Young adult women in the United States reported higher past-month binge drinking rates than their male counterparts between 2021 and 2023, reversing trends observed in earlier years, according to a cross-sectional analysis.
Among adults aged 18 to 25 years, females had a binge drinking prevalence of 31.6 per 100 persons, compared with 29.9 per 100 persons for males/ This finding marks a statistically significant difference of 1.8%, and a reversal from 2017 to 2019 when women in this age group had lower binge drinking rates than men.
The study authors, led by Bryant Shuey, MD, of the University of Pittsburgh, used data from the National Survey on Drug Use and Health (NSDUH), which surveys a nationally representative sample of U.S. adults. They evaluated responses from 267,843 participants aged 18 years or older across two periods: 2017 to 2019 and 2021 to 2023. The year 2020 was excluded due to changes in methodology that were introduced during the COVID-19 pandemic when web-based interviews were adopted.
Binge drinking was defined as consuming five or more alcoholic drinks on a single occasion for men and four or more for women. Heavy drinking was defined as binge drinking on 5 or more days in the past 30 days. The researchers' analyses used logistic regression models with marginal effects that were adjusted for sociodemographic factors such as income, education, employment status, rurality, and household composition.
Across all age groups, males continued to report higher levels of binge and heavy drinking than females, but the sex gap narrowed in recent years. Among all adults, binge drinking prevalence dropped from 22.6 to 21.8 per 100 women and from 29.2 to 25.7 per 100 men from 2017 to 2019 and 2021 to 2023.
For adults aged 26 to 49, the 2021 to 2023 binge drinking prevalence was 27.4 among women and 30.7 among men. Among adults who were older than 65, rates were 9.4 for women and 14.4 for men per 100 persons.
Heavy drinking followed a similar trend. In 2021 to 2023, the prevalence was 5 per 100 for women and 7.8 for men. Among 18- to 25-year-olds, heavy drinking was 6.9 in women vs 8.1 in men. These figures represent a narrowing gap from 2017 to 2019, when rates were 4.5 (women) and 8.3 (men).
The researchers noted that self-reported behavior may be subject to social desirability bias and that changes in survey mode could impact comparability. “Analyses rely on the assumption that this methodological change did not differentially impact estimates between females and males,” they wrote.
The findings are consistent with other national estimates and suggest a shifting pattern of alcohol use by sex among younger adults.
The study was supported by grants from the National Institute on Drug Abuse, the National Institute on Aging, and the National Institute on Alcohol Abuse and Alcoholism. Authors reported affiliations with the University of Pittsburgh, Harvard Medical School, and Duke University.
Full disclosures can be found in the study.
Source: JAMA