Sex-based differences in heavy episodic drinking among adults in Canada, 2017-2023: a repeated cross-sectional analysis.

Heavy episodic drinking (HED) is a key population indicator for harmful alcohol consumption. We used data from the Canadian Community Health Survey to examine recent trends in sex-based differences in HED among adults by age group from 2017 to 2019 and 2022 to 2023. The overall prevalence of HED was 20.5% (95% CI: 20.1, 20.8) in 2017 to 2019 and 20.3% (95% CI: 19.9, 20.8) in 2022 to 2023. Overall, males had a higher HED prevalence than females; however, sex-based differences narrowed in 2022 to 2023 compared to 2017 to 2019. Among those aged 18 to 25 years, females reported a higher HED prevalence than males in 2022 to 2023 (prevalence: 27.9% vs. 24.2%), yielding a prevalence difference of -3.7% (95% CI: -9.4,1.9), although the confidence interval includes zero, indicating uncertainty about whether a meaningful difference exists. From 2017 to 2019 and 2022 to 2023, the prevalence of HED in Canada remained high, and sex-based differences narrowed across all age groups, particularly among young adults, where rates converged.