New Zealanders are drinking much less than 20 years ago, bucking a global trend of rising alcohol consumption.
Millennials are partly driving the trend, as the younger generation are increasingly risk-averse and health conscious.
But despite the drop in consumption, one-in-three New Zealanders are still binge-drinking regularly, a study published in the prestigious Lancet journal shows.
Between 1990 and 2017, Kiwis' average alcohol consumption fell from 13.5 litres of pure alcohol a year to 10.8litres a year in this country.
That meant New Zealanders older than 15 were drinking around three standard drinks, or three bottles of 4 per cent beer a day - almost 1100 a year.
Around 11 per cent of New Zealand adults did not drink at all, while 34 per cent had a heavy drinking episode - 60mg of pure alcohol or around six bottles of beer - at least once a month.
Alcohol Healthwatch executive director Nicki Jackson said the per capita fall in consumption was positive, but it also masked New Zealand's heavy drinking culture.
"It is really a problem with our middle-aged and older adults - we have made no progress in that regard," she said.
"And this is going to cost us in chronic disease. It is going to cost us in cancers, in heart disease, in dementia. We've got to turn down the tap."
While adults are still drinking hazardously, consumption among millennials is falling.
"This is the health-conscious generation. All of the risk behaviours have come down - drinking, substance abuse, smoking, early sex. That has driven the reduction in consumption in adolescence."
Evidence shows the most effective measures to reduce alcohol abuse were price, availability and marketing. The Law Commission recommended changes in these areas in 2010 but they were not adopted in reforms passed by the National Government at the time.
"Yesterdaywe saw strong action on those three measures in relation to cannabis," Jackson said.
"And we've seen no action on those three measures in relation to reducing the burden from alcohol. And alcohol is by far the most harmful drug in society."
New Zealand's Health Promotion Agency recommends no more than two standard drinks a day for women or three for men to reduce long-term health risks, and at least two alcohol-free days a week.
Alcohol consumption in New Zealand has fallen since 1990 at a similar rate to comparable countries like Australia and the United Kingdom. Australians now drink slightly less, at 10.7 litres a year, and people in the UK drink slightly more, at 11.4 litres a year.
Worldwide, adults drank 6.5 litres of pure alcohol in 2017 - up from 5.9 litres in 1990. It is forecast to rise to 7.6 litres by 2030.
The global increase in consumption is driven by developing countries.
"Before 1990, most alcohol was consumed in high-income countries, with the highest use levels recorded in Europe," said the study's author Jakob Manthey, from Technische Universität Dresden in Germany.
"However, this pattern has changed substantially, with large reductions across Eastern Europe and vast increases in several middle-income countries such as China, India, and Vietnam.
The regional differences were influenced by religion, alcohol policies, and economic growth. As the middle class in China and India grew, overall drinking levels rose.
The trends in the study showed that the World Health Organisation's goal of reducing harmful alcohol use by 10 per cent before 2025 would not be achieved, Manthey said.
"Instead, alcohol use will remain one of the leading risk factors for the burden of disease for the foreseeable future, and its impact will probably increase relative to other risk factors," Manthey said.
The biggest drinking country in the world is Moldova, the study showed, and the most sober country is Kuwait.
New Zealand: 13.5 litres/year
Global: 5.9 litres/year
New Zealand: 10.8 litres/year
Global: 6.5 litres/year
New Zealand: 12.1 litres/year
Global: 7.6 litres/year
(Average pure alcohol per year for people aged 15 and older, Global Burden of Disease Study)
ADVICE FOR ADULTS
Reduce your long-term health risks by drinking no more than:
- two standard drinks a day for women and no more than 10 standard drinks a week
- three standard drinks a day for men and no more than 15 standard drinks a week
- at least two alcohol-free days every week
Reduce your risk of injury on a single occasion of drinking by drinking no more than:
- four standard drinks for women on any single occasion
- five standard drinks for men on any single occasion
The above advice is based on "standard drinks'. A standard drink contains 10g of alcohol. A common serve or pour of an alcoholic beverage is often more than standard drink. Find out more about standard drinks.
(Source: Health Promotion Agency)
WHAT IS A STANDARD DRINK?
330 ml can of beer @ 4% alcohol = 1 standard drink
100 ml glass of table wine @ 12.5% alcohol = 1 standard drink
335 ml bottle of RTD spirits @ 8% alcohol = 2.1 standard drinks
750 ml bottle of wine @ 13% alcohol = 7.7 standard drinks
1000 ml bottle of spirits @ 47% alcohol = 37 standard drinks
3 litre cask of wine @ 12.5% alcohol = 30 standard drinks
(Source: Ministry of Health)