Alcohol consumption is falling across the United States, but the decline is being driven almost entirely by younger adults, according to a new study published in the Annals of Internal Medicine. The research, based on more than 114,000 responses to the National Health Interview Survey collected between 2018 and 2024, found that Millennials and Gen Z adults are drinking significantly less than they did just a few years ago. Older Americans, by contrast, are moving in the opposite direction.
Adults aged 50 to 64 increased their overall drinking by 4% between 2018 and 2024, while heavy drinking in that group spiked by 36%. Heavy drinking is defined in the study as five or more drinks per day or 16 or more per week for men, and four or more drinks per day or eight or more per week for women. The findings arrive amid a broader temperance boom: an August Gallup poll showed that only 54% of Americans ever consume alcohol, down sharply from 67% in 2010.
«It’s encouraging to see alcohol use decline for the first time since the start of the pandemic,» said lead author Dr. Brian Lee, a hepatologist and liver transplant specialist with Keck Medicine of USC, in a statement accompanying the report. «However, use remains above pre-pandemic levels and certain groups continue to have concerning trends.»
The generational split is stark. Total drinking dropped nearly 6% among Gen Z from 2022 to 2024, compared with about 2% for Millennials. Heavy drinking fell by roughly a fifth in both generations. Nationally, overall drinking declined 2% and heavy drinking 8% in that same two-year window. But the 50-to-64 cohort has bucked the trend consistently since 2018, and researchers say the reasons are not fully understood.
Greater public awareness of alcohol’s health risks may be driving the overall decline. Alcohol has been linked to 62 different diseases, according to the Harvard T.H. Chan School of Public Health, including liver disease, cardiovascular disease and several forms of cancer. Past research from 2024 found that far more younger people recognize those harms than older adults do. Some of that awareness may trace back to the COVID-19 pandemic, when public messaging focused heavily on young adults dying from alcohol-related causes.
«There was a lot of messaging around young adults who were dying more from alcohol-related harm during the pandemic,» Lee said. «So they could have been targeted for this.» Older adults, he added, could benefit from similar public information campaigns, especially as their drinking rates climb. «This age group faces some of the greatest risks of harm from alcohol, including cirrhosis and alcohol-related cancers,» Lee said.
Another leading theory is substitution. With cannabis now legal in many states, younger adults may be choosing it over alcohol. «The idea of substitution is a leading theory,» Lee said. «With the legalization of cannabis, are people using that rather than alcohol?» Economics may also play a role. Younger adults generally have less disposable income to spend on alcohol than middle-aged or older adults, Lee noted.
Social norms appear to reinforce the shift. «When fewer people around you drink, there is less and less societal pressure,» Lee said. «Older adults grew up in an era where everyone was drinking heavily around them and it was acceptable, whereas that’s no longer the case among Gen Z or Millennials.» Whatever the causes, the study’s authors emphasize that less alcohol consumption benefits everyone. Younger Americans may have recognized that first, but the data suggest older age groups have the most to gain from following their lead.