Per capita alcohol consumption and all-cause mortality in 14 European countries

(1) To estimate the relationship between per capita alcohol consumption and male all-cause mortality in 14 European countries. (2) To compare the estimates with predictions from the U-shaped curve at the aggregate level.

The outcome measures comprised annual data, after 1950, on male mortality (all-cause mortality and mortality from diseases) for the following age groups: 15+, 15-29, 30-49, 50-69 and 70+ years. Female mortality was included as a control variable. Alcohol sales were used as proxy for per capita consumption. The data were analysed using the Box-Jenkins technique. The estimated alcohol effects were pooled within low-, medium- and high-consumption countries.

For all-cause mortality (15+), the effect estimates were significantly positive in eight of the 14 countries. The effect on mortality of a 1-litre increase in consumption tended to be stronger in low-consumption countries (3% per litre) than in medium- and high-consumption countries (1%). This pattern deviates from that predicted from the U-shaped curve. No significant impact of alcohol was found in the youngest age group when mortality from diseases was used as the outcome.

Increases in overall consumption seem to be associated with increases in total mortality. Differences in drinking patterns are discussed as a possible explanation for the variation between country groups in alcohol effect.