Summary
Drugs can cause harm to individuals, families and communities. These drugs include alcohol, tobacco, electronic cigarettes and vapes (‘e‑cigarettes’), illicit drugs, and pharmaceuticals used for non-medical purposes. The harm caused by drugs can be health‑related, such as tobacco causing lung cancer or car accidents involving alcohol and drug use. However, people can also experience social and economic harms, including contact with the criminal justice system.
This report provides insights into the use of alcohol, tobacco, e‑cigarettes, and illicit drugs in Australia in 2022 and 2023, using results from the 2022–2023 National Drug Strategy Household Survey (NDSHS) (Figure 1). Although the daily smoking rate is the lowest it has ever been, more people are using e‑cigarettes and risky consumption of alcohol has remained steady.
Figure 1: Summary of alcohol, tobacco, e-cigarette, and illicit drug use, people aged 14 and over, 2022–2023
Source: NDSHS 2022–2023, Tables 2.3, 3.4, 4.26 and 5.7.
Use of alcohol and other drugs has historically been higher among males than females, but this gap is closing, particularly for young Australians aged 18–24. Use of alcohol, e‑cigarettes, and illicit drugs, including cocaine, have all risen among young women.
The NDSHS is the leading survey of licit and illicit drug use in Australia. The 2022–2023 survey was the 14th conducted under the auspices of the National Drug Strategy. The survey was first undertaken in 1985 and has been undertaken every 3 years since 1995. The data collected through these surveys have contributed to the development of policies for Australia’s response to drug‑related issues.
1 in 12 people smoke daily
Between 2019 and 2022–2023, the national tobacco smoking rate for people aged 14 and over dropped from 11.0% to 8.3% (Figure 2). That’s around 1.8 million people smoking daily in 2022–2023, down from 2.3 million in 2019.
Figure 2: Smoking status, 1991 to 2022–2023
Source: NDSHS 2022–2023, Table 2.1.
Declines in daily smoking occurred across many age groups, with daily smoking dropping below 10% for people aged 18–24 (5.9%), 25–29 (7.3%), and 30–39 (8.8%). Daily smoking remained stable for people in their 60s (10.4% in 2022–2023) and older (4.9%).
As a result, people who smoke were much older as a group in 2022–2023 than in previous years. Around 1 in 4 people (25%) who smoked daily were aged 60 or older in 2022–2023, compared to around 1 in 7 (13.6%) in 2010.
Use of electronic cigarettes and vapes increases, especially among young people
Electronic cigarettes and vapes (‘e‑cigarettes’) are personal vaporising devices where users inhale vapour rather than smoke. The vapour may or may not contain nicotine.
From early 2024, new regulations on vapes and electronic cigarettes come into effect. These include restrictions on the importation of vapes (including those that do not contain nicotine), except for therapeutic purposes, such as tobacco smoking cessation and nicotine dependence (TGA 2023).
The 2022–2023 NDSHS was conducted before these restrictions were put into place. At the time, in most jurisdictions, it was legal for adults to purchase e‑cigarettes that did not contain nicotine without restrictions. Adults could also import nicotine e‑cigarettes with a prescription.
These results reflect the prevalence of e‑cigarette use among young people in Australia prior to the new restrictions coming into effect in 2024.
The use of e-cigarettes increased substantially between 2019 and 2022–2023 (Figure 3).
Figure 3: E‑cigarette and vaping results, 2022–2023
Source: NDSHS 2022–2023, Tables 3.3, 3.4 and 3.17.
While current use of e‑cigarettes among people aged 14 and over nearly tripled between 2019 (2.5%) and 2022–2023 (7.0%), it quadrupled among people aged 18–24 (from 5.3% to 21%) and increased more than five-fold among people aged 14–17 (from 1.8% to 9.7%). In contrast, only 1.6% of people aged 60–69 currently used e‑cigarettes in 2022–2023, and just *0.4% of people 70 and over were using them (Figure 4). This is the opposite pattern to tobacco smoking, which was more common among older people.
* Estimate has a relative standard error between 25% and 50% and should be interpreted with caution.
Figure 4: Current(a) use of e‑cigarettes by age, 2016 to 2022–2023
(a) Includes people who use e‑cigarettes ‘daily’, ‘at least weekly (but not daily)’, ‘monthly (but not weekly)’, or ‘less than monthly’.
Source: NDSHS 2022–2023, Table 3.3.
Results from the National Drug Strategy Household Survey do not provide evidence for or against the use of e-cigarettes as a smoking cessation tool, or as a gateway to tobacco smoking. The age groups most likely to smoke tobacco in 2019 and 2022–2023 were the least likely to use e-cigarettes, and the age groups most likely to use e-cigarettes had low tobacco smoking rates in 2019 and 2022–2023.
More than half of e-cigarettes contained nicotine
In Australia, during the survey period it was illegal to obtain e‑cigarettes containing nicotine without a prescription (TGA 2020). In 2022–2023, around half of people who had ever used e‑cigarettes (54%) reported that the last one they used contained nicotine, and for those currently using e‑cigarettes, it was around three quarters (73%). A vast majority (87%) of people who had used e‑cigarettes with nicotine reported that they had obtained them without a prescription.
Risky alcohol consumption remains stable
In 2022–2023, close to 1 in 3 people (31%) drank alcohol in ways that put their health at risk, which is around 6.6 million people. 1 in 4 people (25%) reported consuming more than 10 standard drinks per week on average, with a similar proportion consuming more than 4 standard drinks in a single day at least once a month (24%).
While this was not a large difference to 2019, the proportion of people drinking alcohol at risky levels continued a gradual, long-term decline that began in 2013 (Figure 5).
Figure 5: Risky drinking behaviours, people aged 14 and over, 2007 to 2022–2023
Source: NDSHS 2022–2023, Table 4.27.
Drinking alcohol under the age of 18 remains steady
People under 18 years of age should not drink alcohol, to reduce the risk of harm (NHMRC 2020). While there was a substantial reduction in the proportion of people aged 14–17 who consumed alcohol in Australia between 2001 and 2016, the proportion has remained stable since then (Figure 6).
Figure 6: Consumption of alcohol in the previous 12 months, people aged 14–17, 2001 to 2022–2023
Source: NDSHS 2022–2023, Table 4.6.
For the first time in 2022–2023, people were asked what they believe about alcohol consumption among 16- and 17-year-olds:
- Over 1 in 3 people (32%) aged 14 and over agreed that a 16- or 17-year-old can occasionally drink 1 or 2 standard drinks without putting their health at risk.
- Around 1 in 4 people (24%) agreed that it is beneficial to provide a 16- or 17-year-old with a little bit of alcohol in preparation for drinking as an adult.
Alcohol consumption while pregnant continues long-term decline
Women who are pregnant or planning a pregnancy should not drink alcohol, to prevent harm to their unborn child (NHMRC 2020).
Around 1 in 4 (28%) women aged 14–49 who were pregnant at some point in the previous 12 months consumed alcohol while they were pregnant. This represents a long-term decline from 2013, when 42% of pregnant women had consumed alcohol while pregnant.
For women who had a period of time when they were pregnant but did not know that they were pregnant:
- Almost 2 in 3 (64%) drank alcohol while they did not know they were pregnant.
- Once aware of their pregnancy, they were much less likely to drink alcohol while pregnant (*14.9%).
* Estimate has a relative standard error of 25% to 50% and should be interpreted with caution.
Use of illicit drugs increases, driven by hallucinogens
Almost 1 in 5 people in Australia (17.9%) had used an illicit drug in the previous 12 months in 2022–2023. This equates to about 3.9 million people, an increase from 2019 when 3.4 million people had done so. Figure 7 summarises the changes in illicit drug use between 2019 and 2022–2023.
Figure 7: Use of illicit drugs, 2019 and 2022–2023
Note: Methamphetamine and amphetamine, and pharmaceutical stimulants, were included in the survey for the first time in 2022–2023.
Source: NDSHS 2022–2023, Table 5.6.
There was a sharp increase in the use of hallucinogens between 2019 (1.6% or 300,000 people) and 2022–2023 (2.4% or 500,000 people), continuing an increasing trend since 2016 when only 1.0% of people (200,000 people) reported using them in the previous 12 months. At the same time, the types of hallucinogens being used also changed. In 2019 the most commonly used hallucinogens were LSD/acid/tabs (1.1% of the population in Australia), but this shifted to mushrooms and psilocybin in 2022–2023 (1.8%).
Use of ecstasy dropped substantially between 2019 and 2022–2023, but this is likely to be a temporary reduction. Supply of ecstasy was disrupted, potentially due to COVID-19 related health measures, and there were fewer events such as raves and dance parties held, particularly in 2022. Early evidence shows that use of ecstasy began increasing again in 2023 (Figure 8).
Figure 8: Use of ecstasy in Australia before and after COVID-19 related public health measures, 2004 to 2019 and 2022 to 2023
Source: NDSHS 2022–2023, Tables 5.15 and 5.80.
Use of many illicit drugs remained stable. Cannabis remained the most commonly used illicit drug, used by around 2.5 million people in the previous 12 months (11.5% of the population). Use of cocaine also remained high, used by around 1.0 million people in Australia in the previous 12 months (4.5% of the population) and remaining the second-most used illicit drug in Australia.
Less prevalent illicit drugs such as inhalants (1.4%), heroin (*0.1%) and non‑medical use of tranquillisers/sleeping pills (1.6%) also remained stable between 2019 and 2022–2023.
* Estimate has a relative standard error between 25% and 50% and should be interpreted with caution.
Two newly defined categories of illicit drug were introduced in the 2022–2023 National Drug Strategy Household Survey:
- Around 200,000 people (1.0% of the population) reported having used methamphetamine and amphetamine in the previous 12 months, and more people reported that they had mainly used crystal/ice (43%) than powder/speed (31%).
- Around 400,000 people (2.1% of the population) had used pharmaceutical stimulants such as dexamfetamine and methylphenidate (for example, Ritalin, Concerta) for non‑medical purposes in the previous 12 months.
Young women more likely to have used alcohol and other drugs than in 2019
While use of most illicit drugs remained stable between 2019 and 2022–2023 across the whole population, men and women showed different trends. This was particularly true when comparing young women with young men. As shown in Figure 9, recent use of the most commonly used substances increased among women aged 18–24:
- Use of any illicit drug among young women increased from 27% in 2019 to 35% in 2022–2023, while use of any illicit drug among men was 35% in both 2019 and 2022–2023.
- Use of cannabis increased for young women between 2019 and 2022–2023, making them just as likely as young men to have used cannabis in 2022–2023 (both 26%).
- While only 8.0% of young females had used cocaine in the previous 12 months in 2019, 11.9% had done so in 2022–2023, a similar proportion to males (11.2%).
Figure 9: Recent(a) use of selected illicit drugs by gender, people aged 18–24, 2019 and 2022–2023
(a) Used at least once in the previous 12 months.
(b) For non-medical purposes.
Source: NDSHS 2022–2023, Tables 5.8, 5.50, 5.65 and 6.9.
These changing trends did not only occur for illicit drugs. Other risky behaviours, such as use of e‑cigarettes and drinking alcohol at risky levels, also saw gaps between young males and young females reduce as use increased among young women between 2019 and 2022–2023 (Figure 10). Recent consumption of alcohol also increased among young females aged 14–17, from 28% in 2019 to 35% in 2022–2023. In contrast, 27% of young males aged 14–17 had consumed alcohol in the previous 12 months.
This represents a major shift in the demographics of young people who consume alcohol and use illicit drugs, and as young people are the most likely to use illicit drugs and drink alcohol at risky levels, an overall shift in the demographics of risky drug use in Australia.
Figure 10: Use of tobacco and e-cigarettes, and risky alcohol consumption, by gender, people aged 18–24, 2019 and 2022–2023
(a) Includes people who use e‑cigarettes ‘daily’, ‘at least weekly (but not daily)’, ‘monthly (but not weekly)’, or ‘less than monthly’.
(b) Consumed more than 10 standard drinks per week on average, and/or more than 4 standard drinks in a single day at least once a month.
Source: NDSHS 2022–2023, Tables 2.4, 3.9 and 4.28.
How has policy changed since 2019?
These changes in the use of alcohol, tobacco, e-cigarettes, and other drugs have occurred alongside several policy changes announced by the Australian Government between the previous survey in 2019 and today:
- The National Tobacco Strategy 2023–2030 was released in May 2023, with targets of reducing daily smoking prevalence below 10% by 2025 and below 5% by 2030 (Department of Health and Aged Care 2023).
- National awareness of electronic cigarettes and vapes has expanded since 2019, and new policies are being introduced to curb access to e‑cigarettes among people who are not smoking tobacco in 2024 (TGA 2023).
- Updated advice for Australia on the amount of alcohol people can drink without putting their health at risk was released in 2020 (NHMRC 2020), as well as recommendations for people under the age of 18 and pregnant women.
- The National Preventative Health Strategy 2021–2030 was released in December 2021, with targets of reducing harmful alcohol consumption (10% reduction by 2025) and recent illicit drug use (15% decrease in prevalence by 2030) (Department of Health and Aged Care 2021).
- Health-related restrictions (including limitations on public events) were implemented for some time across much of Australia in response to the COVID-19 pandemic. While the data in this report were not collected during the height of these restrictions, comparisons between 2019 and 2022–2023 can be used to show the medium-term impacts of the pandemic on alcohol, tobacco, and illicit drug use.