Background Alcohol guidelines enable individuals to make informed choices about their alcohol consumption and assist healthcare practitioners to identify and offer support to at-risk drinkers. The UK lower risk drinking guidelines were revised in 2016 and the weekly guideline for men was reduced. This study sought to retrospectively establish 1) the number of additional men in England who have been drinking at increasing risk levels in the past 5 years, and 2) whether this group of newly defined increasing risk male drinkers shared any specific characteristics.

Methods Average weekly alcohol consumption data for men aged 16+ from the cross-sectional nationally representative Health Survey for England were used and regrouped into: non-drinkers; lower risk drinkers (≤14 units per week); newly defined increasing risk drinkers (>14 to ≤21 units pw) and increasing/higher risk drinkers (>21 units pw) in order to 1) calculate annual population prevalence estimates for newly defined increasing risk adult male drinkers from 2011–2015 (n=3487–3790) and 2) conduct a multinomial logistic regression analysis to assess which characteristics were significantly associated with men being newly defined increasing risk drinkers (reference category) versus lower risk and increasing/higher risk drinkers (n=2982). Models were fully-adjusted and included age-group, social class, region, smoking status, marital status, ethnicity and limiting-longstanding illness. Analyses were conducted in Stata 15.

Results Population prevalence estimates of newly defined increasing risk drinkers ranged from 10.2% of the adult male population in England (2,182,401 men) in 2014 to 11.2% (2,322,896 men) in 2011. Lower risk drinkers were significantly less likely (p<0.05) than newly defined increasing risk drinkers to be aged 55–64 (RRR 0.43, 95% CI 0.21 to 0.87); working in professional or managerial occupations (RRR 0.61, 95% CI 0.45 to 0.83); living in the North East (RRR 0.47, 95% CI 0.29 to 0.77), North West (RRR 0.56, 95% CI 0.38 to 0.82), West Midlands (RRR 0.52, 95% CI 0.32 to 0.83) or South West (RRR 0.57, 95% CI 0.36 to 0.91); and to be ex-regular (RRR 0.62, 95% CI 0.46 to 0.83) or current (RRR 0.56, 95% CI 0.39 to 0.81) cigarette smokers. Increasing/higher risk drinkers were significantly more likely than newly defined increasing risk drinkers to be ex-regular smokers (RRR 1.42, 95% CI 1.01 to 1.99).

Conclusion Approximately 11% of adult men would have been reclassified from lower risk to increasing risk drinkers according to the 2016 drinking guidelines. Such an increase in at-risk drinkers could impact clinical services. Newly defined increasing risk drinkers differ from lower risk drinkers on several characteristics but are largely similar to increasing/higher risk drinkers, therefore targeting this group specifically may not be feasible.