Gender differences in the relationship between alcohol use patterns and health-related quality of life in a population experiencing a recent surge in harmful alcohol use among females: the 2018 National survey in Taiwan

We aimed to investigate whether alcohol use patterns are linked to different components of health-related quality of life (HRQoL) and whether gender moderates these relationships in a population experiencing a recent surge in harmful alcohol use among females.

Participants included 15,028 adults aged 18–64 years from the 2018 National Survey of Substance Use in Taiwan. Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT), and HRQoL was measured using the EQ-5D-5 L. Participants were classified as abstainers, former drinkers (AUDIT 0), low-risk drinkers (AUDIT 1–7), or harmful drinkers (AUDIT ≥ 8). EQ-5D-5 L dimensions were dichotomized, while the EQ VAS and index scores were used as continuous variables. Multivariable logistic and linear regressions were conducted to assess the associations between alcohol use patterns and HRQoL after adjusting for sociodemographic and clinical covariates.

The weighted prevalence was 46.22% for abstainers, 7.95% for former drinkers, 39.62% for low-risk drinkers, and 6.21% for harmful drinkers. Compared with abstainers, only low-risk drinkers were associated with limited beneficial effects in terms of decreased odds of problems with mobility and usual activities. However, all former, low-risk, and harmful drinkers were consistently associated with higher odds of experiencing pain/discomfort and anxiety/depression. The latter was moderated by gender, with female drinkers having significantly greater odds than males.

Alcohol consumption has a multifaceted relationship with HRQoL, but all patterns of alcohol use are associated with poorer HRQoL in the pain/discomfort and anxiety/depression dimensions, with females being more vulnerable to anxiety/depression than males.