Alcohol—What it Is and What it Does - Alcohol Consumption In Theunited States

After caffeine, alcohol is the most commonly used drug in the United States. It is legal, generally acceptable (in moderate amounts), readily available, and relatively inexpensive. Although researchers frequently count how many people are drinking and how often, the statistics do not necessarily reflect the true picture of alcohol consumption in the United States. People tend to underreport their drinking. Furthermore, survey interviewees are typically people living in households. Therefore, the results of survey research may not include the homeless, a portion of the U.S. population traditionally at risk for alcoholism.

Per Capita Consumption of Alcoholic Beverages

According to the Economic Research Service of the U.S. Department of Agriculture, the per capita consumption of alcoholic beverages peaked at 28.8 gallons in 1981. (The per capita consumption includes the total resident population and all age groups.) Per capita consumption declined to 24.7 gallons in 1995 and has remained somewhat stable since then. In 2003, the per capita consumption of alcoholic beverages was 25.1 gallons. Table 3.1 shows per capita consumption of alcoholic beverages since 1966 and also shows the per capita consumption of beer, wine, and distilled spirits.

Beer remained the most popular alcoholic beverage in 2003, being consumed at a rate of 21.6 gallons per person. Nonetheless, this level of consumption (also seen in 1997) is the lowest level since 1976, when 21.5 gallons were consumed. Beer consumption peaked in 1981 at 24.6 gallons per person, but its consumption declined steadily to its present relatively stable level by 1995. The per capita consumption of wine and spirits in the United States is much lower than that of beer; the 2003 per capita consumption of wine was 2.2 gallons and of distilled spirits (liquor) 1.3 gallons.

It is interesting to see how the level of consumption of alcoholic beverages compares with other beverages. As Table 3.2 shows, per capita consumption in 2003 of milk (21.6 gallons) was exactly the same as beer. That same year, the per capita consumption of coffee was 24.3 gallons—higher than either beer or milk. Bottled water has become a popular beverage in recent years. Per capita consumption increased from 17.4 gallons in 2000 to 22 gallons in 2003. Per capita consumption of carbonated soft drinks in 2003 topped consumption of all other drinks at 46.4 gallons.

A complex set of factors contributes to variations in alcohol use over individuals' life spans. Part of the decline in alcohol consumption is a result of population TABLE 3.1
Per capita consumption of beer, wine, and distilled spirits, 1966-2003[In gallons]
SOURCE: "Alcoholic Beverages: Per Capita Consumption," U.S. Department of Agriculture, Economic Research Service, December 21, 2004, http://www.ers.usda.gov/data/foodconsumption/spreadsheets/beverage.xls#PccLiq!a1 (accessed February 21, 2005)

	Total resident population
Year	Beer	Winea	Distilled spirits	Totalb
1966	16.5	1.0	1.6	19.0
1967	16.8	1.0	1.6	19.4
1968	17.3	1.1	1.7	20.1
1969	17.8	1.2	1.8	20.8
1970	18.5	1.3	1.8	21.6
1971	18.9	1.5	1.8	22.3
1972	19.3	1.6	1.9	22.8
1973	20.1	1.6	1.9	23.6
1974	20.9	1.6	2.0	24.5
1975	21.3	1.7	2.0	25.0
1976	21.5	1.7	2.0	25.2
1977	22.4	1.8	2.0	26.1
1978	23.0	2.0	2.0	26.9
1979	23.8	2.0	2.0	27.8
1980	24.3	2.1	2.0	28.3
1981	24.6	2.2	2.0	28.8
1982	24.4	2.2	1.9	28.5
1983	24.2	2.3	1.8	28.3
1984	24.0	2.4	1.8	28.1
1985	23.8	2.4	1.8	28.0
1986	24.1	2.4	1.6	28.2
1987	24.0	2.4	1.6	28.0
1988	23.8	2.3	1.5	27.6
1989	23.6	2.1	1.5	27.2
1990	23.9	2.0	1.5	27.5
1991	23.1	1.8	1.4	26.3
1992	22.7	1.9	1.4	25.9
1993	22.4	1.7	1.3	25.5
1994	22.3	1.7	1.3	25.3
1995	21.8	1.7	1.2	24.7
1996	21.7	1.9	1.2	24.8
1997	21.6	1.9	1.2	24.7
1998	21.7	1.9	1.2	24.8
1999	21.8	2.0	1.2	25.0
2000	21.7	2.0	1.3	24.9
2001	21.8	2.0	1.3	25.0
2002	21.8	2.1	1.3	25.2
2003	21.6	2.2	1.3	25.1
aBeginning in 1983, includes wine coolers
bComputed from unrounded data.

trends. In the 1980s and 1990s the number of people in their early twenties—the leading consumers of alcohol—declined fairly steadily. The United States is also seeing a growing number of residents in their fifties and sixties. This is a group that is, in general, unlikely to consume as much alcohol as younger people.

Individual Consumption of Alcohol

The data for alcohol consumption noted in the previous section are per capita figures, which are determined by taking the total consumption of alcohol per year and dividing by the total resident population, including children. This figure is useful to see how consumption changes from year to year because it takes into account changes in the size of the resident population. Nonetheless, babies and small children generally do not consume alcohol, so it is also useful to look at consumption figures in the population over twelve years of age.

The Substance Abuse and Mental Health Services Administration (SAMHSA), in its 2003 National Survey on Drug Use and Health (released September 9, 2004), reported that 83.1% of the U.S. population twelve years of age and over had tried an alcoholic beverage at least once in their lives. (See Table 3.3.) Among them, 42.9% of those twelve to seventeen years old had tried alcohol at some time in their lives, as had 87.1% of those between the ages of eighteen and twenty-five. Sixty-five percent of Americans twelve years of age and over had consumed at least one drink during the year prior to the survey, while 50.1% had used alcohol in the month prior to the survey. As Table 3.3 shows, consumption of alcohol in all age groups and in all categories increased from 2000 to 2003.

Table 3.4 shows the percentage of survey respondents who reported consuming alcohol in the past month in 2000-2003. The percentage use of alcohol by the total population age twelve years and over increased from 46.6% in 2000 to 50.1% in 2003. Men aged eighteen and older were more likely to have consumed alcoholic beverages in the past month than were women aged eighteen and older. Girls aged twelve to seventeen were more likely to have consumed alcoholic beverages in the past month than were boys in the same age group.

Table 3.4 also shows that alcohol consumption varies significantly by race and level of education. Across all age groups, a higher percentage of whites had used alcohol within the month prior to the survey than had African-Americans or Hispanics. Among twelve- to seventeen-years-olds in 2000-2003, those reporting past-month use of alcohol was highest among Native American or Alaska Natives. Among respondents aged eighteen years and over, past-month alcohol use increased with level of education.

The Prevalence of Problem Drinking

The National Health Interview Survey (NHIS) is one of the major data collection programs of the National Center for Health Statistics (NCHS). The NCHS is one of twelve centers, institutes, and offices of the Centers for Disease Control and Prevention (CDC) located in Atlanta, Georgia. The CDC, an agency of the U.S. Department of Health and Human Services (HHS), is the lead federal agency charged with protecting the health and safety of the people of the United States.

The National Health Interview Survey has been conducted annually since 1957. Figure 3.1 shows 1997 to 2002 NHIS data on excessive alcohol consumption. The 2002 NHIS estimate of the percentage of adults who TABLE 3.2
Per capita consumption of nonalcoholic beverages, 1980
SOURCE: "Beverages: Per Capita Consumption," U.S. Department of Agriculture, Economic Research Service, December 21, 2004, http://www.ers.usda.gov/data/foodconsumption/spreadsheets/beverage.xls#pcc!a1 (accessed February 21, 2005)

	Milk						Carbonated soft drinks
Year	Whole	Lowfata	Totalb	Teac	Coffeed	Bottled water	Diet	Regular	Total	Selected fruit juicese	Fruit drinks, cocktails, and sides	Canned iced tea	Vegetable juices
1980	17.0	10.5	27.6	7.3	26.7	2.4	5.1	29.9	35.1	7.4	NA	NA	NA
1981	16.3	10.8	27.1	7.2	26.0	2.7	5.3	30.0	35.4	7.3	NA	NA	NA
1982	15.5	10.9	26.4	6.9	25.9	3.0	5.5	29.8	35.3	7.0	NA	NA	NA
1983	15.2	11.1	26.3	7.0	26.3	3.4	6.0	29.3	35.2	8.6	NA	NA	NA
1984	14.8	11.6	26.4	7.1	26.8	4.0	6.6	29.3	35.9	7.4	NA	NA	NA
1985	14.3	12.3	26.7	7.1	27.4	4.5	7.1	28.7	35.7	7.8	NA	NA	NA
1986	13.5	13.0	26.5	7.1	27.5	5.0	7.6	28.2	35.8	7.8	NA	NA	NA
1987	13.0	13.1	26.1	6.9	26.7	5.7	9.4	32.4	41.9	8.6	5.4	0.1	0.2
1988	12.4	13.7	26.1	7.0	25.6	6.5	10.1	34.5	44.7	7.9	5.7	0.1	0.3
1989	11.4	14.7	26.0	6.9	26.2	7.4	10.7	34.7	45.4	8.2	5.9	0.1	0.3
1990	10.5	15.2	25.7	6.9	26.8	8.0	10.7	35.6	46.2	7.0	6.3	0.1	0.3
1991	10.1	15.4	25.5	7.4	26.7	8.0	11.6	36.2	47.8	7.9	6.9	0.2	0.3
1992	9.7	15.4	25.1	8.0	25.8	9.7	11.5	36.7	48.2	7.5	6.5	0.2	0.3
1993	9.2	15.2	24.4	8.3	23.3	10.3	11.4	37.2	48.6	8.6	6.9	0.4	0.3
1994	9.0	15.3	24.3	8.1	20.8	11.3	11.3	37.1	48.4	8.5	7.3	0.6	0.3
1995	8.6	15.3	23.9	7.9	20.2	12.1	10.9	36.5	47.4	8.1	7.7	0.7	0.3
1996	8.5	15.3	23.8	7.6	22.1	13.0	10.6	36.0	46.6	8.7	7.9	0.7	0.3
1997	8.3	15.2	23.4	7.2	23.3	13.9	10.6	36.2	46.8	8.5	8.2	0.8	0.3
1998	8.1	14.9	23.0	8.3	23.9	15.0	11.0	36.8	47.9	9.1	7.7	0.7	0.3
1999	8.2	14.8	22.9	8.2	25.1	16.4	11.4	38.2	49.7	9.0	7.7	0.7	0.3
2000	8.1	14.4	22.5	7.8	26.3	17.4	11.6	37.7	49.3	8.9	NA	NA	NA
2001	7.8	14.2	22.0	8.2	24.2	18.8	11.2	35.5	46.7	9.1	NA	NA	NA
2002	7.7	14.2	21.9	7.8	23.6	20.7	11.2	35.4	46.6	8.4	NA	NA	NA
2003	7.6	13.9	21.6	7.6	24.3	22.0	11.1	35.3	46.4	8.4	NA	NA	NA
Notes: NA=Not available. Data use U.S. resident population, July 1 for all beverages except coffee, tea, and fruit juices which use U.S. total population, July 1.
aIncludes buttermilk.
bComputed from unrounded data.
cConverted to fluid equivalent as follows: 200 6-ounce cups per pound of tea, dry leaf equivalent.
dIncludes instant and decaffeinated coffee. Converted to fluid equivalent as follows: 60 6-ounce cups per pound of regular roasted coffee and 187.5 6-ounce cups per pound of instant coffee.
eCanned, bottled, and frozen (reconstituted).

TABLE 3.3
Alcohol use in lifetime, past year, and past month for three age groups and total population, 2000-03 [In percent]
SOURCE: Adapted from Results from the 2001 National Household Survey on Drug Abuse: Volume II. Technical Appendices and Selected Data Tables, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, August 2002, http://oas.samhsa.gov/nhsda/2k1nhsda/vol1/toc.htm (accessed February 21, 2005), and Results from the 2003 National Survey on Drug Use and Health: Detailed Tables, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2004, http://oas.samhsa.gov/nhsda.htm#NHSDAinfo (accessed February 21, 2005)

	Lifetime				Past year				Past month
	2000	2001	2002	2003	2000	2001	2002	2003	2000	2001	2002	2003
Total	81.0	81.7	83.1	83.1	61.9	63.7	66.1	65.0	46.6	48.3	51.0	50.1
12-17	41.7	42.9	43.4	42.9	33.0	33.9	34.6	34.3	16.4	17.3	17.6	17.7
18-25	84.0	85.0	86.7	87.1	74.5	75.4	77.9	78.1	56.8	58.8	60.5	61.4
26 or older	85.8	86.5	88.0	88.0	63.7	65.7	68.4	67.0	49.0	50.8	53.9	52.5
Note: Total population includes only persons aged 12 or older.

consumed alcohol excessively was 9.3%. This estimate is not statistically different from the estimates for 1997-99, which are shown on the graph. This means that approximately the same percentage of people consumed alcohol excessively each year from 1997 to 2002. The variation shown from year to year can be due simply to chance variations within the samples of the population from which the data were taken. The brackets at the top of the bars show the amount of variation likely for each year.

TABLE 3.4
Alcohol use in past month, by age group and demographic characteristics, 2000-03 [In percent]
SOURCE: Adapted from Results from the 2001 National Household Survey on Drug Abuse: Volume II. Technical Appendices and Selected Data Tables, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, August 2002,http://oas.samhsa.gov/nhsda/2k1nhsda/vol1/toc.htm (accessed February 21, 2005), andResults from the 2003 National Survey on Drug Use and Health: Detailed Tables U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2004, http://oas.samhsa.gov/nhsda.htm#NHSDAinfo (accessed February 21, 2005)

	Age group (years)
	12-17				18-25				26 and older				Total
	2000	2001	2002	2003	2000	2001	2002	2003	2000	2001	2002	2003	2000	2001	2002	2003
Total	16.4	17.3	17.6	17.7	56.8	58.8	60.5	61.4	49.0	50.8	53.9	52.5	46.6	48.3	51.0	50.1
Race/ethnicity
Not Hispanic	16.3	17.6	17.8	18.0	59.0	60.6	62.7	63.4	49.6	51.7	54.9	53.7	47.4	49.4	52.1	51.3
White only	18.4	19.5	20.1	20.5	63.3	64.4	66.8	68.0	52.7	54.9	57.5	56.4	50.7	52.7	55.0	54.4
Black only	8.8	10.6	10.9	10.1	43.9	46.5	48.3	47.2	36.0	37.2	43.6	41.1	33.7	35.1	39.9	37.9
American Indian or Alaska Native	19.0	22.1	22.6	16.3	NA	NA	60.0	52.3	NA	36.5	45.5	45.0	35.1	35.0	44.7	42.0
Asian	7.1	11.5	7.4	8.7	39.4	47.9	49.9	48.9	29.0	31.8	39.0	42.1	28.0	31.9	37.1	39.8
Hispanic	16.8	15.1	16.6	16.2	44.7	48.7	49.8	52.1	43.3	42.1	46.1	43.5	39.8	39.5	42.8	41.5
Gender
Male	16.2	17.2	17.4	17.1	62.5	64.7	65.2	66.9	57.5	58.6	61.9	61.5	53.6	54.8	57.4	57.3
Female	16.5	17.3	17.9	18.3	51.3	53.0	55.7	55.8	41.4	43.7	46.6	44.3	40.2	42.3	44.9	43.2
Adult education
Less than high school	NA	NA	NA	NA	44.3	46.0	48.2	48.5	31.7	30.8	35.5	34.1	33.9	33.4	NR	NR
High school graduate	NA	NA	NA	NA	52.2	54.4	55.9	56.7	44.4	46.8	50.7	47.5	45.6	48.0	NR	NR
Some college	NA	NA	NA	NA	64.0	64.4	68.0	68.7	53.0	54.2	56.7	57.0	55.1	56.2	NR	NR
College graduate	NA	NA	NA	NA	74.4	77.4	76.0	78.2	62.3	64.3	66.7	65.6	63.2	65.2	NR	NR
Current employment
Full-time	NA	NA	NA	NA	62.0	63.8	66.4	66.3	56.6	58.6	61.2	60.5	57.3	59.3	NR	NR
Part-time	NA	NA	NA	NA	56.0	58.6	59.1	62.2	49.3	52.1	58.5	53.3	51.2	54.0	NR	NR
Unemployed	NA	NA	NA	NA	53.7	58.2	56.7	58.6	52.0	49.7	58.4	56.1	52.6	52.5	NR	NR
Other	NA	NA	NA	NA	45.1	46.1	49.9	50.0	33.8	35.2	37.7	36.4	35.0	36.2	NR	NR
Notes: NA=not applicable. NR=not reported. Total refers to persons 12 and older. Data on adult education and current employment not shown for persons 12-17. Other refers to retired, disabled, homemaker, or student.

Data from the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) show that the twelve-month prevalence of alcohol abuse within the total U.S. population over the age of eighteen years was higher in 2001-2002 than in 1991-1992. (See Table 3.5.) In 2001-2002, 4.65% of the population over eighteen years of age abused alcohol. In 1991-1992, 3.03% of the population over eighteen abused alcohol. The percentages of males and females who abused alcohol were also higher in 2001-2002 than in 1991-1992.

In contrast, the twelve-month prevalence of alcohol dependence within the total U.S. population over the age of eighteen years was lower in 2001-2002 compared with 1991-1992. (See Table 3.6.) In 2001-2002, 3.81% of the population over eighteen years of age was dependent on alcohol. In 1991-1992, 4.38% of those over eighteen were alcohol dependent. The percentages of males and females who were dependent on alcohol were also lower in 2001-2002 than in 1991-1992.

The estimated national costs related to alcohol abuse and dependence (everything from crime, treatment services, health care costs, and lost wages) were projected to be approximately $185 billion in 1998, up from slightly more than $148 billion in 1992. (See Table 3.7; these are the latest figures available.)

PROBLEM DRINKING AND THE ELDERLY.

Elderly people may turn to alcohol periodically to cope with depression, the loss of a spouse, or an injury, but data suggest an overall rise in problem drinking among senior citizens. According to "Inebriated Elders," by Susan Abrams (Elder Law Journal, May 2002), as many as one in six Americans over sixty years of age are dependent on alcohol. Twenty percent of the elderly admitted to psychiatric wards exhibit symptoms of alcoholism or some other form of substance abuse. As many as 10 to 15% of health problems among the elderly may be linked to excessive alcohol use ("When Seniors Drink," Missouri FIGURE 3.1
Percentage of adults with excessive alcohol consumption, 1997-2002
SOURCE: "Figure 9.1. Percent of Adults Aged 18 Years and over with Excessive Alcohol Consumption: United States, 1997-2002," in Early Release of Selected Estimates Based on Data from the 2002 National Health Interview Survey, Centers for Disease Control and Prevention, National Center for Health Statistics, June 18, 2003, http://www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease200212.pdf (accessed February 22, 2005) Bar, http://www.mobar.org/law/seniors.htm, accessed March 11, 2005). The prevalence of problem drinking in nursing homes may be as high as 30 to 49%. A 2000 report by Alcohol Concern (a national agency on alcohol misuse in the United Kingdom) cited a 75% increase in drinking among women over age sixty-five during a recent ten-year period.