Intergovernmental committee on Drugs working party on Fetal Alcohol Spectrum Disorders
Fetal Alcohol Spectrum Disorders in Australia: An Update
2.1 Alcohol consumption in Australia
Alcohol is widely used in Australian society and is very much a part of the social and cultural aspects of Australian life (Commonwealth Department of Health and Ageing 2001). About 81 percent of people aged 14 years or more report that they drink alcohol, 40 percent drink weekly and seven percent report that they drink on a daily basis (AIHW 2011). Among women, 78 percent report having drunk in the past year, with about a third reporting weekly drinking and about 5 percent drinking daily (AIHW 2011).
The 2009 National Health and Medical Research Council Australian Guidelines to reduce health risks from drinking alcohol propose that for low risk of harm from alcohol-related disease or injury, no more than two standard drinks should be consumed per day for men or women. The guidelines propose that for low risk of alcohol related injury on a single drinking occasion, no more than four standard drinks should be consumed per day. These guidelines state that there are few gender differences in the risk of harm due to low risk alcohol consumption; however, at higher levels, the lifetime risk of alcohol-related disease increases more quickly for women, while the lifetime risk of alcohol-related injury increases more quickly for men (NHMRC 2009).
Previous research has indicated that the majority of Australians consume alcohol at levels that are low risk to their health, (NHMRC 2001); however, in 2010, 1 in 5 people aged 14 years or older reported alcohol consumption at a level that put them at risk of harm from alcohol-related disease or injury over their lifetime, and this remained stable between 2007 (20.3%) and 2010 (20.1%). The number of people drinking alcohol in risky quantities increased from 3.5 million in 2007 to 3.7 million in 2010 (AIHW 2011). This increase has been reported since 1995 with the percentage of Australians drinking at risky and high risk levels, rising from eight percent in 1995 to 13 percent in 2004-05 (NHMRC 2001)*. Although larger proportions of men report drinking at risky levels, the increase in adult women reporting drinking at risky and high risk levels has been greater than for men with the percentage doubling from six percent to 12 percent over this time period compared with an increase from 10 percent to 15 percent for men (Australian Bureau of Statistics 2006).
Indigenous Australians are less likely to consume alcohol than other Australians, with 21 percent of Aboriginal and Torres Strait Islander respondents in the 2004 National Drug Strategy Household Survey (NDSHS) reporting abstinence compared with 16 percent of other Australians (AIHW 2005). However, Indigenous people are more likely to drink at levels above the 2001 National Health and Medical Research Council of Australia (NHMRC) guideline if they do drink. Twenty three percent of Aboriginal and Torres Strait Islander participants reported drinking above the guidelines for alcohol-related disease risks (i.e. over the longer term) and 39 percent reported drinking at levels above the recommended limits for accidents and injuries (short term risk). These figures compare with approximately 10 percent and 21 percent of other Australians, respectively (AIHW 2005).
Estimates of alcohol use among Indigenous Australians in the more recent NDSHS, including that conducted in 2004, have been criticised by Chikritzhs and Brady (2006; 2007). These authors cite a number of methodological problems, including the content of items on alcohol use and response rates (46 percent in 2004) leading to low numbers of Indigenous participants. These authors argue that the 1994 NDSHS, in which a separate national survey was conducted with 2,993 Indigenous people in urban areas to supplement data collected in the 1993 NDSHS remains the best estimates of the prevalence of alcohol use among Indigenous people (Commonwealth Department of Human Services and Health 1996; Chikritzhs and Brady 2007). The 1994 NDSHS findings showed a similar pattern to subsequent surveys, with higher rates of abstinence (37 percent of Indigenous Australians versus 22 percent of the general population) and higher rates of risky drinking among those who drank alcohol. However, among those who drank, higher proportions of Indigenous respondents (70 percent of males and 67 percent of females) reported drinking at levels considered to be high risk as compared with later NDSHS findings. General population figures were 24 percent and 11 percent, respectively (Commonwealth Department of Human Services and Health 1996)*.
In the general population, the pattern of alcohol consumption and the type of alcoholic beverage consumed shows distinct age-related patterns. The highest rates of drinking and risky patterns of alcohol consumption occur in adolescents and young adults who are among those in their childbearing years. Amongst 20-29 year olds, 17 percent of women drank at levels indicating risk of alcohol-related harm over a lifetime and 18.7 percent reported drinking more than 4 drinks on a single occasion at least monthly; 16.8 percent did so at least weekly, placing them at risk of alcohol related injury (AIHW 2011). Of women who gave birth in 2008, 41.2 percent were aged between 20-29 years (Laws et al. 2010).
* Based on the 2001 NHMRC Guidelines which state that for males, consumption of up to four standard drinks per day over the longer term is considered low risk, five to six standard drinks per day is risky and seven or more standard drinks per day is high risk for development of alcohol-related diseases. For females, an average daily consumption of up to two standard drinks is considered low risk, three to four standard drinks per day is risky and five or more standard drinks per day is high risk. For short term risk of accident or injury, the consumption of 11 or more standard drinks for males or seven or more for females on any one day is considered to be high risk3.
For a review, see Australian Indigenous HealthInfoNet website.
Chapter 2: Prevalence and correlates of alcohol use in pregnancy