Drinking; alcohol use and quantity decreased in the US!!

 A recent Gallup poll found that alcohol consumption in the US has reached a new low, both in the numbers of people drinking and the amount drunk: https://news.gallup.com/poll/693362/drinking-rate-new-low-alcohol-concerns-surge.aspx (this link to the report does give more granular year-by-year reports). go to this article to see all of the graphs. this blogger website is now limiting my ability to include graphs

Findings:

-- self-reported drinking is down to 54% after consecutive annual declines

    -- this is the lowest number in Gallup's 90-year trend

    -- of note, there was a bump up in the covid years:  self-reported drinking was 63% in 2018, then 65% in 2019, 60% in 2021, 67% in 2022, 62% in 2023, 58% in 2024, and now down to the 54% in 2025

-- belief that moderate drinking as bad for health has increased to a new high of 53%

    -- their graph is quite shocking, increasing numbers of people thought it was bad for one's health beginning in about 2018, with a sharp incline thereafter and a crossing of the curves at 2024 (when around 45% thought it was bad, 45% thought it didn't matter, and 8% thought it was good)

    -- in 2025: 53% thought alcohol was bad, 37% that it didn't matter, and 6% thought it was good

    -- women were more likely than men to view moderate drinking as unhealthy (60% vs 47% in men), Democrats more than Republicans (58% vs 44%), with Independents at 55%

    -- minimal differences by race/ethnicity, education and income

    -- the group with the most frequently negative perception of alcohol was those 18-34yo, as first assessed by Gallup in 2001, then overall increasing over time. now it is up to  to 66%

        -- those 35-54yo has had increasingly negative perception of drinking since about 2007, now at 50%

        -- and those 55 and older similarly increased since about 2007 to 48%

-- those drinking report less drinking and less frequently

    -- the graph here is quite erratic over the years. in 1996 it was bout 2.8 drinks in past 7 days, peaked in 2004 to 5.1, and in 2025 is down to 2.8

        -- these results include zero drinks for drinkers who reported not having any alcohol in the past week

Commentary:

-- as we know, there was a long-standing promotion of light-to-moderate alcohol consumption in medicine that was reinforced in the general population: moderate alcohol consumption is good for the heart. this was based on terrible studies (eg patients in the alcohol abstention group included patients who had stopped drinking because they had liver- or heart- or other-related medical problems that themselves decreased their life expectancy; ie, reverse causation: they may have been heavy drinkers who stopped because they were sick; hence the need to use the category "never drinkers" instead of "current abstainers". in brief, a more current literature review shows:

    -- light- to moderate-alcohol consumers in some studies were healthier than those who were never drinkers: exercised more, ate better, had less obesity, had higher incomes, had better dentition than non-drinkers that included "sick quitters" and former alcohol drinkers (the majority of big studies included former drinkers and/or occasional drinkers in the alcohol abstainer group:https://gmodestmedblogs.blogspot.com/2023/04/alcohol-consumption-small-amounts-not.html ). ie, moderate drinkers had lifestyles and demographics that themselves were heart-healthy

    -- mendelian randomization studies have found no protective effect of even small amounts of alcohol on cardiovascular disease: https://gmodestmedblogs.blogspot.com/2023/04/mendelian-randomization-alcohol-does.html and another blog on genetic differences: https://gmodestmedblogs.blogspot.com/2019/05/stroke-risk-lowest-if-zero-alcohol.html

-- there is reasonable concern that those decreasing alcohol consumption now may just be increasing other mind-altering drugs, such as marijuana. this Gallup report comments that "although marijuana use is higher today than a decade ago, it has been fairly steady over the past four years and thus doesn’t appear to be a factor in people choosing not to drink alcohol. Another Gallup poll (https://news.gallup.com/poll/284135/percentage-americans-smoke-marijuana.aspx) found that 14% of US adults smoked marijuana in 2021-2022, which increased to 15% in 2023-2024. But a survey by Statista found a jump in US marijuana users from 2020 (49,634) to 2021 (53,181) to 2022 (61901) to 2023 (61,816) to 2024 (64,194), overall a 30% increase. However, marijuana use in this poll was flat from 2022 to 2024. so, in the time of the greatest decrease in alcohol use from 2023 to 2025 (going from 62% to 54%) and comparing it to the data from Statista from 2023 to 2024, there actually was only a 3% increase. so perhaps a small decrease in alcohol use in those with an increase in marijuana use?

Limitations:

--this study is based on self-reported alcohol consumption. it is possible that people under-report more often now, since there has been a more anti-drinking public health messaging in the later years

-- similarly, the studies on marijuana use are self-reported and not necessarily so accurate (and perhaps even less reported given its non-legal status in much of the country)

    -- but, in order to get better data on whether there was a switch from alcohol to marijuana as a major component of the decreased alcohol consumption trend, it would have been helpful to have the same information on the same cohort at the same time including both drugs being used in a single survey

-- we really do not know why there is less alcohol consumed. is it because of a grand awakening? (perhaps even independent of my anti-alcohol prior blogs...?) is it because many nondrinkers have had alcohol-related problems and stopped (as with the above issue with moderate drinking being heart-healthy in the bad older studies?)

so,

-- pretty good news for the prospects of livers, cancers, cognitive health, cardiac health in the US...

-- these results are concordant with my questioning of waiters in restaurants and a few weddings i've been to: less alcohol being served and more alcohol-free substitutes

-- and one of the big pluses is the decrease in alcohol at the same time there is a decrease of smoking: there is a much more than an additive effect of these two quite addicting substances in the development of oropharyngeal cancers, for example, or cardiovascular disease

-- so, in this time of lots of recurrent bad news, a small change for the positive is welcome.....

geoff

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