Asian Journal of Medical Principles and Clinical Practice

Background: Harmful alcohol use remains a major public-health problem in Nigeria, but the evidence base is fragmented across adolescent, university, community, pregnancy, occupational, and injury studies.

Objective: The systematic review aimed to synthesize empirical evidence from a public health perspective in Nigeria on alcohol consumption and associated health problems, and to interpret these findings against sub-Saharan African and global evidence.

Methods: A PRISMA 2020-aligned systematic review with narrative synthesis was undertaken. PubMed/MEDLINE, Web of Science, ScienceDirect, African Journals Online (AJOL), EMBASE, Google Scholar, citation chasing, and authoritative contextual sources were reviewed for publications from January 2010 to March 2026. Fourteen Nigerian empirical studies met the criteria for the primary synthesis. Regional and global systematic reviews and burden analyses were examined separately for contextual interpretation. Design-appropriate quality appraisal tools informed interpretation.

Results: The 14 included Nigerian studies comprised four adolescent- or school-based studies, five university-based studies, one semirural community study, two transport- or injury-related studies, and two pregnancy studies. Alcohol use was already evident in adolescents, with 9.2% lifetime alcohol use in one school survey, 21.4% 12-month alcohol/substance use in another adolescent study, 34.0% alcohol experimentation nationally, and 12.5% problematic alcohol use in an online adolescent sample. Among university students, current or lifetime use ranged from 31.1% to 78.4%, while problem or hazardous drinking ranged from 10.8% to 14.9%. Current alcohol use among semirural adults was 23.7%; among commercial drivers, 84.4% used alcohol, and 23.3% were hazardous users; and 41.2% of trauma patients reported pre-trauma alcohol use. Drinking during pregnancy ranged from 12.7% to 59.3%. Associated harms included psychological distress, risky sexual behaviour, alcohol-related injury, severe trauma, impaired functioning, and fetal exposure.

Conclusion: Alcohol-related harm in Nigeria is substantial but preventable. The burden is concentrated in adolescents and young adults but extends to occupational safety, trauma care, and maternal-child health. A stronger response should combine population-level alcohol control policies with routine screening, brief intervention, and referral systems embedded in schools, universities, primary care, antenatal care, emergency services, and mental-health services.