NCHS Data Brief ■ No. 374 ■ August 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Heavy Drinking Among U.S. Adults, 2018

Peter Boersma, M.P.H., Maria A. Villarroel, Ph.D., and Anjel Vahratian, Ph.D., M.P.H.

Key findings

Data from the National 

Health Interview Survey 

● In 2018, two-thirds (66.3%)

of adults aged 18 and over

consumed alcohol in the

past year.

● Among adults aged 18 and

over, 5.1% engaged in heavy

drinking (consumption of

an average of more than 14

alcoholic drinks per week for

men or more than 7 drinks

per week for women in the

past year).

● Non-Hispanic white adults

(6.4%) were more likely

than non-Hispanic black

(2.9%), Hispanic (2.6%),

and non-Hispanic Asian

(2.0%) adults to engage in

heavy drinking.

● Adults who regularly felt

worried, nervous, or anxious,

or who regularly felt depressed,

were more likely than adults

without these feelings to

engage in heavy drinking in the

past year.

● Adults who saw a doctor in

the past year were as likely as

adults who did not see a doctor

to engage in heavy drinking.

Heavy drinking is defined as the average consumption of more than 7 drinks 

per week for women and more than 14 drinks per week for men in the past 

year (1). Heavy drinking is associated with an increased risk of alcohol use 

disorders, suicide, interpersonal violence, traffic injuries, liver disease, certain 

cancers and infectious diseases, and adverse birth outcomes in pregnant women 

(1,2). This report describes adult alcohol use in the United States and presents 

the prevalence of heavy drinking by demographic characteristics, select mental 

health indicators, and select measures of health care access and utilization.

In 2018, two-thirds of adults aged 18 and over consumed 

alcohol in the past year.

In 2018, 5.1% of adults engaged in heavy drinking in the past year, 15.5% 

engaged in moderate drinking, 45.7% engaged in light drinking, and 33.7% 

did not consume alcohol (Figure 1).

1

12.6

Heavy weekly drinker 

Moderate weekly 5.1%

drinker

15.5%

Light weekly drinker

45.7%

Did not drink in 

past year

33.7%

Figure 1. Percent distribution of current alcohol drinking status among adults: United States, 2018 

NOTES: An adult who engaged in light drinking averaged three or fewer drinks per week in the past year. An adult who engaged in 

moderate drinking averaged 4 to 14 drinks per week for men and 4 to 7 drinks per week for women in the past year. An adult who 

engaged in heavy drinking averaged more than 14 drinks per week for men and more than 7 drinks per week for women in the 

past year. Estimates are based on household interview of a sample of the civilian noninstitutionalized population. Access data table 

for Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db374-tables-508.pdf#1. 

SOURCE: National Center for Health Statistics, National Health Interview Survey, 2018.

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 374 ■ August 2020

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The percentage of adults who engaged in heavy drinking in the past year 

varied by age, Hispanic origin, and race.

● Men (5.0%) were as likely as women (5.2%) to engage in heavy drinking in the past year 

(Figure 2).

● The percentage of adults who engaged in heavy drinking was lowest among adults aged 65 

and over (4.1%). 

● Non-Hispanic white adults (6.4%) were more likely than non-Hispanic black (2.9%), 

Hispanic (2.6%), and non-Hispanic Asian (2.0%) adults to engage in heavy drinking.

Figure 2. Percentage of adults who engaged in heavy drinking in the past year, by select demographic characteristics: 

United States, 2018

1Significant quadratic trend by age group (p < 0.05). 2Significantly different from Hispanic, non-Hispanic black, and non-Hispanic Asian adults (p < 0.05). 

NOTES: Heavy drinking is the average consumption of more than 7 drinks per week for women and more than 14 drinks per week for men in the past year. 

Estimates are based on household interview of a sample of the civilian noninstitutionalized population. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db374-tables-508.pdf#2. 

SOURCE: National Center for Health Statistics, National Health Interview Survey, 2018.

Percent

0 1 2 3 4 5

2.0

2.9

26.4

2.6

4.1

5.6

5.2

15.2

5.0

5.2

6 7 8

Non-Hispanic Asian

Non-Hispanic black

Non-Hispanic white

Hispanic

65 and over

45–64

30–44

18–29

Men

Women
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The percentage of adults who engaged in heavy drinking in the past year 

varied by select mental health indicators.

Adults who regularly felt worried, nervous, or anxious (7.0%) and adults who regularly felt 

depressed (7.6%) were more likely than adults without these feelings to engage in heavy drinking 

in the past year (Figure 3).

Figure 3. Percentage of adults who engaged in heavy drinking in the past year, by select mental health indicators: 

United States, 2018

1Significantly different from adults who did not regularly feel worried, nervous, or anxious (p < 0.05). 2Significantly different from adults who did not regularly feel depressed (p < 0.05). 

NOTES: Heavy drinking is the average consumption of more than 7 drinks per week for women and more than 14 drinks per week for men in the past year. 

Estimates are based on household interview of a sample of the civilian noninstitutionalized population. Access data table for Figure 3 at: 

https://www.cdc.gov/nchs/data/databriefs/db374-tables-508.pdf#3. 

SOURCE: National Center for Health Statistics, National Health Interview Survey, 2018.

Percent

5.0

4.9

17.0

27.6

0 1 2 3 4 5 6 7 8

Did not regularly

feel depressed

Regularly felt depressed

Did not regularly feel

worried, nervous,

or anxious

Regularly felt worried,

nervous, or anxious
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The percentage of adults who engaged in heavy drinking in the past year 

varied little across select measures of health care access and utilization.

● The percentage of adults who engaged in heavy drinking was lower, but not significantly 

different from, those who were insured (5.0%) or saw a doctor in the past year (5.0%), 

compared with those who were uninsured or did not see a doctor in the past year (5.8% and 

5.6%, respectively) (Figure 4).

● Adults without a usual place of care (6.5%) were more likely than adults with a usual place 

of care (4.8%) to engage in heavy drinking.

Figure 4. Percentage of adults who engaged in heavy drinking in the past year, by select measures of health care access 

and utilization characteristics: United States, 2018

1Significantly different from adults who do not have a usual place of care (p < 0.05). 

NOTES: Heavy drinking is the average consumption of more than 7 drinks per week for women and more than 14 drinks per week for men in the past year. 

Estimates are based on household interview of a sample of the civilian noninstitutionalized population. Access data table for Figure 4 at:

https://www.cdc.gov/nchs/data/databriefs/db374-tables-508.pdf#4. 

SOURCE: National Center for Health Statistics, National Health Interview Survey, 2018.

Percent

6.5

14.8

5.8

5.0

5.6

5.0

0 1 2 3 4 5 6 7 8

No usual place of care

Usual place of care

Uninsured

Insured

Did not see a doctor,

past 12 months

Saw a doctor,

past 12 months
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Summary

During 2018, 1 in 20 adults (5.1%) aged 18 and over engaged in heavy drinking. Heavy drinking 

was lowest among adults aged 65 and over compared with adults of other ages and highest 

among non-Hispanic white adults compared with non-Hispanic black, non-Hispanic Asian, and 

Hispanic adults.

The U.S. Preventive Service Task Force recommends screening adults for unhealthy alcohol 

use in primary care settings and providing brief behavioral counseling to those whose drinking 

exceeds certain weekly, daily, or per-occasion amounts (3). These results show that adults who 

visited a doctor or health care professional in the past year were as likely as those who had 

not visited any of these clinical settings to engage in heavy drinking. In addition, there was no 

association between heavy drinking and current health insurance status. However, adults who 

have a usual place of care were less likely to engage in heavy drinking than adults without a usual 

place of care. Adults who regularly felt depressed or anxious were more likely to engage in heavy 

drinking than those without these feelings.

Definitions

Doctor visit in the past 12 months: Based on combined responses of “6 months or less” and “more 

than 6 months, but not more than 1 year ago” to the survey question, “About how long has it been 

since you last saw or talked to a doctor or other health care professional about your own health? 

Include doctors seen while a patient in a hospital.” 

Heavy drinking: Defined as averaging more than 14 drinks per week in the past year for men and 

more than 7 drinks per week for women. This was based on responses to the following questions 

asked to sample adults who previously reported having had at least 12 in any 1 year or in their 

entire life: 1) “In the past year, how often did you drink any type of alcoholic beverage?” and 2) 

“In the past year, on those days that you drank alcoholic beverages, on the average, how many 

drinks did you have?” Alcohol-use questions begin with the prompt, “Included are liquor such as 

whiskey or gin, beer, wine, wine coolers, and any other type of alcoholic beverage.” The National 

Health Interview Survey (NHIS) does not ask about serving size. In the United States, a standard 

drink is defined as 12.0 ounces of beer (5% alcohol), 5.0 ounces of wine (12% alcohol), or 1.5 

ounces of liquor (40% alcohol) (3).

Race and Hispanic origin: Based on two separate questions that determine Hispanic or Latino 

origin and race. Persons of Hispanic or Latino origin may be of any race.

Regularly felt depressed: In separate questions, respondents were asked, “How often do you feel 

depressed? Would you say daily, weekly, monthly, a few times a year, or never?” and, “Thinking 

about the last time you felt depressed, how depressed did you feel? Would you say a little, a 

lot, or somewhere in between?” Respondents who reported feeling depressed either “a lot” or 

“somewhere in between” daily or feeling “a lot” on a weekly basis were recorded as regularly 

feeling depressed.

Regularly felt worried, nervous, or anxious: In separate questions, respondents were asked, “How 

often do you feel worried, nervous, or anxious? Would you say daily, weekly, monthly, a few 

times a year, or never?” and, “Thinking about the last time you felt worried, nervous, or anxious, 
NCHS Data Brief ■ No. 374 ■ August 2020

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how would you describe the level of these feelings? Would you say a little, a lot, or somewhere 

in between?” Respondents who reported feeling worried, nervous, or anxious either “a lot” or 

“somewhere in between” daily or feeling “a lot” on a weekly basis were recorded as regularly 

feeling worried, nervous, or anxious.

Uninsured: A person was defined as uninsured if he or she did not have any private health 

insurance, Medicare, Medicaid, Children’s Health Insurance Program, state-sponsored or other 

government-sponsored health plan, or military plan at the time of the interview. A person was also 

defined as uninsured if he or she had only Indian Health Service coverage or had only a private 

plan that paid for one type of service, such as accidents or dental care.

Usual place of care: Based on a positive response to the survey question, “Is there a place that 

you usually go to when you are sick or need advice about your health?” Adults whose usual place 

of care was the hospital emergency room were considered not to have a usual place of care.

Data source and methods

Data from the 2018 NHIS were used for this analysis. NHIS is a nationally representative 

household survey of the civilian noninstitutionalized U.S. population. It is conducted 

continuously throughout the year by the National Center for Health Statistics (NCHS). Interviews 

are conducted in respondents’ homes, but follow-ups to complete interviews may be conducted 

over the telephone. For more information about NHIS, visit https://www.cdc.gov/nchs/nhis.htm.

The NHIS sample design is described in more detail elsewhere (4). Point estimates and the 

corresponding variances for this analysis were calculated using SUDAAN software (5) to account 

for the complex sample design of NHIS. Tests for quadratic trends by age were evaluated using 

orthogonal polynomials. Differences between percentages were evaluated using two-sided 

significance tests at the 0.05 level. All estimates met NCHS data presentation standards (6).

About the authors

Peter Boersma, Maria A. Villarroel, and Anjel Vahratian are with the National Center for Health 

Statistics, Division of Health Interview Statistics.
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References

1. Centers for Disease Control and Prevention. Excessive alcohol use. Available from: 

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/alcohol.htm.

2. World Health Organization. Global status report on alcohol and health 2018. 

Geneva, Switzerland. 2018. Available from: https://apps.who.int/iris/bitstream/hand

le/10665/274603/9789241565639-eng.pdf?ua=1.

3. U.S. Preventive Services Task Force. Screening and behavioral counseling interventions to 

reduce unhealthy alcohol use in adolescents and adults: U.S. Preventive Services Task Force 

Recommendation Statement. JAMA320(18):1899–1909. 2018.

4. National Center for Health Statistics. Survey description, National Health Interview Survey, 

2018. Hyattsville, Maryland. 2019.

5. RTI International. SUDAAN (Release 11.0.01) [computer software]. 2013.

6. Parker JD, Talih M, Malec DJ, Beresovsky V, Carroll M, Gonzalez Jr JF, et. al. National 

Center for Health Statistics data presentation standards for proportions. National Center for 

Health Statistics. Vital Health Stat 2(175). 2017.
NCHS Data Brief ■ No. 374 ■ August 2020

Keywords: alcohol use • health care access and utilization • mental health • 

National Health Interview Survey

Suggested citation

Boersma P, Villarroel MA, Vahratian A. 

Heavy drinking among U.S. adults, 2018. 

NCHS Data Brief, no 374. Hyattsville, MD: 

National Center for Health Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Health Interview Statistics

Stephen J. Blumberg, Ph.D., Director

Anjel Vahratian, Ph.D., M.P.H., Associate 

Director for Science

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