Background: Rates of binge drinking have nearly doubled among US women ages 30-49 since 2006. Employment influences alcohol use and varies by the prestige and structure (e.g., authority, autonomy, expertise) of one's occupation.

Methods: We examined trends in binge drinking among adults ages 30-49 in the labor force in 2006-2018 National Health Interview Surveys (N = 108,981) by occupation, work prestige (General Social Survey's occupational prestige score), work structure (occupational authority, autonomy, automation, expertise), and gender. We estimated odds of binge drinking by year with survey-weighted logistic regression controlled for sociodemographics, smoking, and disability.

Results: In 2018, 30% of women and 43% of men reported binge drinking; drinking increased annually from 2006-2018 (OR for women = 1.08, OR for men = 1.03). Work status, prestige, and work structure modified the association. Women in high- (OR = 1.10, 95% CI: 1.09-1.12) versus low-prestige (OR = 1.05, 95% CI: 1.04-1.06) jobs had higher increases, as did men in high-prestige jobs (OR = 1.04, 95% CI: 1.03-1.05). Respondents in higher relative to lower authority, autonomy, and expertise jobs increased binge drinking.

Conclusions: Though all strata of workforce adults increased binge drinking, increases were concentrated among women in higher-status careers, implicating gendered shifts in labor as one determinant of recent national alcohol trends.