• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Incidence, Prevalence and Trends

Key messages

• The level of alcohol consumption in the UK has risen steadily as the retail price of alcohol relative to personal disposable income has fallen over time. ¹ See figure 2.
• In the past 50 years, alcohol consumption in the UK has more than doubled, with a 121 percent per capita increase since 1951. ²
• Binge drinking is particularly prevalent in Britain, with Ireland and the UK coming first and third, respectively, in a European survey on alcohol use. ³
• The level of excessive drinking in the UK is higher than in most other countries of the world, including culturally similar countries such as the United States (US), Canada, and Australia. ⁴
• Age specific mortality related to alcohol in England and Wales has risen sharply over the past decade and is peaking earlier in men. ⁵
• In Scotland, alcohol was a contributory factor in 11 percent of all attendances in accident and emergency departments; most were men (71 percent) and over half had sustained some form of injury. ⁶
• Alcohol dependence is more prevalent than problem drug use in England. ⁷
• Young people in the UK have one of the highest rates for weekly drinking and episodes of drunkenness across 35 countries worldwide. ⁸
• The greatest impact in reducing alcohol related problems in a population can be made by reducing alcohol consumption in excessive drinkers rather than focusing on individuals with alcohol dependence. ⁹

Sex

Men are much more likely to have an alcohol use disorder than women. In 2004 an estimated 38 percent of men and 16 percent of women (aged 16-64) had an alcohol use disorder in England. ⁷ This represented 8.2 million people (26 percent of the total population). ⁷

Men are also much more likely to be hazardous or harmful drinkers than women. In 2004, out of the 8.2 million people in England who had an alcohol use disorder, 7.1 million individuals were hazardous or harmful drinkers; 32 percent were men and 15 percent women. ⁷

Binge drinking

Men are twice as likely as women to be binge drinkers. In 2004, 21 percent men and 9 percent women in England were binge drinkers, ⁷ and similar proportions engaged in binge drinking at least once in the past week. ²

Binge drinking (drinking twice the daily limit in a single session) accounts for 40 percent of all drinking occasions among men and 22 percent among women—a rate far higher than reported in most other countries. ¹⁰ Just one in 10 Europeans said that they had five or more drinks in one setting. ³

Although binge drinking is commonly associated with young people, it often persists into middle age. ¹¹

Alcohol dependence

Men are more likely to be dependent on alcohol than women. In England in 2004, 1.1 million people (4 percent) had alcohol dependence; 6 percent of men and 2 percent of women. ⁷

Alcohol dependence is considerably more prevalent (4 percent of the total population) than problem drug use in England, which occurs in 0.8 percent of the adult population. ⁷

Age

Young people tend to more drink more heavily than other age groups, but they generally cut down their drinking as they get older.

Young men are more likely to drink over the recommended limits than young women.

In 2003, 37 percent of young men and 26 percent of women (aged 16-24) in England and Wales drank over recommended limits ¹⁰ compared with 35 percent and 21 percent reported in 1996. ¹²

The rates of heavy drinking in young women are high compared with figures for the adult population (see above).

Young people in the UK have one of the highest rates for weekly drinking and episodes of drunkenness. ¹³ In a WHO survey of young people across 27 countries, 47 percent and 36 percent of English boys and girls aged 11-15 years drink alcohol weekly. ⁸ As young people typically do not drink as frequently as adults, this increased consumption often results from binge drinking.

Ethnic groups

Ethnic minority groups in England have a lower prevalence of hazardous or harmful alcohol use but a similar prevalence of alcohol dependence than the white population. ⁷ The prevalence of hazardous or harmful drinking in these groups was about 14 percent, compared with 23 percent in the general population. ⁷ The prevalence of alcohol dependence was 3 percent compared with 4 percent in the general population. ⁷

Population effects

Most alcohol related problems are not caused by the heaviest drinkers, who are generally individuals with alcohol dependence, but are caused by the much larger group of excessive drinkers. Excessive drinkers outnumber dependent drinkers by a ratio of 7:1. ⁷

The greatest impact in reducing alcohol related problems in a population can be made by reducing alcohol consumption in excessive drinkers rather than focusing only on the most extreme or heaviest drinkers; this is sometimes known as the preventive paradox. ¹⁴

The preventive paradox is more pronounced in populations where heavy episodic drinking or intoxication is a common part of the drinking pattern. ^{9 15} Thus the preventive paradox is particularly pertinent in the UK.