Alcohol, tobacco & other drugs in Australia

Introduction

Socioeconomic area is a key determinant of health and influences people’s health and wellbeing (AIHW 2024b). Both in Australia and internationally, people living in lower socioeconomic areas are at greater risk of poor health (WHO 2024). For example, people living in the lowest socioeconomic areas have had the highest crude death rate and the highest rates of public hospitalisation (AIHW 2025a; AIHW 2025b). This is also true in the context of alcohol and other drugs, where both use and harms vary by socioeconomic area. 

This page focuses on alcohol and other drug use and harms by socioeconomic area across Australia. 

What data sources are available?

There are a limited number of data sources that contain information about alcohol and other drug use and harms across socioeconomic areas. These include self-report surveys that ask people about their use of alcohol and other drugs and reports that analyse health administrative data sets (such as administrative data routinely collected by hospitals). Each data set uses a different methodology, and the language used to describe alcohol and other drugs or socioeconomic areas may also differ across sources.

For more information about each data source, see Technical notes.

How does alcohol and other drug use vary across socioeconomic areas?

Tobacco and e-cigarette use

Social and economic factors shape people’s behaviours of vaping or smoking. In general, people who live in the most disadvantaged areas of Australia are far more likely to smoke daily than those living in the least disadvantaged areas. Specifically:

• The 2022–2023 NDSHS found 13.4% of people aged 14 and over living in the most disadvantaged areas smoked daily, compared with 4.1% of people living in the least disadvantaged areas (AIHW 2024a, Table 9a.14).
• Similar results were reported in the 2022 NHS, where 18.1% of adults aged 18 and over living in the most disadvantaged area smoked daily, compared with 5.4% of those living in the least disadvantaged area (ABS 2023a, Table 6.3).

Rates of current smoking have fallen across most socioeconomic areas between 2019 and 2022–2023, with the steepest decline occurring among people living in the most disadvantaged areas (AIHW 2024a; Figure 1).

Generally, people living in the lowest socio-economic areas were the most likely to currently smoke but not vape (13.2% in 2022–2023). By contrast, people living in the highest socio-economic areas were the most likely to vape but not smoke (6.6%) (AIHW 2024a, Table 3.43).

Risky drinking

The 2022–2023 NDSHS found that people living in the lowest socioeconomic areas were the least likely to drink at risky levels (27% of people in the lowest quintile) and most likely to have abstained from drinking alcohol in the previous 12 months (30.5% of people in the lowest quintile) (AIHW 2024a, Table 4.34).

Illicit drug use

The  2022–2023 NDSHS found that people living in areas of the most socioeconomic advantage were more likely than those living in the most disadvantaged areas to have recently used: 

• cannabis (13.1% compared with 11.6%)
• ecstasy (3.6% compared with 0.7%)
• cocaine (7.4% compared with 1.9%)
• pharmaceutical stimulants for non-medical purposes (3.5% compared with 1.3%) (AIHW 2024a, Table 9a.14) (Figure 1).

Conversely, people living in the most disadvantaged socioeconomic areas were 1.6 times as likely as those from the most advantaged socioeconomic areas to have used pain-relievers/opioids for non-medical purposes (2.8% compared with 1.7%). There was little variation in the recent use of methamphetamine and amphetamine for those living in the lowest socioeconomic areas compared with those living in the highest socioeconomic areas (1.1% and 1.3%, respectively) (AIHW 2024a, Table 9a.14).

How do alcohol and other drug-related harms vary across socioeconomic areas?

Alcohol and other drug-related hospitalisations

Analysis by the National Drug and Alcohol Research Centre (NDARC) showed that people living in the most disadvantaged areas made up 23% of drug-related hospitalisations in 2022–23. This was largely consistent between males and females and across most age groups. People living in the four other socioeconomic areas made up 18–19% each (Chrzanowska et al. 2025a).

Deaths involving alcohol and other drugs

Despite slightly lower rates of risky drinking, the rate of alcohol-induced deaths is higher among people from the most disadvantaged areas than people from the most advantaged areas (AIHW 2024a, ABS 2025). Similarly, rates of drug-induced deaths are generally higher among those living in the most disadvantaged areas.

• Preliminary estimates from the ABS indicate that people in the most disadvantaged socio-economic areas had the highest rates of alcohol-induced deaths in 2024 (10.7 deaths per 100,000 people for Quintile 1 (most disadvantaged areas) compared with 2.8 per 100,000 for Quintile 5 (least disadvantaged area)) (ABS 2025, Table 13.14).
• NDARC analysis of preliminary revised death rates showed that almost 1 in 3 drug-induced deaths (32% or 575 deaths) occurred among people living in Quintile 1. This has remained relatively stable since 2018, and was consistent by sex and across most age groups and all drug types except for cocaine (Chrzanowska et al. 2025b).

Where do I go for more information?

• National Drug and Alcohol Research Centre Reports
• National Drug Strategy Household Survey