Australian workers at risk: Patterns of alcohol, tobacco, and drug use in the workforce

Background: Why Focus on Substance Use in the Workplace?

In Australia, more than two-thirds of the population is employed [1], and many workers regularly use substances like alcohol, tobacco, and illicit drugs [2]. Workplaces are an important environment in which to implement place-based interventions aimed at reducing substance use and associated harms [3]. Substance use can negatively impact workers in several ways, including their mental and physical health, as well as their job performance, risk of workplace accidents, and rates of absenteeism.

Previous research in Australia and internationally suggests that certain workplaces have higher rates of substance use due to factors such as stressful working conditions, demanding workloads, shift patterns, workplace culture, or the demographics of workers attracted to particular industries [4-7]. However, prior Australian research largely focused on prevalence rates within industries or occupations without adequately considering the total numbers of workers affected or adjusting comprehensively for other contributing factors [2, 8, 9].

In a study we recently published in Health Promotion International, we addressed these gaps by examining not only the prevalence of substance use but also the total number of affected workers and the odds that workers in certain industries and occupations would engage in risky substance use, after controlling for other demographic and socioeconomic variables.

Method: How Was the Study Conducted?

We analysed data from the 2022–23 Australian National Drug Strategy Household Survey, a nationally representative survey of Australians aged 14 years and older. Our analysis focused specifically on employed participants, with a total sample of 16,281 workers for industry analyses and 17,247 for occupation analyses.

Three key measures of substance use were examined:

• High-Risk Alcohol Consumption: Defined as exceeding Australia’s national guidelines (more than 10 drinks per week or more than four drinks on a single occasion).
• Current Smoking Status: Whether workers reported being a current smoker of tobacco products.
• Illicit Drug Use: Use of any illicit drugs within the past year.

Statistical models identified which industries and occupations had the highest prevalence rates and the greatest absolute numbers of users. In addition, we conducted weighted logistic regression models to determine which industries demonstrated an increased likelihood (odds ratios) of substance use—even after controlling for various factors including age, gender, socioeconomic status, mental health, and working conditions.

Results and Discussion: What Did the Study Find?

We found substantial differences in substance use between different occupations and industries:

High-Risk Alcohol Consumption:

Workers in the mining industry had the highest prevalence of risky drinking (53%), followed closely by those in the construction (46%) and utility sectors (i.e., electricity, gas, water, and waste services). However, in terms of estimated absolute numbers of high-risk drinkers, the health care and social assistance sector led, followed by the construction and education sectors. When adjusting for various demographic factors, mining and administrative services remained significantly associated with higher odds of high-risk drinking when compared to the education sector.

Technicians and trades workers exhibited the highest prevalence of high-risk alcohol consumption (45%), while professionals were the occupation type with the highest estimated number of high-risk drinkers. However, adjusted regression models showed that only managers were associated with increased odds of high-risk drinking when compared to professionals.

Tobacco Use:

The administrative and support services industry had the highest smoking prevalence at 32%, followed by mining (24%) and hospitality (24%). Yet, due to their large workforce, the health care and social assistance sector accounted for the largest absolute number of smokers, followed by construction and hospitality. After controlling for other variables, administrative services and retail workers demonstrated significantly increased odds of being smokers compared to the education sector.

Labourers showed the highest prevalence of current smokers (33.0%), while technicians and trades workers was the occupation type with the highest estimated number of smokers. When adjusting for covariates, labourers and machinery operators and drivers demonstrated an increased propensity to be current smokers.

Illicit Drug Use:

Workers in hospitality exhibited the highest illicit drug use prevalence (28%), with construction (26%) and mining (24%) close behind. Once again, health care and social assistance had the highest absolute number of illicit drug users due to the size of their workforce, followed by construction and mining. Adjusted analyses indicated that the utilities, mining, hospitality, and construction industries were significantly more likely to engage in illicit drug use.

When looking at occupations, technicians and trades workers had the highest prevalence of illicit drug use (25%), yet professionals had the largest estimated number of workers who use illicit drugs. When adjusting for covariates, technicians and trades workers were more likely to engage in illicit drug use when compared to professionals.

Why Does This Matter?

The study’s comprehensive approach provides crucial insights for policymakers, employers, and public health professionals looking to target workplace interventions effectively. Interventions tailored specifically to high-risk industries such as mining, construction, and hospitality could significantly reduce substance-related harms by addressing workplace-specific stressors, cultural norms, and environmental influences on substance use.

Effective workplace strategies, as supported by previous research [10], often involve multifaceted approaches, including health promotion programs, tailored education, policy enhancements, confidential screening, and accessible support services. It is important that workplace interventions incorporate these evidence-based strategies [11] and emphasise collaboration between workers, employers, policymakers, and health practitioners to tailor interventions that address specific workplace needs. Given the potential for significant health, social, and economic impacts from workplace substance use, prioritising resources to address these challenges can offer considerable benefits for workers, employers, and society as a whole.

References

1. Australian Bureau of Statistics. Labour Force, Australia: ABS; 2024 [Available from: https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia/nov-2024.

2. McEntee A, Pointer S, Pincombe A, Nicholas R, Bowden J. Alcohol and Other Drug Use: A Focus on Employed Australians: Part 1: Prevalence and Consequences. Adelaide, South Australia: National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute (FHMRI), Flinders University; 2023.

3. Department of Health. National Preventive Health Strategy 2021–2030. Canberra: Department of Health; 2021.

4. Frone MR, Bamberger PA. Alcohol and illicit drug involvement in the workforce and workplace. In: Tetrick L, Fisher G, Ford M, Quick J, editors. Handbook of occupational health psychology (3rd ed)2024. p. 361-83.

5. Pidd K, Roche A, Kostadinov V. Trainee chefs' experiences of alcohol, tobacco and drug use. Journal of Hospitality and Tourism Management. 2014;21:108-15.

6. Roche AM, Lee NK, Battams S, Fischer JA, Cameron J, McEntee A. Alcohol use among workers in male-dominated industries: A systematic review of risk factors. Safety Science. 2015;78:124-41.

7. Tynan RJ, Considine R, Wiggers J, Lewin TJ, James C, Inder K, et al. Alcohol consumption in the Australian coal mining industry. Occupational and Environmental Medicine. 2017;74(4):259-67.

8. Bywood P, Pidd K, Roche A. Illicit Drugs in the Australian Workforce: Prevalence and Patterns of Use. National Centre for Education and Training on Addiction, Flinders University; 2006.

9. Roche AM, Pidd K, Bywood P, Freeman T. Methamphetamine use among Australian workers and its implications for prevention. Drug and Alcohol Review. 2009;27(3):334-41.

10. Morse AK, Askovic M, Sercombe J, Dean K, Fisher A, Marel C, et al. A systematic review of the efficacy, effectiveness and cost-effectiveness of workplace-based interventions for the prevention and treatment of problematic substance use. Frontiers in Public Health. 2022;10.

11. Duraisingam V, McEntee A, Nicholas R, Pointer S, Bowden J. Alcohol and other drug use: A focus on employed Australians: Part 2: Prevalence and consequences. Adelaide, South Australia: National Centre for Education and Training on Addiction (NCETA), Flinders Health and Medical Research Institute (FHMRI), Flinders University,; 2022.

Authors: Dr Gianluca Di Censo, Dr Kirrilly Thompson & Prof Jacqueline Bowden

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