Background and aims Studies on the role of labour market position and change in alcohol use during midlife are scarce and their results are inconclusive mainly due to their failure to define comprehensive and distinct labour market groups and the short periods of time studied. In this study we used different activity categories for men and women to examine alcohol use trajectories in midlife covering a period of 17 years.

Methods Using data from four sweeps of the National Child Development Study covering ages 33–50 (N=9960), we used multilevel growth models to study the association between labour market categories and longitudinal changes in weekly units of alcohol consumed.

Results In the reference group of full-time employed men alcohol trajectory decreased over the follow-up period (β=−0.14; 95% CI −0.18 to −0.11) while in the reference group of employed women it increased (β=0.06; 95% CI 0.04 to 0.08). Men and women who were ‘mainly sick’ had significantly steeper declines in their alcohol consumption trajectory. Women who became employed after being homemakers had the steepest increase in alcohol use (β=0.05; 95% CI 0.01 to 0.09).

Conclusions Being employed is a strong determinant of alcohol use for men and women in midlife, making the workplace a good target for health promotion programmes and policies aimed at reducing alcohol use. Caution is needed when interpreting the health effects of alcohol consumption as low alcohol users may have previously been heavy drinkers.