Data from the National Vital Statistics System, Mortality

• Age-adjusted rates of alcohol-induced deaths among adults aged 25 and over were stable from 2000 to 2006, then increased 43% from 10.7 per 100,000 in 2006 to 15.3 in 2018.
• For both males and females, alcohol-induced death rates increased at a greater rate between 2000 and 2018 in rural compared with urban areas.
• Among males, the rate of alcohol-induced deaths was highest in large central metro areas in 2000 (21.3); by 2018, rates in medium (25.1) and small metro (25.9), micropolitan (26.7), and noncore (25.3) areas were highest.
• Among females, the rate of alcohol-induced deaths in noncore areas (4.4) was among the lowest in 2000; by 2018, rates in noncore areas had more than doubled (9.9).

Excessive alcohol consumption is a well-known risk factor for mortality and has been causally linked to many diseases, conditions and injuries, including alcohol-attributable cancer, liver cirrhosis, and alcohol poisonings (1). Alcohol-induced deaths, or deaths from dependent and nondependent use of alcohol, as well as accidental poisoning by alcohol (2), have been increasing in the United States since 1999 with differences by sex, age, urban–rural classification, and other demographic characteristics (3,4). This Data Brief focuses on alcohol-induced deaths among adults aged 25 and over, which account for more than 99% of the alcohol-induced deaths in the United States. The report presents trends from 2000 through 2018 by sex and urbanization level of county of residence.