Health Survey for England, 2022 Part 1

This report provides results from the 2022 Health Survey for England (HSE) describing adult alcohol consumption and problem drinking using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire.

Detailed tables accompanying this report can be accessed here.

• In 2022, 81% of adults reported that they had drunk alcohol in the last 12 months. A higher proportion of men than women had drunk alcohol in the last 12 months (84% and 78% respectively).
• 55% of men and 42% of women drank alcohol at least once a week.
• A higher proportion of men (32%) than women (15%) drank at levels that put them at increasing or higher risk of alcohol-related harm (over 14 units in the last week).
• 30% of those aged 55 to 74 drank at least 14 units of alcohol per week, compared with 19-24% of other age groups.
• According to the Alcohol Use Disorders Identification Test (AUDIT), 88% of adults had low risk drinking behaviour or abstained.
• An AUDIT score indicating increasing risk drinking behaviour, higher risk drinking behaviour or possible alcohol dependence decreased with age. It was highest among those aged 16-24 (20%) and lowest among those aged 65 and over (6%).

The health risks associated with drinking alcohol include accidents, injuries, cancer, heart disease and reduced life expectancy (Source: Department of Health). These risks tend to increase with higher consumption.

Since 2016, UK guidelines have focused on regular weekly consumption, with the recommendation that men and women should not normally consume more than 14 units of alcohol a week, and that this should include some days where no alcohol is drunk (Source: Department of Health). Guidance on single drinking episodes focuses on reducing risks rather than specific quantities.

The HSE has asked about drinking alcohol since it began in 1993. Since 2011, the questionnaire has included the following areas covered by this report:

• Frequency of drinking in the last 12 months (including those who never drink)
• The frequency of drinking different types of drink and the amounts of each drunk on a typical day in the last 12 months (providing average weekly consumption)
• Number of drinking days in the last week
• The amounts of different types of alcohol drunk on the day they drank most (‘maximum amount drunk on any day in the last week’).

These questions were asked as part of the interview. In 2022, all young adults aged 16 to 17, and some aged 18 to 24, answered these questions in a computer-assisted self-completion interview (CASI) to ensure confidentiality.

In 2022, the Alcohol Use Disorders Identification Test (AUDIT) questionnaire was included to assess problem drinking. Adults, aged 16 and over, were asked the AUDIT questions in a paper self-completion.  

Alcohol consumption is reported in terms of units of alcohol; one unit of alcohol is 10ml by volume of pure alcohol (alcohol by volume - ABV). In 2022, revised alcohol conversion factors have been applied. Table A shows the conversion factors used. For further details on the revised alcohol conversion factors see Alcohol consumption methodology.

The HSE measures average weekly consumption and does not take into account varying patterns of consumption, for example, at different times of year. By definition, it does not reflect occasions when consumption might be higher or lower than usual, for instance, holidays, celebrations or periods of fasting.

Measures of usual weekly consumption are presented in line with the current guidelines for sensible drinking.

• lower risk (up to 14 units for men and women)

• increasing risk (above 14 and up to 50 units for men, above 14 and up to 35 units for women)
• higher risk (above 50 units a week for men, above 35 units for women)

In 2022, 81% of participants reported that they had drunk alcohol in the last 12 months, and 48% reported that they drank alcohol at least once a week. A higher proportion of men than women had drunk alcohol in the last 12 months (84% and 78% respectively). 55% of men and 42% of women drank alcohol at least once a week.

The proportion who drank alcohol in the last 12 months varied by age. Those in the youngest and oldest age groups were least likely to drink in the previous year (75% of 16 to 24 year olds and 78% of those aged 75 and over) and those aged 55 to 64 year olds were most likely to do so (86%). There was a similar pattern for drinking at least once a week. Those aged 16 to 24 were least likely to drink at least once a week (36%) and those aged between 65 and 74 years old were the most likely to do so (60%).

For more information: Table 1

Estimates in this section are based on typical consumption across the year and do not represent consumption in any specific week.

In 2022, 19% of adults had not drunk alcohol in the last 12 months. 57% of adults drank at levels which put them at lower risk of alcohol-related harm, that is 14 units or less in the last week. 24% of adults drank at levels which put them at increasing or higher risk of alcohol-related harm (more than 14 units per week).

Among those adults that drank alcohol, the average (mean) amount drunk was 13.3 units of alcohol in a typical week (17.6 units for men and 9.0 units for women).

There were some differences between men and women in typical weekly alcohol consumption, with women more likely to drink at lower levels or to not drink than men.

• 17% of men and 22% of women did not drink alcohol in the last 12 months
• 51% of men and 62% of women drank at levels that put them at lower risk of alcohol-related harm
• a higher proportion of men (32%) than women (15%) drank at increasing or higher risk levels (over 14 units in the last week for both men and women)
• 6% of men drank over 50 units a week and 4% of women usually drank over 35 units a week (higher risk levels) in a week

The proportions of men and women who usually drank more than 14 units in a week (at increasing and higher risk) varied across age groups, increasing up to the age of 55 to 64 (30% of all adults, 38% and 23% of men and women respectively). The proportions drinking at these levels then declined among both sexes, from the age of 75 and above for men and age 65 and above for women. Across all age groups, men were more likely than women to drink at increasing or higher risk levels.

For more information: Table 3

In 2022, an estimated 9.0 million adults had not drunk alcohol in the last 12 months. 26.4 million adults drank at recommended (lower risk) levels.

Regional data are shown in the data tables, both as observed and age-standardised estimates. Observed data show the actual prevalence rate found in the survey. Age-standardised data take into account the different age profiles within regions enabling comparisons between regions. 

There were differences between regions in weekly alcohol consumption estimates. After controlling for age, the highest proportion of non-drinkers in the last 12 months was in London (27%) and the lowest in the East of England (14%).

Among men, the highest proportion of non-drinkers was in West Midlands (24%) and the lowest proportion was in East Midlands and East of England (11% for both). Among women, the highest proportions were in London (32%), and the lowest proportion was in the East of England (16%).

The proportions of men and women who drank more than 14 units of alcohol per week also varied across regions.

Men living in the North East were the most likely to drink alcohol at increasing or higher risk levels (39%), and those living in the East Midlands were the least likely (25%). Women living in the South West were the most likely to drink more than 14 units of alcohol per week (19%), and those living in the West Midlands were the least likely (10%).

For more information: Table 4

The English Index of Multiple Deprivation (IMD) is a measure of area deprivation, based on 37 indicators, across seven domains of deprivation. IMD is a measure of the overall deprivation experienced by people living in a neighbourhood, although not everyone who lives in a deprived neighbourhood will be deprived themselves. To enable comparisons, areas are classified into quintiles (fifths). For further information about the IMD, see the HSE 2022 Methods documentation, available on the first page.

There was a difference in the proportion of non-drinkers by area deprivation:

• the most deprived areas had the highest proportion of non-drinkers (31%; 29% of men and 34% of women)
• the least deprived areas had the lowest proportions of non-drinkers (15% in the two least deprived quintiles; 12 to 14% of men and 16 to 18% of women)

The proportion of adults drinking at increasing or higher risk (over 14 units of alcohol a week) varied by area deprivation:

• 35% of men and 15% of women in the least deprived quintile drank over 14 units per week
• 37% of men and 19% of women in the second least deprived quintile drank over 14 units per week
• 23% of men and 12% of women in the most deprived areas drank over 14 units per week

For more information: Table 5

In 2022, 19% of adults had not drunk alcohol in the last 12 months. This proportion has remained stable, between 17% and 20%, since 2011. This finding excludes 2021 since data from that year are not directly comparable with previous HSEs due to changes in survey methodology and response rates.

The methodology used to estimate the number of units of alcohol changed in 2006 and 2022. Findings relating to alcohol consumption from the 2022 survey are not directly comparable with previous HSEs.

Trends in the usual weekly alcohol consumption between 2011 and 2022 are shown in Table 2. It shows both the original and revised estimates for 2022. More details can be found in the Appendix to the 2022 HSE report on Alcohol consumption methodology.

For more information: Table 2

More than half (56%) of all adults reported drinking alcohol in the last week, and 11% of adults drank alcohol on five or more days.

The proportions who reported drinking in the last week increased with age from 46% of 16 to 24 year olds to 64% of those aged between 55 and 64 years old, and were lower in the older age groups (63% of those aged 65 to 74 and 54% of those aged 75 and over).

The proportions of those who drank alcohol on five or more days in the last week increased from 3% of 16 to 24 year olds to 21% of adults aged 75 and over.

A higher proportion of men (61%) than women (51%) drank alcohol in the last week. This was true across most age groups.

The mean number of days on which adults drank alcohol in the last week was 2.9 and was higher among men than women (3.0 days and 2.7 days respectively). As with the proportion of adults drinking alcohol, the mean number of days increased with age, from 2.0 days among adults aged 16 to 24 to 3.8 days among adults aged 75 and over.

For more information: Table 6

In 2022, men were more likely to drink more than the recommended daily limit than women (37% compared with 30%). The proportion of all adults who drank more than three units (women) or four units (men) on any day in the last week increased with age from 27% of 16 to 24 year olds to 40% of 55 to 64 year olds and then gradually decreased to 23% of participants aged 75 and over.

For more information: Table 7

Regional data are shown in the data tables, as both observed and age-standardised estimates. Observed data show the actual prevalence rate found in the survey. Age standardised data take into account the different age profiles within regions enabling comparisons between regions.

There were regional differences in maximum alcohol consumption on any day in the last week. After controlling for age, the proportion of all adults who drank more than three units (women) and four units (men) on any day in the last week was lowest in the West Midlands (29%) and highest in the North East (42%).

For more information: Table 8

The English Index of Multiple Deprivation (IMD) is a measure of area deprivation, based on 37 indicators, across seven domains of deprivation. IMD is a measure of the overall deprivation experienced by people living in a neighbourhood, although not everyone who lives in a deprived neighbourhood will be deprived themselves. To enable comparisons, areas are classified into quintiles (fifths). For further information about the IMD, see the HSE 2022 Methods documentation, available on the first page.

The proportion of adults who drank more than more than three units (women) or four units (men) on any day in the last week varied by area deprivation. Adults living in the most deprived areas were least likely to drink more than three units (for women) and four units (for men) on any day in the last week (24%) and those living in the least deprived areas were most likely to do so (38% in the least quintile and 39% in the second least).

For more information: Table 9

The methodology used to estimate the number of units of alcohol changed in 2006 and 2022. Findings relating to alcohol consumption from the 2022 survey are not directly comparable with previous HSEs.

Trends in the maximum amount of alcohol drunk on any day in the last week between 1998 and 2022 are shown in Table 7. It shows both the original and revised estimates for 2006 and 2022. More details can be found in the Appendix to the 2022 HSE report on Alcohol consumption methodology.

For more information: Table 7

The Alcohol Use Disorders Identification Test (AUDIT) is a questionnaire used to assess problem drinking. AUDIT is widely considered to be the best screening tool for detecting problematic alcohol use. It comprises ten indicators of problem drinking: three indicators of consumption, four of use of alcohol considered harmful to oneself or others, and three of physical dependency on alcohol. In line with the World Health Organisation (WHO) guidelines on using the test, responses to each of the ten AUDIT questions were assigned values of between 0 and 4. Scores for the ten questions were summed to form a scale, from 0 to 40, of alcohol use.

The questionnaire, scoring and interpretation guidelines can be found here. The WHO guidelines for interpreting AUDIT scale scores are as follows:

This report uses the term at-risk drinking behaviour to refer to a score of 8 or above on the AUDIT.

88% of all adults were categorised as having low risk drinking behaviour (or abstinence), according to AUDIT. Women were more likely than men to have low risk drinking behaviour (91% compared with 84%).

The proportion of adults who had AUDIT scores indicating increasing risk drinking behaviour was 11%, higher risk drinking behaviour was 1% and possible alcohol dependence was 1%. A higher proportion of men than women were classified as being at increasing risk, higher risk or possible alcohol dependence (16% of men and 9% of women).

The proportion of adults classified as having low risk drinking behaviour increased with age. Those aged 16 to 24 were least likely to have low risk drinking behaviour (80%) and those aged 65 and over were most likely to do so (94%). Conversely, an AUDIT score indicating increasing risk, higher risk or possible alcohol dependence was highest among those aged 16 to 24 (20%) and lowest among those aged 65 and over (6%).

For all adults, the average (mean) AUDIT score was 4.5. Men had a higher average (mean) AUDIT score than women (5.0 compared to 4.0). Average (mean) AUDIT score varied by age group, being lowest among those aged 65 and over (3.6) and highest among those aged 16 to 24 (5.6).

For more information: Table 10

The prevalence of at-risk alcohol consumption (according to AUDIT) did not vary by area deprivation.

For more information: Table 11

Adults with an AUDIT score indicating increasing risk, higher risk or possible alcohol dependence reported higher usual weekly alcohol consumption than those with a low risk AUDIT score. An AUDIT score indicating increasing risk, higher risk or possible alcohol dependence was more prevalent for those who drank more than 35 units (for women) or 50 units per week (for men) (63%) compared with those who drank up to 14 units per week (6%).

Average (mean) AUDIT score increased with usual weekly alcohol consumption. The average (mean) AUDIT score was lowest in those who usually drank up to 14 units of alcohol per week (3.3) and was highest in those who usually consumed more than 35 units (for women) 50 units (for men) of alcohol per week (10.2). 

For more information: Table 12

The proportions of men and women with an AUDIT score indicating increasing risk, higher risk or possible alcohol dependence increased with higher levels of alcohol consumption on the day they drank most in the last week.

Among women who drank more than six units of alcohol on any day in the last week 28% had an AUDIT score indicating increasing risk, higher risk or possible alcohol dependence (compared to 8% of women who drank up to 3 units on any day in the last week). Among men who drank more than eight units of alcohol on any day in the last week, 48% had an AUDIT score indicating increasing risk, higher risk or possible alcohol dependence (compared to 6% of men who drank up to 4 units on any day in the last week).

For more information: Table 13