The traditional gender difference in alcohol misuse and alcohol-related harm, where men have been at much higher risk than women is changing, a recent study has confirmed.

The investigators searched MEDLINE, EMBASE and PsychINFO for studies that recorded alcohol consumption and related harm in representative sample populations and that expressed data comparing men and women across more than one birth cohort.

The data used in the studies were collected between 1948 and 2014 and related to birth cohorts from 1891 to 2000. More than three-quarters of the 68 eligible studies included in the meta-analysis were carried out in North America or Europe.

Among those born in the late 19th/early 20th century between 1891 and 1910, men were:

• More than twice as likely as women to consume alcohol; sex ratio 2.2 (95% CI: 1.9-2.5)

• Three times as likely to drink alcohol at problematic levels; sex ratio 3.0 (95% CI: 1.5-6.0)

• More than three times more likely to experience alcohol-related harm; sex ratio 3.6 (95% CI: 0.4-30.4).

However, in population cohorts born in the late 20th/early 21st century, between 1991 and 2000, men were:

• Only 1.1 times more likely to drink alcohol than women; sex ratio 1.1 (95% CI: 1.1-1.2)

• 1.2 times more likely than women to use alcohol problematically; sex ratio 1.2 (95% CI: 0.9-1.5)

• 1.3 times more likely than women to experience harm related to their alcohol use; sex ratio 1.3 (95% CI: 1.2-1.3)

The present study did not set out to explore why the gender gap in alcohol consumption is changing. However, others have suggested that the convergence of male and female roles and the increasing number of women in employment outside the home are possible contributing factors.

The study authors conclude:

‘These results have implications for the framing and targeting of alcohol use prevention and intervention programmes. Alcohol use and alcohol use disorders have historically been viewed as a male phenomenon.

The present study calls this assumption into question.’

Young women in particular should be targeted, they add.

These findings confirm closing of the historical male-female gap in alcohol use and related harm, particularly for today’s young adults.

In modern times, GPs need to maintain an equally high index of suspicion for alcohol-related problems in their male and female patients, particularly the younger ones.

Dr Jez Thompson

Slade T, Chapman C, Swift W et al. Birth cohort trends in the global epidemiology of alcohol use and alcohol-related harms in men and women: systematic review and metaregression. BMJ Open 2016;6:e011827. doi:10.1136/bmjopen-2016-011827