The Healthy Ireland Survey 2023 has found a decline in people reporting good health and an increase in the use of e-cigarettes and antibiotics.
The eighth annual survey by the Department of Health - based on interviews with more than 7,000 people aged 15 and over - also found that alcohol consumption has decreased while smoking levels are stable.
It also found that 80% of people reported being in 'good' or 'very good health', down two points from 2022.
The figure has continuously declined over the past five years.
Some 40% of people have a long-term health condition, up from 29% just two years ago.
High blood pressure or hypertension, arthritis, high cholesterol, asthma and diabetes are among the biggest health issues.
Some 18% of the population smoke, a figure that has remained stable over the past three years
The numbers using e-cigarettes has risen from 6% to 8%, with 20% of women aged 15-24 using them daily or occasionally.
Some 70% of people drank alcohol in the past 12 months, down from 75% reported in 2018 before the Covid-19 pandemic.
Almost a quarter (24%) of those who drink are considered binge drinkers because they drink six or more
standard drinks in a sitting. This is also down from 27% on pre-Covid figures.
Some 38% say they drink once a week, 21% say they drink multiple times a week and more men (37%) report binge drinking then women (12%).
Chief Medical Officer Prof Breda Smyth said tobacco use has plateaued at a level of 18%, but that this is still a "long way off our desired target of 5% within the population".
She told RTÉ's News at One: "Even within the age cohort 15-to-24 years, one in five women are using e-cigarettes and 16% of men are using it in this age group.
"Currently, in response to this, we have the public health tobacco and nicotine inhaling products bill, which has passed all stages in the Dáil, and is now currently going through the Seanad stage and we hope to have this in law by Christmas."
Prof Smyth welcomed the decrease in binge drinkers, but warned it is still at a very high level compared with international levels.
She said: "This is one of the highest rates of what we categorise as binge drinking in the world.
"As a result of this, we have our public health alcohol act which was introduced in 2018...one of the more recent ones introduced as the minimum of new unit pricing.
"We are currently undergoing an evaluation of the effectiveness of this within our population. But recent data from Scotland who introduced it before us showed that alcohol sales fell by 8%.
"The reduction of sales was greatest in those that were consuming most so it was targeting those at greatest risk".
Drug use
The survey asked people about drug use for the first time.
Some 21% reported lifetime illegal drug use with cannabis being the most popular substance used.
While 13% reported lifetime use of sedatives or tranquillisers, with 6% saying they used them without a prescription.
The number of people visiting their GP has increased on pre-pandemic levels from 73% to 76%.
There was a significant increase in people taking antibiotics, 41% compared to 27% just two years before, but the report says this is likely linked to less people visiting GPs and lower infection rates during the pandemic.
There is an increase in those visiting emergency departments, using minor injury clinics and attending medical assessment units since before the pandemic.
Mental health
Those reporting positive mental health was higher than when last measured in 2021 but lower than in 2016.
More men then women reported positive mental health.
Some 86% reported their quality of life as good or very good.
More than a third of people said they feel more socially connected since Covid-19 restrictions were eased, while 22% say they feel less socially connected and 43% say that their social connectedness has not changed since Covid-19 restrictions eased.
Those aged 15-24 are most likely to feel socially connected.
While people who live in Dublin are more likely to say they feel lonely 'often' or 'always'.
Some 41% of people say they participate in a social group or club with men (44%) more likely than women (38%) to be a member of a social group or club.
