Excessive Drinking in Tennessee

Tennessee

Death rates from alcohol-related causes increased significantly between 2000 and 2019. An estimated 178,000 people die every year from excessive alcohol use, making it one of the leading preventable causes of death in the United States, behind tobacco and poor diet/physical inactivity. Short- and long-term excessive alcohol consumption can have negative impacts on individuals and those around them. Short-term excessive alcohol use is associated with poor decision-making and risky behaviors such as unprotected sex. It also increases the risk of alcohol poisoning, unintentional injuries like falls, drownings, burns and motor vehicle accidents, and violence such as homicide, suicide and sexual assault. Risks associated with long-term excessive alcohol use include:

• Hypertension, heart disease, stroke and liver disease.
• Cancer of the breast, throat, liver or colon.
• Alcohol dependence.
• Memory and learning problems.

Excessive drinking is responsible for an average of 488 deaths per day. In 2010, excessive alcohol use cost the U.S. a total of $249 billion.

According to America’s Health Rankings analysis, the prevalence of excessive drinking is higher among:

• Men compared with women.
• Adults ages 18-44 compared with those who are older. 
• Multiracial, Hispanic, white, American Indian/Alaska Native and Hawaiian/Pacific Islander adults compared with Asian adults. Black adults also have a low prevalence.
• Adults with an annual household income of $75,000 or more compared with those who have lower incomes. 
• Adults who have difficulty with cognition and adults without a disability compared with adults who have difficulty with mobility.
• LGBQ+ adults compared with straight adults.

The Centers for Disease Control and Prevention (CDC) advises that certain individuals abstain from alcohol consumption altogether, including anyone younger than 21 and those who are pregnant. For those who do drink, consuming alcohol in moderation can reduce the risk of adverse health outcomes. More detailed recommendations for moderate drinking are provided by the most recent Dietary Guidelines for Americans.

The U.S. Preventive Services Task Force recommends that clinicians screen adults for unhealthy alcohol use and provide behavioral counseling interventions when appropriate. The CDC has a free online alcohol screening tool to anonymously check one’s drinking, identify barriers to and motivators for drinking less, and make a personalized change plan. 

Some evidence-based strategies to reduce excessive drinking and related health and social costs include:

• Increasing alcohol excise taxes.
• Reducing the density of alcohol outlets.
• Reducing the days and hours alcohol sales are permitted.
• Holding alcohol retailers liable for injuries or damage done by their intoxicated or underage customers.
• Electronic screening and brief intervention (e-SBI) to reduce self-reported excessive alcohol use.

A recent study found that reducing alcohol consumption can decrease cancer mortality caused by alcohol use. It is recommended to limit alcohol intake to no more than two drinks per day for men and one drink per day for women.

Healthy People 2030 has multiple alcohol-related goals, including:

• Reducing the proportion of adults over 21 who engaged in binge drinking in the past month.
• Reducing the proportion of people who had alcohol use disorder in the past year.
• Reducing the proportion of motor vehicle crash deaths that involve a drunk driver.

Esser, Marissa B., Sarra L. Hedden, Dafna Kanny, Robert D. Brewer, Joseph C. Gfroerer, and Timothy S. Naimi. “Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011.” Preventing Chronic Disease 11 (November 20, 2014): 140329. https://doi.org/10.5888/pcd11.140329.

Esser, Marissa B., Adam Sherk, Yong Liu, S. Jane Henley, and Timothy S. Naimi. “Reducing Alcohol Use to Prevent Cancer Deaths: Estimated Effects Among U.S. Adults.” American Journal of Preventive Medicine 66, no. 4 (April 2024): 725–29. https://doi.org/10.1016/j.amepre.2023.12.003.

Esser, Marissa B., Adam Sherk, Yong Liu, and Timothy S. Naimi. “Deaths from Excessive Alcohol Use — United States, 2016–2021.” MMWR. Morbidity and Mortality Weekly Report 73, no. 8 (February 29, 2024): 154–61. https://doi.org/10.15585/mmwr.mm7308a1.

Kanny, Dafna, Robert D. Brewer, Jessica B. Mesnick, Leonard J. Paulozzi, Timothy S. Naimi, and Hua Lu. “Vital Signs: Alcohol Poisoning Deaths - United States, 2010-2012.” MMWR. Morbidity and Mortality Weekly Report 63, no. 53 (January 9, 2015): 1238–42. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4646044/.

Llamosas-Falcón, Laura, Omer S. M. Hasan, Paul A. Shuper, and Jürgen Rehm. “Alcohol Use as a Risk Factor for Sexually Transmitted Infections: A Systematic Review and Conclusions for Prevention.” International Journal of Alcohol and Drug Research, March 31, 2023. https://doi.org/10.7895/ijadr.381.

Planalp, Colin, Caroline M. Au-Yeung, and Tyler N. A. Winkelman. “Escalating Alcohol-Involved Death Rates: Trends and Variation across the Nation and in the States from 2006 to 2019.” State Health Access Data Assistance Center (SHADAC), April 2021. https://www.shadac.org/sites/default/files/publications/Alcohol-Involved-Deaths/AID-4.21-SHADAC-Brief.pdf.

U.S. Department of Agriculture and U.S. Department of Health and Human Services. “Dietary Guidelines for Americans, 2020-2025.” Washington, D.C.: U.S. Department of Agriculture and U.S. Department of Health and Human Services, December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.

World Health Organization. Global Status Report on Alcohol and Health 2018. Geneva: World Health Organization, 2018. https://apps.who.int/iris/handle/10665/274603.

World Health Organization. “Global Status Report on Alcohol and Health 2018.” Geneva, Switzerland: World Health Organization, September 27, 2018. https://www.who.int/publications/i/item/9789241565639.