Overview of Alcohol-Related Topics

Alcohol use questions for adults were included in the National Health Interview Survey periodically between 1977 and 1995 and annually between 1997 and 2018. Alcohol content will be included on a rotating basis after the 2019 questionnaire redesign.

Alcohol drinking status

• Questions about alcohol drinking status were first asked in the National Health Interview Survey in 1977. These questions asked about beverage-specific typical drinking frequency (without any reference period) and usual number of drinks consumed.
• In 1983, the NHIS fielded an extensive alcohol supplement, funded by the National Institute on Alcohol Abuse and Alcoholism. Questions included current (past 2 weeks) and recent (past year) drinking practices and lifetime drinking history. A similar supplement was fielded in 1988.
• The Health Promotion and Disease Prevention Supplements of 1985, 1990, 1995 and 1998 asked a few questions that allowed estimation of lifetime and current drinking status. The questions in the 1991 Health Promotion and Disease Prevention Supplement asked only about past year and past 2-week drinking; lifetime drinking status could not be assessed.
• The 1988 Alcohol Supplement was the only year in which detailed drinking history was collected. Quantity and frequency of drinking were asked not only of adults who drank in the past year but also those who quit drinking and those who drank infrequently in their lifetimes.

Excessive drinking

• The first NHIS question about excessive drinking (5 or more drinks on an occasion) was asked in 1977. In the 1983 Alcohol and Health Practice Supplement and the 1985 Health Promotion Supplement, respondents were asked how many days in the past year they had 9 or more drinks and how many days they had 5 or more drinks. Then in 1997, a question asking number of days the adult had 5 or more drinks in one day was added to the Sample Adult core questionnaire. In 2014, the question was modified to lower the threshold for women only to 4 or more drinks, consistent with NIAAA definitions of excessive drinking for women. The question continued annually through 2018.
• A question asking about binge drinking was added to the Sample Adult core questionnaire in 2015. Women were asked how many times they had 4 drinks or more on a single occasion in the past 30 days; men were asked how many times they had 5 drinks or more on a single occasion in the past 30 days.

Self-perceptions about drinking

• In 1983, question about self-perceptions (light, moderate, heavy) of one’s drinking over a lifetime were asked in the Alcohol and Health Practices Supplement. These have not been repeated.
• Perceptions of current drinking levels of the respondent and of his or her family members were asked in 1983 and 1988. These have not been repeated.

Opinions about definitions of drinking levels

• The 1988 Alcohol Supplement asked respondents’ opinions about how often and how much a person must drink in order to be considered a light, moderate, or heavier drinker.

Family history of alcohol problems

• The 1988 NHIS Alcohol Supplement asked a battery of questions about alcohol problems of family members.

Symptoms of alcohol abuse or alcoholism

• The 1983 Alcohol and Health Practices Supplement had questions about lifetime and past 12 month experiences of selected alcohol related problems. Respondents were asked to specify the nature of the problems but the verbatim responses were not included on the data file.
• The 1988 NHIS Alcohol Supplement included a self-administered symptom checklist for alcohol abuse developed by the National Institute on Alcoholism and Alcohol Abuse. The variables can be combined to obtain a DSM-5 diagnosis of alcohol abuse. This portion of the questionnaire was inadvertently omitted from appendix III of Current Estimates, but is available separately here [PDF – 76 KB].

Knowledge of health consequences of drinking

• The Health Promotion and Disease Prevention Supplements of 1985 and 1990 included questions about knowledge of the health consequences of drinking. The 1987 Cancer Supplement asked about risk of cancer.

Alcohol screening and treatment

• The 1990 Health Promotion and Disease Prevention Supplement was the only time the NHIS included a question about attending meetings of Alcoholics Anonymous.
• Questions about routine screening for alcohol use were included in the 1991, 1993, 1994 and 1998 Clinical and Preventive Services section of the Health Promotion and Disease Prevention Supplements.
• Detailed questions about alcohol treatment (frequency, cost, wait list, etc.) were asked in the 1994 and 1995 Disability Supplements.
• Advice to cut down on alcohol use due to high blood pressure was asked in the 1990, and 1998 Health Promotion and Disease Prevention Supplements, and the 2003 Sample Adult Heart Disease and Stroke Supplement.
• The 2002 and 2007 Alternative Medicine Supplements included questions on use of alternative medicine therapies to treat alcohol problems.

Workplace services

• The 1994 Health Promotion and Disease Prevention Supplement had a section on Occupational Safety and Health in which employed adults were asked whether their employer offered materials or programs on alcohol or drug abuse and whether they participated. The same questions were repeated in the 1998 Adult Prevention Module in the Workplace Health Promotion section.

Other alcohol topics

• Reasons for not drinking were asked in the 1983 and 1988 Alcohol Supplements as well as the 1985 and 1990 Health Promotion Supplements.
• The 1992 Drug and Alcohol Use Supplement included questions on the use of alcohol to relieve drug withdrawal symptoms.
• Questions about family discussions about alcohol use were included in the 1994 and 1998 Healthy People 2000 Supplements.