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NOTES


INTRODUCTION

This article provides an overview of the level, prevalence and type of alcohol consumption; the health status, risk factors and demographic characteristics of those who drink alcohol at risky or high risk levels; as well as information on mortality and health costs.


DATA SOURCES

This article uses data from the 2004-05 National Health Survey (NHS), the 2004-05 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and the Causes of Death Collection.

This article also draws on measures of alcohol consumption from the Apparent Consumption of Alcohol Collection, which uses excise and import trade administrative data to produce an indirect measure of consumption of alcohol, based on a population aged 15 years or more (ABS 2006a).

Data from the 2004 National Drug Strategy Household Survey (NDSHS) are also used in this article (AIHW 2005a).

Both short and long term risk of harm were measured in the 2004-05 NHS (footnote 1). Unless otherwise stated, this article presents NHS information on alcohol consumption for long term risk of harm. Survey respondents were categorised as drinking alcohol at low, risky or high risk levels based on the guidelines of the National Health and Medical Research Council (NHMRC) (footnote 2).

Data were collected in the 2004-05 NHS from those aged 18 years and over, and from those aged 14 and over (with a small sample from 12-13 year olds) in the 2004 NDSHS. (The response rate for the latter survey was 46%.) In both surveys, homeless and institutionalised people were excluded. Caution should be used in interpreting data from both surveys as the collection of accurate data in recall situations on the quantity of alcohol consumed is difficult.


INQUIRIES

For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email client.services@abs.gov.au.


ALCOHOL CONSUMPTION

Alcohol, though widely used and enjoyed in Australian society, is a depressant drug. In low quantities it causes people to become less inhibited, in higher doses it can cause unconsciousness and even death. It is thought that low to moderate alcohol consumption may offer some protective health effects. However, high alcohol consumption increases the risk of heart, stroke and vascular diseases, liver cirrhosis and some cancers. It also contributes to disability and death through accidents, violence, suicide and homicide (WHO 2004).

The term 'alcohol' refers to ethyl alcohol (ethanol) which is found in drinks intended for human consumption. The quantities of consumed alcoholic drinks given by respondents in the 2004-05 NHS were converted to quantities of pure alcohol from which the risk level was determined according to NHMRC guidelines.

Alcohol dependence and harmful use was ranked 17th in the 20 leading causes of burden of disease and injury for Australia in 2003, and harm from alcohol was estimated to be the cause of 5.5% of the burden of disease for males and 2.2% for females (AIHW 2006a).


PATTERNS OF ALCOHOL CONSUMPTION

• While the majority of adults reported drinking alcohol in the week before the NHS interview (62%), about one in every eight adults drank at a risky/high risk level (footnote 2). This represents 13% of all adults, or approximately 2.0 million persons in 2004-05.
• 78% of those who drank alcohol in the week before the survey, did so at a low health risk level.
• The proportion of people drinking at a risky/high risk level has increased over the past three National Health Surveys, from 8.2% in 1995 to 10.8% in 2001 and 13.4% in 2004-05 (after adjusting for age differences) (footnote 3).

Risky/high risk alcohol consumption

• In 2004-05, 15% of adult males and 12% of adult females reported drinking at a risky/high risk level, while 55% of males and 43% of females reported drinking at a low risk level.
• The increase in those drinking at a risky/high risk level since 1995 has been greater for women than men. From the three surveys since 1995, the proportion of females who drank at a risky/high risk level increased from 6.2% to 11.7%, while for males the increase was from 10.3% to 15.2%, after adjusting for age differences.

Risky/high risk alcohol consumption

• The proportions of males and females drinking at risky and high risk levels were highest in the middle age groups and this proportion has increased over time.
• In 2004-05, 18% of males aged 45-54 years were risky/high risk level drinkers. This compares to 15% in 2001 and 12% in 1995.
• In 2004-05, 13% of females aged 45-54 years were risky/high risk level drinkers. This compares to 10% in 2001 and 6.7% in 1995.

Risky/high risk alcohol consumption by age

• Drinking at or above risky/high risk levels in the short term, i.e. on any single occasion, is sometimes referred to as 'binge' drinking (footnote 4).
• Binge drinking can lead to an increased incidence of falls, other accidents (including motor vehicle accidents) and violence (NHMRC 2001).
• Short term risky/high risk consumption equates to seven or more standard drinks for males and five or more standard drinks for females on any single occasion (NHMRC 2001).
• Data from the 2004-05 NHS show that among people aged 18 years and over, 48% of males and 30% of females consumed alcohol at risky/high risk levels in the short term on at least one occasion in the last 12 months.
• These figures are comparable with data from the NDSHS which show that in 2004, among people aged 14 years and over, 40% of males and 31% of females consumed alcohol at risky/high risk levels in the short term. (AIHW 2005a).
• According to the 2004-05 NHS, among people aged 18 years and over, 12% of males and 4% of females had consumed alcohol at risky/high risk levels in the short term at least once a week over the previous 12 months.
• Of these, young people aged 18-24 years were most likely to drink at this risk level. About one in five males (19%) and one in ten females (11%) in this age group had consumed alcohol at risky/high risk levels in the short term at least once a week in the 12 months prior to interview .

• Children have a greater vulnerability to alcohol than adults; as well as being physically smaller, they lack experience of drinking and its effects (NHMRC 2001).
• Young people when intoxicated are more likely to indulge in risky behaviour such as swimming, driving, unsafe or unwanted sex, verbal or physical abuse (DrugInfo clearinghouse 2002).
• In 2004, 25% of those aged 14-19 years drank alcohol on a daily or weekly basis in the last 12 months compared to 50% of all persons 14 years and over (AIHW 2005a).
• Among teenagers aged 14-19 years drinking at risky/high risk levels in the long term, 77% of boys usually consumed regular strength beer, while 85% of girls usually consumed bottled spirits and liqueurs (AIHW 2005a).

• In 2004-05, around half of all Indigenous adults (49%) reported having consumed alcohol in the week prior to the interview, of whom one-third (16%) reported drinking at risky/high risk levels in the long term (ABS 2006d).
• After adjusting for age-differences, the proportion of Indigenous adults who reported drinking at risky/high risk levels was similar to that for non-Indigenous adults (ABS 2006d).
• A higher proportion of Indigenous men than women had consumed alcohol at risky/high risk levels in the week prior to the survey, except those aged 55 years and over where the rate was similar for males and females (ABS 2006d).
• Indigenous women had the highest rate of risky/high risk alcohol consumption in the 25-34 years age groups while for Indigenous men this occurred in the 35-44 years age group. By comparison, the highest rates of risky/high risk consumption occurred for non-Indigenous women in the 35-44 years age group and for non-Indigenous men in the 45-54 years age group.
• Among Indigenous young people aged 18-24 years, 20% of males and 14% of females consumed alcohol at risky/high risk levels (ABS 2006d).
• There was no statistically significant difference between remote (15%) and non-remote (17%) risky/high risk alcohol consumption for Indigenous Australians (ABS 2006d).

Risky/high risk alcohol consumption 2004-05, males

Risky/high risk alcohol consumption 2004-05, females

• In 2004-05, 13% of people aged 18 years and over in major cities of Australia had risky/high risk levels of alcohol consumption, compared to 15% in inner regional Australia and 16% in outer regional Australia/other areas.
• 15% of Australian born people reported consuming alcohol at risky/high risk levels in the long term. This is similar to the proportion for those born in the United Kingdom and higher than for all other birthplaces.
• People born in North Africa and the Middle East had the lowest proportion of adults consuming alcohol at risky/high risk levels (2.2%), followed by those born in South-East Asia (4.4%) and Southern and Eastern Europe (6.0%).
• 11% of respondents in the most disadvantaged areas (1st quintile of the SEIFA Disadvantage Index) were classified as drinking alcohol at risky/high risk levels, compared to 16% in the least disadvantaged areas (5th quintile) (footnote 5).

• Some lifestyle related health risk factors can be associated with risky/high risk level of drinking. The effects of alcohol are often worsened by other risk factors, such as smoking and dietary factors (NHMRC 2001).
• Of those who were risky/high risk drinkers in the long term, 40% of males and 35% of females were current smokers, compared to 24% males and 20% females who drank at a low risk level.
• In 2004-05, 64% of males and 51% of females who were risky/high risk drinkers reported eating one or less serves of fruit daily (less than the recommended daily intake); whereas 51% of males and 40% of females who drank at a low risk level ate one or less serves of fruit daily.

• Drinking heavily over a long period of time can cause harm to a person's brain and liver functioning and contribute to depression, relationship difficulties and hence quality of life. It can also increase the risk of developing cancer, cirrhosis of the liver, cognitive problems, dementia and alcohol dependence (NHMRC 2001).
• High risk consumption of alcohol is strongly associated with oral, throat and oesophageal cancer (AIHW 2005a).
• Drinking alcohol increases the risk of breast cancer among females (Ridolfo and Stevenson, 1998).
• In 2004-05, 16% of males with risky/high risk levels of alcohol consumption reported having hypertension, compared with 13% males with low alcohol consumption levels (after adjusting for age differences).
• Of those who drank at risky/high risk levels, more people reported high/very high psychological distress compared with those who drank at low risk levels. Those most affected were in the age group 18-24 years, women more so than men (footnote 6).

High/very high psychological distress, by alcohol consumption risk level
	Low Risk	Risky/High Risk
	%	%
Males 18-24 years	10	13
Females 18-24 years Persons 18-24 years Persons 25 years or more All persons 18 years or more	17 13 10 10	31 21 12 13

• Of those who drank at risky/high risk levels (based on their consumption in the week prior to interview), overall and for men the preferred beverage was beer, while women preferred wine/sparkling wine.
• 61% of risky/high risk drinkers consumed beer, compared to 45% of those who drank at a low risk level.
• Of risky/high risk drinkers, 84% of males and 32% of females drank beer, compared to 68% of male and 16% female low risk level drinkers.
• According to the 2004-05 NHS, 78% of female and 40% male risky/high risk drinkers consumed wine/sparkling wine, compared to 62% of female and 35% male low risk drinkers.
• Of risky/high risk drinkers aged 18-24 years, 75% drank ready to drink spirits and liqueurs compared to 56% of low risk drinkers of the same age.

• Of those aged 18-24 years, 25% (27% of males and 23% of females) experienced an event which resulted in injury in the four weeks prior to the NHS interview. This is higher than for all persons 18 years and over, of whom 18% reported a recent injury event (19% of males and 18% of females).
• Of those aged 18-24 years, 1.7% of males and 1.5% of females reported having a recent injury while under the influence of alcohol or other substance.
• 5.1% of males and 7.6% of females aged 18-24 years reported a recent injury while under the influence of alcohol or other substance at the time of injury, compared to 1.7% of males and 1.2% of females of the same age, but who drank at a low risk level.
• Of all adults who drank at a risky/high risk level, 1.5% of males and 2.4% of females aged 18 years and over reported a recent injury while under the influence of alcohol or other substance at the time of injury, compared to 0.5% of males and 0.3% of females aged 18 years and over who drank at a low risk level.

• The apparent annual per person consumption by those aged 15 years and over in Australia in 2004-05, was 4.6 Litres of alcohol (Lal) beer, 3.1 Lal wine and 2.1 Lal spirits, totalling 9.8 Lal per person (ABS 2006a).
• Of 2.1 Lal spirits apparently consumed per person aged 15 years and over, 0.9 Lal (44%) was in the form of 'Ready To Drink' beverages (ABS 2006a).

• Alcohol is the second largest cause of drug-related deaths and hospitalisations in Australia (after tobacco) (AIHW, 2005a).
• Alcohol is the main cause of deaths on Australian roads. In 1998, over 2,000 deaths of the total 7,000 deaths of persons under 65 years, were related to alcohol (Ridolfo and Stevenson, 1998).
• In 2004, the age standardised rate for male deaths due to alcoholic liver disease as the underlying cause was 5.5 per 100,000, compared with 1.5 per 100,000 for females (ABS 2006b).
• In 2004, the age standardised rate for male deaths with mental and behavioural disorders due to alcohol as the underlying cause was 1.9 per 100,000, compared with 0.4 per 100,000 for females (ABS 2006b).

• In the seven years from 1998-99 to 2004-05, the overall number of hospital separations with principal diagnosis of mental and behavioural disorders due to alcohol increased from 23,490 to 35,152; the number per 1,000 population increased by 39% for all ages during that time period (by 41% for those under 20 years) (AIHW 2006).
• According to a study by Ridolfo and Stevenson (2001), the largest number of alcohol-related hospital separations among both men and women in 1998 was due to alcoholism and alcoholic liver cirrhosis. The second-largest number was due to road injuries for men and cancer for women.
• It has been estimated that 31,132 Australians died from alcohol-caused disease and injury between 1992 and 2001; of these 75% were male and 25% female. From 1993-94 to 2000-01, there were over half a million hospitalisations due to risky and high-risk drinking in Australia (Chikritzhs et.al. 2003).
• At the community level, the estimated economic cost of alcohol misuse to the Australian community in 1998-99 totalled $7.6 billion, and this estimate includes associated factors such as crime and violence, treatment costs, loss of productivity and premature death (Collins and Lapsley, 2002).