Epidemiologic assessment of population risks and benefits of alcohol use

The relation of alcohol intake with mortality seems to be curvilinear, resembling the shape of the letter 'J'. The higher the intake, the higher the mortality excepting abstainers, who have slightly higher mortality than moderate drinkers. The higher mortality among non-drinkers is partly explained by two causes: becoming an ex-drinker because of illness or being a heavy smoker. However, lifelong abstainers have higher mortality and morbidity (after controlling for smoking) than light drinkers. Light drinking may increase the life span. Alcohol intake decreases the risk of death from coronary heart disease, but increases that of several other diseases. Morbidity is lowest among light drinkers, slightly higher among lifelong abstainers and much higher among heavy drinkers. Due to several sources of error in study design, statistical analysis, assessment of alcohol intake, and in diagnosing diseases and causes of death, no precise limits of safe drinking can be recommended. Common sense should be cultivated. Heavy drinking and drunkenness should be discouraged.