A recent newspaper report detailed a decline in alcohol use, and the latest data indicates alcohol-induced mortality may be following.
A study detailed in The New York Times highlighted that Americans are drinking less.1 The article presents findings from Gallup’s annual Consumption Habits survey, which show 54% of US adults self-report consuming alcohol in 2025 – the lowest percentage in 90 years of data collection.
This compares to at least 60% in the period of 1997 to 2023 and 58% in 2024. The survey also indicates Americans who drink are imbibing less alcohol than before.
Is alcohol-related mortality following suit?
That is the question most pertinent to the insurance industry. To further understand changes in drinking behavior and alcohol-induced mortality trends, RGA analyzed substance use metrics from the National Survey on Drug Use and Health (NSDUH) and mortality data from the Centers for Disease Control’s (CDC) National Vital Statistics System (NVSS).
While data from the NSDUH was limited to 2024, estimates indicate a few significant declines for the period of 2021 to 2024:2
Any alcohol use for ages 12+ also showed a mild but insignificant decline in 2024 (46.6%), following an increase between 2021 (47.4%) and 2022 (48.7%); ages 26+ noted a similar insignificant pattern. See Figure 1.
Further, underage drinking behavior showed a decline, with 13.3% of individuals aged 12-20 reporting any past month alcohol use in 2024 compared to 15.6% in the 2021 survey.
The New York Times report suggests that social norms may have shifted – with movements like “mindful drinking” and “sober curious” or a potential preference for cannabis over alcohol in young people. Nothing is conclusive yet regarding the causes behind drinking behavior changes, but such declines provide some hope for future alcohol-related mortality trends.
RGA analyzed US general population mortality data from NVSS from January 2018 through March 2025. The data for 2024 is provisional, and the data for 2025 is provisional and partial with reporting lags.3 See the appendix for details on the ICD-10 codes used in this analysis. US Census Bureau population data was used to calculate mortality rates.
This analysis indicated that alcohol-induced mortality continues to show declines, as discussed in a previous RGA report. Figure 2 shows the annual death count and mortality rate for alcohol-induced deaths from 2018 to 2024. This shows a steady decline since the peak in 2021.
Figure 3 compares quarterly alcohol-induced deaths to the deaths occurring in the first quarter of 2018. While alcohol-induced deaths have declined, they remain about 23% higher in the first quarter of 2025 compared to those in the same quarter of 2018.
Provisional data for 2024 and 2025 suggest that alcohol-induced mortality is declining for the US general population but remains above 2018 and 2019 levels. Such declines are prevalent for all studied age groups, as shown in Figure 4.
However, not all age groups have experienced the same rate of change throughout recent years. For example, the alcohol-induced mortality rates in 2024 for ages 45-64 are about 8%-9% higher than those in 2018. Other ages present a much larger gap in alcohol-induced mortality between those two years, with ages 25-44 showing a 55% difference and ages 65+ showing a 24% difference.
Various considerations should be taken into account regarding these alcohol-induced mortality trends and what they may mean going forward.
First, alcohol-induced deaths are a subset of alcohol-related deaths. Alcohol-induced deaths encompass deaths where the underlying cause of death is 100% attributable to alcohol, such as alcoholic liver disease. Alcohol-related deaths are a broader category which includes both alcohol-induced deaths and causes of death that are partially attributable to alcohol, such as injuries. One CDC report indicated there were roughly 178,000 annual alcohol-related deaths in 2021 and 2022 – more than triple the number of alcohol-induced deaths in the same period.4
Second, alcohol use and alcohol use disorder are associated with various long-term conditions that can take years to progress. Some implications and alcohol-related disease development were discussed in RGA’s previous report. Due to the long-term nature of such diseases, as well as the difference in mortality trends by demographics (as seen in Figure 4), it is difficult to ascertain the long-term impacts associated with increased alcohol use during the acute phase of the COVID-19 pandemic.
The Gallup survey data and NSDUH data are aligned: Both surveys suggest around half of Americans report consuming alcohol, so while alcohol use has not “dried up,” it has shown declines from 2021 to 2024. Even more, there are overall declines apparent since the peak in 2021 and into the early months of provisional 2025 alcohol-induced mortality data.
Due to the long-term nature of alcohol-related implications and these differences by demographics, only time will tell the future of alcohol-related mortality trends. However, the recent declines in both alcohol consumption and alcohol-induced mortality provide hope.
What to learn more? Check out RGA’s previous report and video on alcohol use and mortality following the COVID-19 pandemic, which highlight differences in alcohol-induced mortality by additional factors, such as education level and marital status, as well as comparing US mortality to that in England and Wales. And stay tuned for an upcoming report from the Society of Actuaries authored by RGA, which will further discuss substance-related mortality trends and drivers in both the general and insured populations.
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