Time trends and projections of binge drinking, tobacco use and their co-occurrence in Brazilian adults from 2006 to 2030

OBJECTIVES: To analyze trends in binge drinking, tobacco use, and their co-occurrence among Brazilian adults by gender, age, and education level from 2006 to 2023, and to project these trends to 2030. STUDY DESIGN: Time-series study. METHODS: Data were drawn from 17 cross-sectional Vigitel surveys conducted between 2006 and 2023 (N = 806,169). Prevalence estimates for tobacco use, binge drinking, and their co-occurrence were calculated annually. Prais-Winsten regression models were applied to assess trends and to project prevalence rates for 2030, stratified by sociodemographic variables. RESULTS: In 2006, prevalence rates were 15.7% for both binge drinking and tobacco use, and 4.9% for their co-occurrence. By 2023, binge drinking increased to 20.8%, tobacco use declined to 9.3%, and co-occurrence decreased to 4.2%. Over this period, binge drinking increased across most sociodemographic groups, in contrast to tobacco use, which showed consistent reductions across all groups. For co-occurrence, there was a significant decline in the total population, particularly among men, young adults, and individuals with lower educational attainment. In contrast, no significant changes were observed among women, older adults, and those with higher years of education. Projections for 2030 estimate binge drinking at 21.4%, tobacco use at 5.8%, and co-occurrence at 3.0%. CONCLUSIONS: Binge drinking is increasing among Brazilian adults and may reach nearly one-quarter of the population by 2030, while tobacco use and co-occurrence have declined, with some exceptions across sociodemographic groups.