Despite the ubiquity of alcohol consumption in Australia across the general population, the majority of alcohol is consumed by a small subset of heavy drinkers. In 2019, we found that the heaviest drinking 10% of the Australian population drank 54.1% of all alcohol consumed and the heaviest drinking 5% drank 36.1% of all alcohol consumed (Cook, Mojica-Perez, Callinan, 2022).
Internationally evidence also finds that a small proportion of consumers account for a high proportion of total alcohol intake, suggesting that alcohol consumption is relatively concentrated within the minority of heavier drinkers (Caetano et al., 2012; Norstrom, 1995; Greenfield & Rogers, 1999; Sheron & Gilmore, 2016).
Our study followed a previous analysis in 2016 which found similar results (Livingston & Callinan, 2019), suggesting relatively stable patterns for the heaviest drinkers in Australia, who continue to consume well above the National Health and Medical Research Council (NHMRC) Australian guidelines to reduce health risks from drinking alcohol (no more than 4 standard drinks on any one day and 10 standard drinks in a week).
Beverage-specific findings
In unpacking the demographic characteristics of the heaviest drinkers, we identified several unique factors. Firstly, almost a quarter (23%) of Australian drinkers who reported cask wine and regular strength beer as their main drink types were among the heaviest drinkers. Tellingly, wine in Australia is taxed by price, not alcohol content, and cask wine – wine sold in a bag-in-box packaging – is the cheapest beverage type per standard drink in Australia (Torney, Room & Callinan, 2023).
More recent Australian research has shown that cask wine drinkers averaged over twice the number of standard drinks per day as the average for moderate-and-high-cost wine drinkers (6.5 standard drinks compared to 3.2 standard drinks (Torney, Room & Callinan, 2023)).
Cask wine drinkers also consumed 5+ standard drinks 1.8 times per week and 96.7% of cask wine was consumed in respondents own homes (Torney, Room & Callinan, 2023).
Gender
We also found men were more likely to be among the heaviest drinkers. Another recent Australian study ofyoung heavy drinkers also found young men (14–24-year-olds) were more likely to drink than women and that young adult men (18-24 years) consumed more and were more likely to participate in single occasion risky drinking than young adult women (Callinan et al., 2023).
In 2022, there were 1,742 alcohol-induced deaths in Australia (a 9.1% increase since 2021), with most deaths among men (1,245 deaths (ABS, 2022)). Given men consume more, are more likely to be among the heaviest drinkers, and experience harms from alcohol, sensitive and considerate prevention strategies tailored towards this high-risk group may be of public health benefit. An example of this is the work influencing risky drinking behaviours among four male ‘social worlds’ by VicHealth (2019).
Location
Our study reported that the heaviest drinkers were more likely to drink at home, in pubs/clubs, and in public spaces. In particular, the heaviest drinkers were 3.4 times as likely to report drinking at home than those who did not drink at home. Home drinking is habitual and cannot be regulated as it can be in a licensed venue, meaning that a more educational approach may be needed to target this type of drinking among the heaviest drinkers. Given that Australians consumed most of their alcohol at home (Callinan et al., 2016), research and policy should consider or focus on drinking in the home.
Industry
These findings are in line with modelling studies that show how financially reliant the alcohol industry is upon heavy drinking (Bhattacharya et al., 2018). The alcohol industry can access and target consumers, including heavy drinkers, more easily than ever before through online platforms, using digital marketing and online advertising to promote their products. Greater government controls are needed to ensure alcohol companies do not target people who are most at risk nor vulnerable populations such as young people.
Conclusion
Our findings underline the importance of policy efforts that sensitively consider heavy drinkers to maximise the likelihood of any public health benefits. Identifying heavy drinkers and tailoring policies to them can be difficult. However, policies that are applied per drink will automatically target the heaviest drinkers as they are consuming most of the alcohol. Specifically, in terms of research, continuing to garner beverage-specific evidence (as has been done more recently in Australia; e.g., Torney et al., 2023) is crucial for ongoing international and future minimum unit pricing (MUP) discussions and supporting price-based policies.
Given our and other research evidence shows that the cheapest alcohol (e.g., cask wine) is more likely to be consumed by the heaviest drinkers (Livingston & Callinan, 2019; Cook et al., 2022; Room et al., 2013), pricing policy interventions may be effective with these drinkers.
Written by Dr Megan Cook, Institute for Social Marketing & Health, University of Stirling, United Kingdom, and Yvette Mojica-Perez and Dr Sarah Callinan, Centre for Alcohol Policy Research, La Trobe University, Melbourne.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.
References
Australian Bureau of Statistics [ABS]. (2022). Causes of Death, Australia. ABS. https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release.
Bhattacharya, A., Angus, C., Pryce, R., Holmes, J., Brennan, A., & Meier, P. S. (2018). How dependent is the alcohol industry on heavy drinking in England?. Addiction, 113(12), 2225-2232.
Caetano, R., Mills, B., Pinsky, I., Zaleski, M., & Laranjeira, R. (2012). The distribution of alcohol consumption and the prevention paradox in Brazil. Addiction, 107(1), 60-68.
Callinan, S., Livingston, M., Room, R., & Dietze, P. (2016). Drinking contexts and alcohol consumption: how much alcohol is consumed in different Australian locations?. Journal of Studies on Alcohol and Drugs, 77(4), 612-619.
Callinan, S., Torney, A., Livingston, M., Caluzzi, G., & Pennay, A. (2023). Who are Australia’s young heavy drinkers? a cross-sectional population study. Australian and New Zealand journal of public health, 47(2), 100020.
Chrysochou, P., Corsi, A. M., & Krystallis, A. (2012). What drives Greek consumer preferences for cask wine?. British Food Journal, 114(8), 1072-1084.
Cook, M., Mojica-Perez, Y., & Callinan, S. (2022). Distribution of alcohol use in Australia. Bundoora, Vic: Centre for Alcohol Policy Research, La Trobe University. Available from: https://fare.org.au/wp-content/uploads/CAPR-report-Distribution-of-alcohol-use-in-Australia.pdf.
Greenfield, T. K., & Rogers, J. D. (1999). Who drinks most of the alcohol in the US? The policy implications. Journal of Studies on Alcohol, 60(1), 78-89.
Livingston, M., & Callinan, S. (2019). Examining Australia’s heaviest drinkers. Australian and New Zealand Journal of Public Health, 43(5), 451-456.
Norström, T. (1995). Prevention strategies and alcohol policy. Addiction, 90(4), 515-524.
Callinan, S., Room, R., Livingston, M., & Jiang, H. (2015). Who purchases low-cost alcohol in Australia?. Alcohol and Alcoholism, 50(6), 647-653.
Sheron, N., & Gilmore, I. (2016). Effect of policy, economics, and the changing alcohol marketplace on alcohol related deaths in England and Wales. BMJ, 353.
Torney, A., Room, R., & Callinan, S. (2023). Cask wine: Describing drinking patterns associated with Australia’s cheapest alcohol. Drug and alcohol review.
VicHealth. (2019). Exploring men’s risky drinking cultures: research highlights. Australia: VicHealth. Available from: https://vichealth.vic.gov.au/sites/default/files/Mens-risky-drinking-summary.pdf