out a national ambition to deliver a sustained reduction in the number of 11- to 15-year-olds drinking alcohol and the amounts consumed.

The Health Survey for England provides children aged 8 to 15 with a self-completion booklet which asks if they have ever had a whole alcoholic drink. Between 2006 and 2019, there has been a large decrease for all age groups in the percentage of respondents who say that they have had an alcoholic drink. The proportion of 13- to 15-year-olds who say that they have drunk alcohol decreased from 67% in 2006 to 35% in 2019. Over the same time period, the proportion of 11 to 12-year-olds who have drunk alcohol decreased from 26.3% to 8.6%, and for those aged 8 to 10 it decreased from 9.4% to 0.5%.

About this data

Alcohol-related deaths:

The National Statistics definition of alcohol-related deaths includes underlying causes of death that are regarded as those being most directly due to alcohol consumption. The definition is primarily based on chronic conditions associated with long-term abuse of alcohol and, to a lesser extent, acute conditions. Apart from poisoning with alcohol (accidental, intentional or undetermined), the definition excludes other external causes of death, such as road traffic and other accidents.

The definition does not include diseases that are partially attributable to alcohol, such as cancers of the mouth, oesophagus and liver. However, all deaths from chronic liver disease and cirrhosis (excluding biliary cirrhosis) are included, even when alcohol is not specifically mentioned on the death certificate.

Alcohol-related admissions:

The number of alcohol-related hospital admissions is calculated using a method developed by the North West Public Health Observatory. This method is based on alcohol attributable fractions of a range of diseases and injuries that are caused by alcohol consumption. The data presented here is based on the narrow measure, which takes account of diagnoses recorded as a primary diagnosis. There is also a broad measure that takes account of both primary and secondary diagnoses.

Alcohol drinking habits:

The Health Survey for England (HSE) consists of an interview that asks adults aged 18 and over who drank in the last week about the maximum amount drunk on any day in the last week. Computer-assisted self-completion interviewing is used to ask young adults aged between 16 and 17 about alcohol consumption to ensure confidentiality. HSE data is weighted for non-response. Data prior to 2006 is not shown due to changes to the methods used by the HSE to convert drinks to units of alcohol.

It also asks children aged 8 to 15 about their experience of alcohol. The questions are presented in a self-completion booklet, to allow the child to answer without revealing the answers to their parents. Children are asked “Have you ever had a proper alcoholic drink – a whole drink, not just a sip?” and “Have you ever drunk alcopops?”. They are counted as having drunk alcohol if they answer yes to either question.

For more information, please see the methods report and data quality statement.