Australian Institute of Health and Welfare (2022) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government, accessed 08 July 2022.
Australian Institute of Health and Welfare. (2022). Alcohol, tobacco & other drugs in Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 20 April 2022, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Jul. 8]. Available from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2022, Alcohol, tobacco & other drugs in Australia, viewed 8 July 2022, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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The National Health and Medical Research Council (NHMRC) publishes guidelines for reducing health risks associated with drinking alcohol. New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the guidelines in place at the time of data collection. For example the 2019 National Drug Strategy Household Survey (NDSHS) and 2017-2018 National Health Survey (NHS) data are collected against the 2009 guidelines, while 2020 NHS data are collected against the 2020 guidelines. NDSHS data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.
The consumption of alcohol is widespread within Australia and associated with many social and cultural activities. Provided compliance with certain conditions, consuming and selling alcohol is legal in Australia and it is widely accepted. When consumed, alcohol produces a number of central nervous system depressant effects.
Alcohol concentration varies considerably with the type of drink. In Australia, beer contains 0.9–6% alcohol, wine contains 12–14%, fortified wines such as sherry and port contain around 18–20%, and spirits such as scotch, rum, bourbon and vodka contain 40–50% (NSW Ministry of Health 2017).
The majority of Australians aged 14 years and over consume alcohol, however the proportion of people drinking in excess of lifetime risk guidelines declined from 21% in 2001 to 16.8% in 2019
In 2019, 25% of people aged 14 and over exceeded the single occasion risk alcohol guideline by consuming more than 4 standard drinks in one sitting, at least monthly
Single occasion risk
Between 2015 and 2020, the highest rates of alcohol and other drug-related ambulance attendances were related to alcohol intoxication
Alcohol accounted for over 74,500 (53%) drug-related hospitalisations in 2019–20
There were 1,452 alcohol-induced deaths in 2020
In 2020–21, alcohol was the most common principal drug of concern in closed treatment episodes provided for clients' own drug use (37%)
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For related content on alcohol availability by region, see also:
Data about the volume of alcohol available for consumption are collated by the Australian Bureau of Statistics (ABS) from information about import clearance, excise and domestic alcohol sales (ABS 2019a).
Over the past 50 years, levels of apparent consumption of different alcoholic beverages have changed substantially. In particular, over the period 1967–68 to 2017–18:
This figure shows a decrease in the per capita consumption of pure alcohol in litres from 1968 to 2018. In 2018, there were 9.51 litres of pure alcohol available for consumption per person aged 15 years and over, a trend that has remained stable since 2017 (9.48 litres) and a decrease from 10.78 litres in 1968. The per capita consumption of wine and spirits/ready to drinks consumed in litres has increased from 1968 to 2018, while the per capita consumption of beer has decreased.
For related content on alcohol consumption by region, see also:
The majority of Australians aged 14 and older have consumed alcohol in their lifetime. The 2019 National Drug Strategy Household Survey (NDSHS) found that:
The figure shows a long-term decline in the proportion of people aged 14 and over who drink weekly or daily, and an increase in people who have never consumed a full glass of alcohol or drink less than monthly. From 2004 to 2019, the graph shows a steady decline in the proportion of people who drink alcohol weekly (from 41.7% to 34.9%) or daily (from 9.1% to 5.4%). Conversely, over the same period, there has been a rise in the number of ex-drinkers (from 6.3% in 2004 to 8.9% in 2019) and people who have never consumed a full glass of alcohol (from 9.3% to 14.4%, respectively). In 2019, people were more likely to drink weekly (both 34.9%).
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These findings are consistent with the National Health Survey (NHS) which found that in 2017–18 among Australians aged 18 and over, 79% had consumed alcohol in the past year (ABS 2018b). A further 8.5% had consumed alcohol 12 or more months ago, and 11.6% had never consumed alcohol (ABS 2018b) (Table S2.27).
Many drinkers consume alcohol responsibly; however, a substantial proportion of drinkers consume alcohol at a level that exceeds that recommended by the NHMRC and in doing so, increase their risk of alcohol-related harm (see Box ALCOHOL1).
The National Health and Medical Research Council (NHMRC) publishes guidelines for reducing health risks of drinking alcohol. The NHMRC released new Australian guidelines to reduce health risks from drinking alcohol in December 2020. Data for alcohol risk in this report are measured against the guidelines in place at the time of data collection. For example NDSHS and 2017-2018 NHS data are collected against the 2009 guidelines, while 2020 NHS data are collected against the 2020 guidelines. NDSHS data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.
The 2009 Guidelines state
Guideline 1: To reduce the risk of alcohol-related harm over a lifetime (such as chronic disease or injury); a healthy adult should drink no more than 2 standard drinks a day.
Guideline 2: To reduce the risks of injury on a single occasion of drinking, a healthy adult should drink no more than 4 standard drinks on any one occasion.
Guideline 3: For children and young people under 18, not drinking is the safest option. For young people aged 15–17 years, delaying the start of alcohol consumption for as long as possible is the safest option.
Guideline 4: Women who are pregnant, planning a pregnancy or breast-feeding should not drink at all. The greatest harm to the foetus or breastfeeding infant occurs when drinking is at high and frequent levels, but no level of drinking is considered safe (NHMRC 2009).
The 2020 Guidelines state:
Guideline 1: To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.
Guideline 2: To reduce the risk of injury and other harms to health, children and people under 18 years of age should not drink alcohol.
a. To prevent harm from alcohol to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol.
b. For women who are breastfeeding, not drinking alcohol is safest for their baby (NHMRC 2020).
There has been a decline in the proportion of Australians exceeding the 2009 guidelines for lifetime risk by consuming more than 2 standard drinks per day, on average (Figure ALCOHOL3). The 2019 NDSHS found that:
Similarly, after adjusting for age, the NHS reported that in 2017–18, 16.0% of adults aged 18 and over exceeded the lifetime risk guideline, a decrease from 17.3% in 2014–15 and 19.4% in 2011–12 (Table S2.26). A higher proportion of males than females exceeded the lifetime risk guidelines (23.7% compared with 8.8%) (Table S2.27).
The National Health Survey 2020-21 was collected online during the COVID-19 pandemic and is a break in time series. Data should be used for point-in-time analysis only and can’t be compared to previous years. Data for this release were collected against the 2020 Australian guidelines to reduce health risks from drinking alcohol. Estimates using self reported data show that in 2020-21:
There are a considerable number of Australians who report consuming alcohol in excess of the single occasion risk guidelines – that is, more than 4 standard drinks on any one occasion (this is the case for the 2009 and 2020 guidelines). Specifically, 2019 NDSHS findings showed that:
The 2017–18 NHS results reported about 2 in 5 (42.1%) adults aged 18 and older consumed more than 4 standard drinks on a single occasion at least once in the past year, exceeding the single occasion risk guidelines (ABS 2018b). Adult males (54.2%) were more likely than females (30.5%) to exceed the single occasion risk guideline in the last 12 months (Table S2.29).
The figure shows a long-term increase in the proportion of people aged 14 and over who exceeded single occasion risky drinking guidelines between 2007 and 2019. People aged 18–24 and 14–17 who exceeded single occasion risky drinking guidelines experienced the largest decrease between 2007 and 2019 (from 53.8% to 40.9% and from 24.7% to 8.9%, respectively). Over the same period there were increases in the proportion of people aged 50–59 and 60–69 who exceeded single occasion risky drinking guidelines (from 23% to 27.4% and 14.9% to 17.4%, respectively). In 2019, people aged 18–24 were most likely to exceed single occasion risky drinking guidelines (40.9%).
As with the national trends for the 2019 NDSHS, there were no significant differences in the proportion of people exceeding the lifetime and single occasion risk guidelines across jurisdictions between 2016 and 2019. However, the proportions reported across jurisdictions in 2019 were lower than those reported in 2007 (AIHW 2020). The proportion of ex‑drinkers increased significantly between 2016 and 2019 in New South Wales (from 7.2% to 9.3%), Victoria (from 7.0% to 8.8%) and South Australia (from 6.6% to 8.5%) (AIHW 2020).
In general, people living in Regional and Remote areas of Australia are more likely than people in Major cities to exceed risk guidelines.
The figure shows the proportion of people aged 14 and over who exceeded lifetime risk guidelines by remoteness area for 2010, 2013, 2016 and 2019. The proportion of people exceeding lifetime risk guidelines has declined across all 5 remoteness areas between 2010 and 2019. In 2019, the proportion of people exceeding lifetime risk guidelines were most likely to be located in Remote and very remote areas (26%) and the proportion of people least likely to exceed these guidelines were located in Major cities (16%).
The National Wastewater Drug Monitoring Program (NWDMP) measures the presence of substances in sewerage treatment plants across Australia. Alcohol is typically one of the most commonly detected substances monitored by the program. Since the beginning of the Program, the estimated population-weighted average consumption of alcohol has remained relatively steady, averaging out short-term fluctuations (ACIC 2022).
Data from Report 15 of the NWDMP showed that nationally:
For state and territory data, see the National Wastewater Drug Monitoring Program reports.
Figure ALCOHOL5: Estimated consumption of alcohol in Australia based on detections in wastewater, 2020 to 2021
(a) “Average consumption” refers to estimated population-weighted average consumption.
Note: Data are from 58 wastewater treatment sites, covering approximately 57% of the Australian population in 2021.
Source: AIHW. Adapted from NWDMP Report 15.
Poly drug use is defined as the use of more than 1 illicit drug or licit drug in the previous 12 months. In 2019, the NDSHS showed more than 1 in 4 recent risky drinkers reported recent use of cannabis (27% for lifetime risky drinkers and 28% for single occasion risky drinkers). Around 1 in 5 reported that they were also daily smokers (21% for lifetime risky drinkers and 18.7% for single occasion risky drinkers) (Table S2.68).
Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System for Alcohol and Other Drug Misuse and Overdose. Data for 2020 are currently available for New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory. Data are presented for 4 snapshot months per year, specifically March, June, September and December. Please see the data quality statement for further information.
In 2020, the proportion of alcohol intoxication-related ambulance attendances where multiple drugs were consumed was low, ranging from 2.5% of attendances in the Australian Capital Territory to 4.7% of attendances in Victoria and Tasmania (Table S2.81).
For related content on alcohol impacts and harms, see also:
Alcohol is absorbed rapidly in the bloodstream and affects the brain within about 5 minutes, though this may vary from person to person depending on body mass and general state of health (NSW Ministry of Health 2017). Short-term effects of alcohol such as a sense of relaxation and reduced inhibitions, may add to the appeal of its consumption. However, when consumed in excess, alcohol can also produce unpleasant effects such as nausea and vomiting and may influence people to engage in harmful behaviour (Table ALCOHOL1).
Source: NSW Ministry of Health (2017).
The Australian Burden of Disease Study 2018, found that alcohol use was the fifth highest risk factor contributing to the burden of disease in Australia, and was responsible for 4.5% of the total burden of disease and injury (AIHW 2021b (Table S2.62). The age-standardised rate of total attributable burden due to alcohol use decreased from 9.5 DALY per 1,000 population to 8.5 in 2018 (a 10.5% decline from 2003 to 2018).
Alcohol use contributed to a number of diseases and injuries including:
The 2019 NDSHS reported that 1.2% of recent drinkers were injured while under the influence of alcohol and required medical attention while less than 1% (0.4%) required admission to hospital for their injuries. Less than 1.0% of recent drinkers required medical attention (0.3%) or hospitalisation (0.2%) because they were intoxicated (AIHW 2020).
This risk increased for people who consumed alcohol at risky quantities. Specifically, 3.0% of people that exceeded lifetime risk guidelines required medical attention due to injuries sustained while drinking or due to intoxication, compared with less than 1% (0.5%) for low risk drinkers. Further, 4.9% of people who consumed 11 or more standard drinks at least monthly, required medical attention for their injuries (Table S2.64; Figure ALCOHOL6).
This figure shows that, in 2019, 3% of people aged 14 and over that exceeded lifetime risk guidelines required medical attention due to injuries sustained while intoxicated, compared with 0.5% for low risk drinkers. Additionally, 4.9% of people who consumed 11 or more drinks on a single occasion at least monthly required medical attention, compared to 3.1% who consumed 11 or more drinks on a single occasion at least yearly.
Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System for Alcohol and Other Drug Misuse and Overdose.The highest number and rate of ambulance attendances continues to be alcohol intoxication-related (tables 12 and S2.81).
In 2020, for alcohol intoxication-related ambulance attendances:
The characteristics of alcohol intoxication-related ambulance attendances varied by region. In 2020:
Drug-related hospitalisations are defined as hospitalisations with a principal diagnosis relating to a substance use disorder or direct harm relating to use of selected substances (AIHW 2018).
AIHW analysis of the National Hospital Morbidity Database showed that alcohol accounted for over 1 in 2 (53%) drug-related hospitalisations in 2019–20 (Table S1.8a). Alcohol has remained the most common drug recorded in drug-related hospitalisations across the 5 years to 2019–20.
The number and rate of alcohol-related hospitalisations increased between 2015–16 (68,236 hospitalisations, or 284.5 per 100,00 population) and 2018–19 (75,765, or 301 per 100,000), then declined in 2019–20 (74,511, or 291.5 per 100,000) (Table S1.8b).
In 2019–20, almost 3 in 4 (71%) alcohol-related hospitalisations occurred in Major cities. Previous analysis by the AIHW indicates that the relative proportions of hospitalisations by drug type were different in each remoteness area with a higher proportion of drug-related hospitalisations for alcohol (as opposed to other drugs) in Remote and very remote areas of Australia than in Major cities and Regional areas (AIHW 2019). In 2019–20, there were 696.7 alcohol-related hospitalisations per 100,000 population in Remote and very remote areas (3,419 hospitalisations) (Table S1.8c).
Alcohol-induced deaths are defined as those that can be directly attributable to alcohol use (that is, where an alcohol-related condition is recorded as the underlying cause of death), as determined by toxicology and pathology reports (for example, alcoholic liver cirrhosis or alcohol poisoning). Alcohol-related deaths include deaths directly attributable to alcohol use and deaths where alcohol was listed as an associated cause of death (for example a motor vehicle accident where a person recorded a high blood alcohol concentration) (ABS 2018a). See also Health impacts: Deaths due to harmful alcohol consumption.
Australian Institute of Health and Welfare (AIHW) analysis of the AIHW National Mortality Database showed that of the 1,452 alcohol-induced deaths registered in 2020:
The most common cause of alcohol-induced death in 2020 was liver disease, followed by mental and behavioural disorders due to psychoactive substance use. Mental and behavioural conditions due to psychoactive substance use was also the most common contributor to alcohol-related deaths (Table S1.1f).
In 2020, ABS Causes of Death reported:
The 2020–21 Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) Early Insights report shows that alcohol was the principal drug of concern in 37% of treatment episodes provided for clients’ own drug use (AIHW 2022a).
This was a similar proportion to 2019–20 (34% of closed treatment episodes) (AIHW 2021a).
Data collected for the AODTS NMDS are released twice each year—an Early Insights report in April and a detailed report mid year. Detailed information about treatment episodes for alcohol will be updated in July 2022.
The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) provides information on treatment provided to clients by publicly funded AOD treatment services, including government and non-government organisations. Data from the AODTS NMDS show that alcohol is the most common principal drug of concern among clients seeking treatment for their own drug use (AIHW 2021a). In 2019–20, over 1 in 3 (34%) closed treatment episodes were for alcohol—a similar proportion to 2018–19 (36% of episodes) (Table S2.76; Figure ALCOHOL7).
In 2019–20, where alcohol was the principal drug of concern:
Source: AIHW Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS).
Supplementary tables S2.76, S2.78 and S2.80.
Where the principal drug of concern was alcohol, the proportion of clients who travelled 1 hour or longer to treatment services in 2016–17 was higher in Regional and remote areas than in Major cities (29% compared with 7%) (AIHW 2019).
For related content on at-risk groups, see:
While alcohol is widely consumed in Australia, some population groups are at a greater risk of problematic consumption.
The National Alcohol Strategy aims to provide a national framework to prevent and minimise alcohol-related harms among individuals, families and communities by:
Access the National Alcohol Strategy 2019–2028 >
The NDSHS includes questions aimed at measuring the level of public support for policies to reduce problems associated with alcohol. In 2019, public support declined for the majority of measures to reduce the harms from alcohol. The policies with the most support to reduce alcohol related harm were:
The least supported policy measure was to increase the price of alcohol (26%) (AIHW 2020).
AABS (Australian Bureau of Statistics) 2016. National Aboriginal and Torres Strait Islander Social Survey, 2014–15. ABS cat. no. 4714.0. Canberra: ABS. Viewed 14 December 2017.
ABS 2017. Household Expenditure Survey, Australia: Summary of Results, 2015-16. ABS cat. no. 6530.0. Canberra: ABS. Viewed 4 January 2018
ABS 2018a. Causes of Death, Australia, 2017. ABS cat. no. 3303.0. Canberra: ABS. Viewed 12 October 2018.
ABS 2018b. National Health Survey, First Results, 2017-18. ABS cat. no. 4364.0.55.001. Canberra: ABS. Viewed 21 December 2018.
ABS 2019a. Apparent consumption of alcohol, Australia, 2017–18. ABS cat. no. 4307.0.55.001. Canberra: ABS. Viewed 10 September 2019.
ABS 2019b. National Aboriginal and Torres Strait Islander Health Survey, 2018-19. ABS cat. no. 4715.0. Canberra: ABS. Viewed 8 January 2020.
ABS 2021. Causes of Death, Australia, 2020. ABS cat. no. 3303.0. Canberra: ABS. Viewed 29 September 2021.
ABS 2022. Alcohol Consumption: 2020–21 Financial Year. ABS website, accessed 25 March 2022.
ACIC (Australian Criminal Intelligence Commission) 2021a. National Wastewater Drug Monitoring Program Report 12. Canberra: ACIC. Viewed 1 March 2021.
ACIC 2022. National Wastewater Drug Monitoring Program Report 15. Canberra: ACIC. Viewed 18 March 2022.
AIHW (Australian Institute of Health and Welfare) 2018. Drug related hospitalisations. Cat. no. HSE 220. Canberra: AIHW. Viewed 18 August 2021.
AIHW 2019. Alcohol and other drug use in regional and remote Australia: consumption, harms and access to treatment, 2016–17. Cat. no. HSE 212. Canberra: AIHW. Viewed 15 March 2019.
AIHW 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW. Viewed 16 July 2020.
AIHW 2021a. Alcohol and other drug treatment services in Australia annual report. Cat. no. HSE 250. Canberra: AIHW. Viewed 16 July 2021.
AIHW 2021b. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018, AIHW, Australian Government. doi:10.25816/5ps1-j259
AIHW 2022. Alcohol and other drug treatment services in Australia: Early insights. Cat. no. HSE 242. Canberra: AIHW. Viewed 8 March 2022.
DoH (Department of Health) 2019. National alcohol strategy 2019–2028. Canberra: DoH. Viewed 8 January 2020.
NHMRC (National Health and Medical Research Council) 2009. Australian guidelines to reduce health risks from drinking alcohol. Canberra: NHMRC. Viewed 12 October 2017.
NHMRC (National Health and Medical Research Council) 2020. Australian guidelines to reduce health risks from drinking alcohol. Accessed 7 April 2022.
NSW Ministry of Health 2017. A quick guide to drugs & alcohol, 3rd edn. Sydney: National Drug and Alcohol Research Centre.
OECD (Organisation for Economic Co-operation and Development) 2021. OECD Health Statistics 2021. Paris: OECD. Viewed 30 August 2021.
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