Population trends in patterns of alcohol use are important data for policymakers but are generally based on repeated cross-sectional surveys.

We used self-reported alcohol consumption data collected repeatedly over 50 years (1948-2003) among 8600 Framingham Heart Study participants to determine patterns of alcohol use and disorders according to sex, age, and birth cohorts.

Among drinkers, there was a decrease across succeeding birth cohorts in average alcohol intake: among individuals between ages 30 and 59 years, age-adjusted mean intake was 30.6, 25.5, and 21.0 g/day for those born in 1900-1919, 1920-1939, and 1940-1959, respectively, in men (P<.001), and 14.2, 12.3, and 10.4 g/day, respectively, in women (P<.001). In all birth cohorts, proportion of abstinence increased and average consumption among drinkers decreased with age. Furthermore, proportion of moderate use was higher but heavy use was lower in the younger birth cohorts than in the older cohorts. The proportion of alcohol from beer decreased and that from wine increased with age for all cohorts. Among the 2 earlier birth cohorts, the cumulative incidence of an alcohol use disorder from age 40 to 79 years was much higher in men (12.8%) than in women (3.8%); it tended to be slightly higher among subjects born after 1920 than among those born 1900-1919.

We found a decrease in average intake and more wine consumption over the more than 50 years of follow-up. The cumulative incidence of alcohol use disorders, however, did not show a decrease.