"Alcohol Consumption and Mortality. I. Characteristics of Drinking Groups"
Abstract:
Aims. This is the first of a set of three papers evaluating drinking status
and mortality risk. Analyses of multiple studies describe associations of
drinking patterns with characteristics hypothesized to confound the
relationships between drinking status and mortality. Characteristics which
both significantly differentiate drinking groups and are consistent across
studies would suggest that mortality studies not controlling for them may
be compromised.
Design and participants. Associations are evaluated from the raw data of 10
general population studies which contained mortality data. Long-term
abstainers are compared to former drinkers, long-term abstainers and former
drinkers are compared to light drinkers (by quantitiy, frequency and volume
in separate analyses) and moderate to heavy drinkers are compared to light
drinkers. Tetrachoric correlation coefficients assess statistical
significance; meta-analysis determines if associations are homogeneous
across studies.
Measurements. Measures of alcohol consumption are quantity, frequency and
volume; long-term abstainers are differentiated from former drinkers.
Multiple measures of health, social position, social integration and mental
health characteristics are evaluated.
Findings. Across studies, adult male former drinkers are consistently more
likely to be heavier smokers, depressed, unemployed, lower SES and to have
used marijuana than long-term abstainers. Adult female former drinkers are
consistently more likely to be heavier smokers, in poorer health, not
religious, and unmarried than long-term abstainers. Both types of
abstainers are more likely to be of normal or overweight than light
drinkers.
Conclusions. Characteristics of two groups of abstainers, other than their
non-use of alcohol, may confound the associations found between drinking
and mortality risk.
Addiction 93(2): 205-218 1998
"Alcohol Consumption and Mortality. II Studies of Male Populations"
Abstract
Aims. This is the second of a set of three papers evaluating drinking
status and mortality risk. Analysis of eight general population surveys of
men evaluated all-cause mortality rates by drinking pattern.
Design and participants. Raw data from three studies of youth and five
studies of adults were evaluated. Logistic regression models controlled for
confounding characteristics. Meta-analysis combined study results.
Measurements. Drinking pattern was alternatively defined by quantity,
frequency and volume of drinking. Final models included drinking pattern
(as well as abstinence in the youth models and long-term abstainers and
former drinkers in adult models), age and other confounding variables.
Models also evaluated interactions of age and , respectively, long-term
abstinence and former drinking.
Findings. No evidence was found for the hypothesis that abstinence is
associated with greater mortality risk than light drinking. In the youth
samples, abstainers had a lower risk of dying than those drinking less than
15 times per month. One study of the adult samples showed a significant age
by former drinker interaction; this did not alter the lack of association
of former drinking with mortality risk or the homogeneity of results across
studies for this finding. The most consistent finding was the association
of heavy drinking with mortality among youth. Among adults, drinking 43 or
more drinks per month and drinking 21 or more times per month were
associated with increased mortality risk. Quantity per occasion was not
significantly associated with mortality risk among adults.
Conclusions. That frequent drinking was related to mortality risk, whereas
heavier quantity was unrelated, is inconsistent with the belief that daily
consumption of a few glasses of wine has salutary effects. Empirically,
however this pattern tends to be unusual. Findings were homogeneous across
studies lending generalizability to results.
Addiction 93(2): 219-229 1998
"Alcohol Consumption and Mortality. III Studies of Female Populations"
Abstract
Aims. This is the third of a set of three papers evaluating drinking status
and mortality risk. Analysis of three general population surveys of women
evaluated all-cause mortality rates by drinking patterns.
Design and participants. Raw data from three studies of adult women were
evaluated. Logistic regression models controlled for confounding
characteristics. Meta-analysis combined study results.
Measurements. Drinking pattern was alternatively defined by quantity,
frequency and volume of drinking. Final models included drinking pattern
(including long-term abstainers and former drinkers) as well as age and
other confounding variables. Models also evaluated interactions of age and,
respectively, long-term abstainence and former drinking.
Findings. In models in which age was controlled, odds of death for
long-term abstainers and former drinkers (defined by volume or quantity)
were greater than those for light drinkers; odds of death for moderate and
heavy drinkers (defined by quantity) were greater than those for light
drinkers. When other psychosocial attributes were controlled, odds of death
were similar for abstainers and light drinkers. When other psychosocial
attributes were controlled, odds of death for heavy drinkers (defined by
volume and quantity) were greater than those for light drinkers. When
interactions of age and the two forms of abstinence were introduced, one
study showed a significant effect of age and former drinking.
Conclusions. Results were consistent with the hypothesis that
characteristics of abstainers other than their non-use of alcohol may
account for their higher mortality risk. With the exception of former
drinkers compared to light drinkers, when interactions were introduced into
models (for measures of quantity and frequency) findings were homogeneous
across studies, lending generalizability to results.