It is clear that the global pandemic has had an immediate impact on alcohol consumption in Aotearoa New Zealand, and that it represents a picture of both good and bad news.
During Level 4 lockdown and post lockdown Level 1, the Health Promotion Agency surveyed drinkers about their alcohol use. Among those who had consumed alcohol in the past four weeks, key findings showed that when compared to pre-lockdown:
increased their consumption
no change in consumption
decreased their consumption
During Level 4 lockdown
In Level 1
Key findings by ethnicity and age (when compared to prelockdown) showed:
- 22% of Māori drinkers increased their consumption in Level 4 lockdown. This prevalence did not decrease once lockdown ended (22% had also increased consumption at Level 1)
- 20% of Pasifika drinkers increased their consumption in Level 4 lockdown, halving to 10% at Level 1.
- 51% of 18-24 year olds decreased their consumption in Level 4 lockdown, and 26% at Level 1.
- 19% of 18-24 year olds increased their consumption in Level 4 lockdown, and 23% at Level 1.
Early findings show that 22% of Māori drinkers increased their consumption during Level 4 lockdown and this did not decrease following the end of lockdown
Across all study participants, reasons given for drinking more included: 1) it helps me relax/switch off, 2) I have been feeling stressed out/anxious, and 3) I have been bored.
Reasons given for drinking less included: 1) haven't been able to, or haven't wanted to, socialise as much or go out/visit the pub etc., 2) money/cost, 3) haven't wanted to go out and buy alcohol, 4) physical health reasons (e.g. weight, health condition, to be healthier), and 5) the lockdown period was a good time to reduce how much I drink and I want to continue drinking less.
It is imperative that we do everything we can to support Aotearoa New Zealanders who have maintained lower levels of drinking during, and after, Level 4 lockdown. This is the ‘good news’ of alcohol use during the global pandemic.
Some impacts of the pandemic on alcohol use will likely be immediate, whilst others will occur over a longer time period. The longer term impacts are believed to include a normalisation of home drinking, reinforcing or introducing drinking as a way to self-medicate symptoms of stress, anxiety, boredom and an increased prevalence of newly diagnosed patients with alcohol use disorders (as well as relapse among persons with a disorder) (see here, here, here, here, here).
Many people will use alcohol to cope with the on-going impacts of the pandemic. Research shows that individuals who drink for coping reasons are at a heightened risk of developing problems with alcohol. Depression and anxiety have been found to be associated with drinking to cope. Factors such as unemployment, time spent unemployed, redundancy, increased workloads and reduced workplace morale due to loss of staff are also likely to result in a heightened vulnerability to developing new, or exacerbating existing, alcohol-related problems.
More males (81.8%) reported drinking in the past year than females (75.2%). Click here to see the full results from the large New Zealand Health Survey.
Comparison between subgroups (adjusted by age/sex /ethnic group)
The 2020/21 New Zealand Health Survey found that:
- Men were 9% more likely to drink than women
- Pacific people (total) were 21% less likely to drink than non-Pacific people, and
- Pacific women were 31% less likely to be past-year drinkers than non-Pacific women
- Asian people (total) were significantly 36% less likely to drink than non-Asian people (total)
- Asian men were 26% less likely to be past-year drinkers than non-Asian men
- and Asian females were 47% less likely to be past-year drinkers than non-Asian women,
- Men/women living in the most deprived neighbourhoods were 15% less likely to drink in the past-year than men/women living in the least deprived neighbourhoods
Changes in past-year drinking over time
Past-year drinking in the total New Zealand adult population significantly decreased between 2006/07 and 2011/12 (79.4%), stabilised until 2017/18 (78.9%), and then significantly increased between 2017/18 and 2018/19 (80.6%).
In 2020/21, the overall prevalence of past-year drinking (78.5%) was significantly lower than in 2019/20 (81.6%) and had returned to around the level of past-year drinking in 2011/12. As this is a single, one-off reduction, we will need to wait to see future surveys to determine any real trend.
Compared to the previous year (2019/20), significant reductions were found among the following groups:
• The total population (from 81.6% in 2019/20 to 78.5% in 2020/21)
• Total population of men (from 84.7% to 81.8%) and total population of women (from 78.5% to 75.2%)
• Persons aged 25-34 years (from 84.0% to 79.2%)
• Persons aged 35-44 years (from 84.6% to 80.7%)
• Persons aged 45-54 years (from 86.1% to 81.8% )
• Persons aged 65-74 years (from 78.1% to 73.4% )
• Total Asian population (from 65.5% to 56.3%) and Asian women (from 55.1% to 44.6%)
• Total non-disabled population (from 82.4% to 79.5%) and non-disabled men (from 85.5% to 82.5%)
As these are single, one-off reductions, we will need to wait to see future surveys to determine any real trend.
No significant reductions were found among Māori, Pacific persons (although some significant differences (increases) in past-year drinking were found in comparisons with other years) and Europeans/Others.
|DATASET: NZ HEALTH SURVEY 2020/21||GRAPHS: PAST-YEAR DRINKING SUBSET|
The prevalence (%) of past-year drinking among the total population, 2020/21 NZ Health Survey.
By age-group (years)
By ethnic group (total response)
By neighbourhoood deprivation
Drinking patterns among adults aged 45 years and above
Alcohol use among older age remains common, although it decreases with advancing age.
In 2020/21, more than three-quarters (average 76.5%) of every age group over 45 years reported drinking in the past year. More than 75% of men in these older age groups reported drinking.
More than 3 in every 4 NZ adults aged 45+ have consumed alcohol in the past year
The prevalence of drinking in the past year among older men and women is shown below:
Hazardous drinking patterns remain prevalent throughout older New Zealanders
New Zealanders aged 45 years and above comprised ~41% (337,000) of all hazardous drinkers in 2020/21.
Whilst 18 to 24 year olds maintain the highest (34.9%) prevalence of hazardous drinking in the country (41% among men aged 18-24 years), hazardous drinking patterns remain prevalent throughout older age groups in New Zealand, particularly among men. In 2020/21, the prevalence of hazardous drinking among men was:
- 30.9% among men aged 45-54 years;
- 26.6% among men aged 55-64 years;
- 17.5% among men aged 65-74 years, and
- 7.3% among men aged 75 years and above.
A substantial proportion of older men drink hazardously, placing themselves and others at risk of harm
Substantial increases in hazardous drinking prevalence among older adults
Of particular concern, there have been significant increases in hazardous drinking over time among older age groups in New Zealand. Following declines in hazardous drinking between 2006/07 and 2011/12, the prevalence of hazardous drinking increased from 2011/12 to 2015/16. These increases were substantial:
- increased by more than 50% among those aged 45-54 years (11.7% to 18.5%);
- increased by more than 70% among those aged 55-64 years (8.4% to 14.4%); and
- almost doubled for those aged 65-74 years (from 5.5% to 10%).
Therefore, all of the positive reductions in drinking that had been achieved between 2006/07 and 2011/12 were lost by 2015/16. The level of increase was so great that some age groups (35-44yrs, 45-54yrs, 65-74yrs) had significantly higher levels of hazardous drinking in 2015/2016 than in 2006/07.
No real change in the prevalence of hazardous drinking in the past six years of comparable surveys (between 2015/16 and 2020/21). Compared to 2019/20, there was a significant reduction in hazardous drinking among the the 45-54 yrs age group in 2020/21 (note that last year showed a big one-off spike in drinking in this group; it has now returned to usual levels).
Should these trends continue, older people will represent a much greater proportion of hazardous drinkers in New Zealand. This is due to the population of older adults being predicted to double by the year 2036 (based on the projection from 2013). At this point, approximately 24% of the population will be aged 65 years and over. High levels of alcohol use in older populations will have significant implications on our strained healthcare system and will compromise well-being in older adults.
Other drinking measures of older adults
The annual New Zealand Health Surveys utilise the Alcohol Use Disorders Identification Test (AUDIT) to assess the prevalence of hazardous drinking in New Zealand. However, this test is not age-specific. Other measures have been developed to quantify alcohol use in older people. This includes the CARET (Comorbidity Alcohol Risk Evaluation) that takes into account other factors that relate to alcohol use and harm among older adults, not just an older person’s drinking frequency and quantity. A report into older people's drinking can be found here.
Comparisons with other countries
New Zealand drinkers were found to have some of the highest levels of drinking across the countries studied. The proportion of frequent heavy drinkers was higher in New Zealand compared with most countries, including England and the United States.
The differential effects of alcohol use on older adults
No safe level of alcohol use exists for older adults.
Older adults are more susceptible to the harmful effects of alcohol at any level of consumption. The same amount of alcohol produces a higher blood alcohol concentration in older than younger adults due to changes in body composition, leading to a longer time for the acute effects of alcohol to diminish. The ability to absorb, metabolise, and excrete alcohol remains largely unchanged with increasing age.
Conditions such as chronic health problems, medication interaction, and other risky behaviours including drinking driving, further contribute to more harmful effects of alcohol on older adults.
Although there has been debate over the potential “health benefits” from low-risk drinking (particularly for older drinkers), recent research suggests that the findings of benefit were more likely the result of methodological differences in studies and under-adjustment for confounding factors (e.g. personal characteristics, socioeconomic status) that relate to different drinking patterns within the population. It is advised that there is no overall positive health benefit for older adults from drinking.
New Zealand research supports the findings that there are differences in the characteristics of older drinkers who have moderate versus high-risk intakes. It is important to take into account of these differences when examining health outcomes from drinking. The former were more likely to be wealthier, whilst the latter were more likely to have lower levels of economic standards than other drinking profiles.
For more information, check this button RESEARCH ON OLDER NEW ZEALANDERS' ALCOHOL USE
|FACTSHEET: DRINKING IN THE PAST YEAR|
In 2020, 494 million litres of alcoholic drinks were available for sale in New Zealand (this is a proxy measure of the alcohol we consume):
- 293 million litres of beer;
- 113 million litres of wine;
- 89 million litres of spirits and spirit-based drinks.
Beer comprises 59% of the total volume of alcoholic beverages consumed in NZ, followed by wine (23%) and spirits (18%)
The figure of 494 million litres is a small (0.8%) increase from 2019 (491 million litres).
However, these beverages are often different alcohol strengths (e.g. a beer can be 4% but spirits can be 40%), so the volume of what we drink doesn't tell us how much alcohol we have consumed as a country. Consumption of the 494 million litres equated to 36 million litres of pure alcohol, rose 1.9% from 35.3 million litres in 2019.
In 2020, 8.7 litres of pure alcohol were available for each person aged 15. To put this into perspective, it is the same as every person aged over 18 years consuming two standard drinks per person every day of the year (i.e. 2 cans of beer (330ml, 4% alcohol) or 2 glasses of wine (12.5%; 100ml)). In reality, New Zealand drinkers don't all drink the same amount. We know that approximately 46% of all alcohol sold in New Zealand is consumed in heavy drinking occasions, ie. 8 or more standard drinks for men and 4 or more standard drinks for women.
In 2020, beer, wine and spirits contributed almost equally to our pure alcohol intake. Beer contributed 12.9 million litres or pure alcohol, wine 11.7 million litres, followed by spirits with 11.3 million litres.
In relation to NZers consumption of pure alcohol (ethanol), we consume an almost equal amount from beer (36%), wine (32.4%) and spirits (31.6%)
New Zealanders are increasingly becoming spirits drinkers - in 2004 spirits contributed 23% of pure alcohol intake, in 2020 spirits contributed 31.6%.
Because spirits are taxed at the highest rate in the excise tax structure (given their high strength) the increase in spirits consumption gave a $119 million windfall in tax revenue to the Government In 2020, Government excise revenue from alcohol was $1.193 billion, up from $1.074 billion in 2019.
Alcohol available for consumption during the COVID-19 pandemic
Alcohol availability is measured on a quarterly basis. In Aotearoa New Zealand, national lockdown occurred in Quarter 2 (April, May, June). During this time, pubs were closed.
In Quarter 2, the overall amount of pure alcohol available for consumption (per capita) dropped by 9%.
Following lockdown, if New Zealand drinkers had returned to their (normal) heavy drinking patterns for Quarters 3 and 4, overall alcohol availability in 2020 should have been lower than previous years (due to the decline during lockdown). Whilst wine availability increased by 5%, spirits availability reduced by 27% and spirits-based drinks reduced by 23%.
Unfortunately, New Zealanders compensated for earlier declines in consumption by adding that volume to later quarters of 2020, resulting in an overall annual increase of 1.9% in pure alcohol consumption.
- Quarter 3 (July–Sept 2020) showed pure alcohol availability per capita was 10% higher than in the same quarter in the previous year. Consumption of wine (12% increase), beer (20% increase), spirits (9% increase) and spirits-based drinks (4%) all increased.
- During Q4 (Oct–Dec 2020), spirits and spirits-based drinks (RTDs) consumption increased substantially by 21% and 16% compared to the same quarter in 2019. Beer availability declined by 9%.
Note that about 15% of spirits consumption is normally unrecorded - being bought from duty free outlets. As duty-free outlets have been closed during the pandemic, consumers would have had to purchase their spirits from local outlets. This may partly explain the substantial increases in spirits availability. What was previously hidden in our figures of national consumption is now in available to be seen.
New Zealand drinking compared to other countries
New Zealanders typically drink a large amount of alcohol in a drinking occasion. Although we drink less (overall) than the Irish and British (and slightly less than Australians), we drink more than Americans, Canadians and South Africans.
We also need to note that our assessment of per capita consumption in New Zealand, when we are comparing countries, is out of date. This is because our per capita consumption calculations are not based on the alcohol content of products in our current market (the per capita calculations assume products have a lower alcohol strength than they currently do). For this reason, we believe that the per capita consumption estimate in New Zealand (of 8.9 litres per person) is likely to be an under-estimate of the true value.
Be careful of estimates of per capita alcohol consumption in NZ; the estimates are based on the concentration of alcohol in products sold in the 1970-80s
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In 2020/21, around one in every five (19.9%) NZ adults (aged 15+) were classified as hazardous drinkers. This equates to 824,000 adults aged 15 years and over.
Around 1 in every 5 New Zealand adults has a hazardous drinking pattern that places them and/or others at risk of harm
Males were 2 times more likely to be classified as hazardous drinkers than females (26.9% vs 13.2%). Click here to see the full results from the New Zealand Health Survey.
Note: ‘Hazardous drinking’ refers to an established alcohol drinking pattern that carries a risk of harming the drinker’s physical or mental health or having harmful social effects on the drinker or others. It is determined by using the World Health Organisation's AUDIT checklist - a score of 8 or more indicates hazardous drinking.
Comparison between subgroup (adjusted by age/sex/ethnic group):
The 2020/21 New Zealand Health Survey found that the highest prevalence of hazardous drinking was among Māori men (42.0%) followed by 18-24-year old men (41.0%). Inequities still persist:
- Māori men were 1.6 times more likely to report hazardous drinking than non-Māori men
- Māori wāhine were 1.9 times more likely to report hazardous drinking than non-Māori women
- Pacific men were 1.4 times more likely to report hazardous drinking than non-Pacific men
- Persons living in the most deprived neighbourhoods were 1.3 times more likely to report hazardous drinking than persons living in the least deprived neighbourhoods
- Disabled adults were 1.2 times more likely to report hazardous drinking than non-disabled adults
Trends in hazardous drinking
Please note that due to changes in the NZ Health Survey, comparisons between years in hazardous drinking prevalence can only be done between 2006/07 & 2015/16, and between 2015/16 & 2019/20.
From 2006/07 to 2011/12, the proportion of adults classified as hazardous drinkers significantly decreased from 18% to 15%. Large reductions were noted in adolescents and young adults. By 2015/16, most of the positive reductions made between 2006/07 and 2011/12 had been lost (except among young people). Rather, many groups had a higher prevalence of hazardous drinking in 2015/16 than in 2006/07 (i.e. Māori women, European/other, middle-aged and older-aged adults).
The latest survey in 2020/21 showed that there was no change in the overall hazardous drinking prevalence.
An increasing proportion of hazardous drinkers are women
The proportion of all hazardous drinkers that are women increased from 28.5% in 2011/12 to 31.6% in 2015/16.
The prevalence of hazardous drinking among Māori wāhine significantly increased from 24.2% in 2006/07 to 29.4% in 2015/16. Since 2015/16, there have been no significant changes in hazardous drinking among Māori wāhine.
Trends over time, by age-group
By age, 15-34 years
From 2006/07 to 2015/16
From 2006/07 to 2011/12, large reductions in hazardous drinking were noted in adolescents (15-17 year olds) and young adults (18-24 year olds). Both groups maintained their lower levels of hazardous drinking. By 2015/16 the prevalence of hazardous drinking was significantly lower when compared to 2006/07.
From 2015/16 onwards
In the past six comparable surveys between 2015/16 and 2020/21, there were no significant changes in hazardous drinking in both age-groups, but the prevalence remain unacceptably high. In 2019/20, there was a significant increase in hazardous drinking among 15-17 year olds (from 6.3% in 208/19 to 11.6% in 2019/20), but this was only a one-off change. In 2021/21, the prevalence of hazardous drinking among 15-17 year olds was 10.2% but this was not a significant decrease from 2019/20. As such, there need further surveys to determine if this is a real trend or random fluctuation.
Click this button for more information on TRENDS IN ADOLESCENT DRINKING.
35 years and over
From 2006/07 to 2015/16
Older groups moved in a different direction. Following declines in hazardous drinking between 2006/07 and 2011/12, the prevalence of hazardous drinking increased from 2011/12 to 2015/16. These increases were substantial among 45-54 years, 55-64 years and 65-74 years.
Therefore, all of the positive reductions in drinking that had been achieved between 2006/07 and 2011/12 were lost by 2015/16. Of particular concern, the level of increase was so great that some age groups (35-44yrs, 45-54yrs, 65-74yrs) had significantly higher levels of hazardous drinking in 2015/2016 than in 2006/07.
Click this button for more information on DRINKING TRENDS IN OLDER ADULTS
From 2015/16 onwards
Trends in hazardous drinking have stabilised in the past six years of comparable surveys (between 2015/16 and 2020/21), except for hazardous drinking among 45-54 year olds - there was a significant decrease from 28% in 2019/20 to 23.8% in 2020/21. As mentioned previously, further surveys are required to determine if this is a real trend or random fluctuation. The result in 2020/21 could also return to usual levels as there was a big-one spike in drinking among 45-54 yrs in the 2019/20 result.
Trends over time by ethnic groups and neighbourhood deprivation
Persistent inequities remain for Māori and deprived population groups. From 2006/07 to 2011/12, the proportion of hazardous drinkers decreased in most of the ethnic groups. By 2015/16, the positive reductions made between 2006/07 and 2011/12 had been lost. Hazardous drinking among Māori women significantly increased in 2015/16 when compared to 2006/07.
The ratio of inequity in hazardous drinking is the highest among Māori (both Māori men & Māori women), Pacific men, and for persons living in the most deprived neighbourhoods (in comparison to the relevant reference group).
Every year (since 2011/12), the Ministry of Health carries out the largest survey into the health and well-being of New Zealanders. It is called the New Zealand Health Survey (NZHS).
The survey is designed to yield an annual sample size of approximately 14,000 adults aged 15 years and over. The data is collected at the respondents’ homes, with the interviewer entering responses directly into a laptop computer and/or asking the respondent to complete a section of the interview by themselves using the laptop computer. The 2020/21 survey, taking place during the pandemic, also used a computer-assisted video interviewing (CAVI) approach for a small sample of participants.
The NZHS 2020/21 represents the sample selected for the period September 2020 to August 2021. For some periods in 2020 and 2021, the survey was suspended in parts of New Zealand that had known community outbreaks of COVID-19. As a result, the sample size for 2020/21 is smaller than usual and the 95% confidence intervals around some estimates are wider than usual. The methodology report is available here.
In 2020/21, the final weighted response rate was 77%. The final sample was 9,709 adults aged 15 years and over. here.
|DATASET: NZ HEALTH SURVEY 2020/21||POST-LOCKDOWN SURVEY|
The prevalence (%) of hazardous drinking in the total population in 2020/21 is shown below:
By age-group (years)
By ethnic group (total response)
By neighbourhood deprivation