Alcohol-related harm and drinking behaviour

Background

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 alcohol-related deaths are potentially avoidable burdens to the health service. Alcohol-related harm includes conditions that are a direct consequence of alcohol consumption, such as alcohol poisoning, as well as conditions that are partly related to alcohol, such as liver cancer. Alcohol-specific harm only includes health conditions which are a direct consequence of alcohol misuse, such as alcoholic liver disease and accidental poisoning by exposure to alcohol.

Population-specific differences in alcohol-specific deaths

Between 2006 and 2019, the alcohol-specific mortality rate in England remained roughly constant, ranging from 11.3 deaths per 100,000 population in 2008 and 10.0 deaths per 100,000 population in 2012. However, in 2020, alcohol-specific mortality rates increased 19% from the previous year to 13 deaths per 100,000 population. In 2022, it increased even further to 14.5 deaths per 100,000 population. This increase in alcohol-specific deaths was seen across genders and in the most and least deprived deciles of the population, albeit to varying degrees.

The alcohol-specific mortality rate in males has been at least twice the rate in females since 2006. In 2020, there were 17.5 deaths per 100,000 males compared with 8.7 deaths per 100,000 females – a 17% increase in males and a 24% increase in females from 2019.

There is a bigger difference in the rates of alcohol-specific mortality between the most and least deprived deciles of the population. In 2022, alcohol-specific mortality was 20.9 per 100,000 population in the most deprived decile, compared with 9.7 per 100,000 population in the least deprived decile – a 38% increase in the most deprived decile and a 30% increase in the least deprived decile from 2019.

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 in 2012.

Between 2016/17 and 2019/20, the rate of hospital admissions related to alcohol consumption increased for both men and women. In 2020/21, the rate of hospital admissions decreased for the first time since this data had been made available, potentially due to restrictions imposed by the Covid-19 pandemic. In 2021/22, the rate of hospital admissions increased again to 1,735 per 100,000 population (overall), similar to levels before the pandemic. 2022/23 had similar rates of admissions to the previous year at 1,705 per 100,000 population (overall). The rate for males (2,646) was three times that for females (881). 

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 2022, 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 12% in 2021. A large increase for all ages occurred from 2021 to 2022, the most pronounced being for the 65–74 age group (from 7% to 15%). This increase could also be explained by a change in methodology in units conversion, see the ‘About this data’ section.

Between 2006 to 2021, the proportion of adults aged 55–64 who drank heavily in the week prior to interview ranged from 13 to 19%. For those aged 65–74, heavy drinking increased from 6% in 2006 to 7.3% in 2021, and for those aged 75 and over it wavered around 2-3%.

Overall, the 55–64 age group reported drinking the most heavily in 2022, with 21% exceeding 8/6 units on any day in the last week. By comparison, only 5% of people aged 75 and over reported heavy drinking. Data from 2020 is unavailable because the survey could not be conducted due to disruptions caused by the Covid-19 pandemic.

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 11–15 year-olds drinking alcohol and the amounts consumed.

The Health Survey for England provides children aged 8–15 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 13–15 year-olds who say that they have drunk alcohol decreased from 67% in 2006 to 34% in 2022. From 2016 to 2019, the proportion of 11–12 year-olds who have drunk alcohol decreased from 26.3% to 8.6%, and for those aged 8–10 it decreased from 9.4% to 0.5%.

In 2022, a new age group was created for 8–12 year-olds, of which 2.2% have said they have had a proper alcoholic drink before.