Comparative study of alcohol use, alcohol use disorder, and consequences among young people and adults with injuries in Northern Tanzania

Introduction Alcohol use is a major risk factor for injury, a leading cause of morbidity and mortality among young people in sub-Saharan Africa. In Tanzania, high rates of alcohol use disorders and heavy episodic drinking have been documented. However, age differences in alcohol use and related harm among injury patients are poorly described. Understanding these differences is important for informing targeted interventions. Methods We conducted a cross-sectional analysis using linked data from the Kilimanjaro Christian Medical Centre Trauma Registry and the Pragmatic Randomized Adaptive Clinical Trial (2020–2025). Acute injury patients aged ≥18 years presenting within 24 h were included. Alcohol use was assessed using the Alcohol Use Disorders Identification Test, and consequences using the Drinker Inventory of Consequences. Outcomes were compared between young people (18–24 years) and adults (≥25 years) using descriptive, age-stratified analyses. Results Among 2427 injury patients (520 young people; 1907 adults), current alcohol use was reported by 46.5% of young people and 59.4% of adults. Adults more often reported alcohol use in the past four weeks (28.7% vs. 18.9%) and within six hours prior to injury (21.3% vs. 11.4%), and were more likely to drink ≥4 times per week (14.1% vs. 5.8%; p < 0.001). Young people more frequently reported injury to themselves or others due to drinking in the past year (14.0% vs. 9.4%; p = 0.026) and higher physical alcohol-related consequences (85.7% vs. 73.5%; p = 0.010). The prevalence of alcohol use disorder was similar between groups (37.2% vs. 39.6%). Conclusion Although adults reported more frequent alcohol consumption, young people had comparable prevalence of alcohol use disorder and experienced greater alcohol-related physical consequences, including injury. These findings highlight distinct age-related drinking patterns and a disproportionate burden of harm, suggesting the need for age-responsive alcohol screening and intervention strategies within emergency care settings.