Alcohol harm across the drinking spectrum

BIT worked with Alcohol Change UK to run an online survey on a nationally representative sample of 4,236 adults between 18 November and 2 December 2024, to explore the extent of alcohol harm across different levels of drinking. Five categories of consumption were used to group the sample: non-drinkers, past drinkers, low risk drinkers, hazardous drinkers, and harmful drinkers. 

We found that: 

1. Alcohol consumption is associated with harm even at lower levels of drinking

Even at low risk levels of consumption, we found statistically significant associations with various health outcomes. Compared to those who had never drunk alcohol, low risk drinkers showed higher rates of cardiovascular disease (5% vs 1%) and cancer (4% vs <1%), reported poorer dental health, and experienced worse sleep quality. These associations often strengthened at hazardous and harmful levels of drinking, with anxiety rates increasing from 24% among never-drinkers to 50% among harmful drinkers. Harmful drinkers showed higher rates of emergency care use and unsuccessful GP visits. Hazardous and harmful drinkers also reported more days off work. 

2. The negative impact of alcohol extends beyond the impact on the individual, and into the healthcare system and economy

All groups who consume alcohol, including those categorised as low risk drinkers, accessed health services more in the last year than those who never consume alcohol. Our estimates very cautiously suggest that harmful drinkers may generate an additional £729 per person in annual NHS costs through increased GP visits, urgent care visits, A&E visits, and days spent in hospitals. However, wide variation in healthcare use within drinking categories and relatively small sample sizes in some groups limit our ability to draw firm conclusions specifically about cost differences. Additionally, hazardous and harmful drinkers are estimated to take 2 and 2.4 more days off work per month respectively, compared to people who have never consumed alcohol. 

3. The impact of alcohol is magnified in particular demographic subgroups

On some outcome measures, the pattern of results differed across demographic groups, particularly the impact of low-level drinking. For example, among men and people with lower socioeconomic status (SES), even low risk drinking was associated with increased health problems compared to never drinking. This pattern was not seen among women or those with higher SES. Similarly, participants with lower SES showed an association between low risk drinking and sleep issues that was not present in participants with higher SES. Young adults (18-24) showed the highest proportion of non-drinkers (13%) of any age group and lower rates of hazardous and harmful drinking than older age groups. 

These findings highlight the associations between alcohol consumption and various health-related outcomes, particularly at higher consumption levels. At a population level, alcohol consumption is associated with increased healthcare service use and decreased workplace attendance. The relationships between alcohol and health outcomes are not uniform across demographic groups, with stronger associations observed among men and participants with lower socioeconomic status.