Alcohol abuse and mortality: a 40-year prospective study of Norwegian conscripts

The availability of a 40-yr prospective study of more than 40,000 Norwegian men born in 1932-33 constituted the point of departure for assessing excess mortality in alcohol abusers as well as proportions of premature deaths in men attributable to alcohol abuse. The conscripts were medically examined at the military screening, alcohol abuse was categorized for those registered as admitted to alcohol treatment units over a 35-yr period from 1951 to 1987, and these data were further linked to the national death register in 1991. A total of 4468 men died before the age of 60 (10.8% of the sample). Alcohol abusers were found to have an overall excess mortality of 3.3, increasing with age. The cumulative risk of death before the age of 60 yr was estimated to 0.405 for the alcohol abusers, and at least 6.7% of all deaths before the age of 60 could be attributed to alcohol abuse. Presence of chronic diseases at conscription did not confound the estimates of excess mortality in alcohol abusers, neither was any significant interaction between chronic diseases at conscription and later alcohol abuse found with respect to mortality. The most prevalent causes of death in the total sample were, in descending order, cardiovascular diseases, malignant tumors, and accidents. The relative risks for alcohol abusers of death from accidents,cardiovascular diseases, and malignant tumors were estimated as 3.2, 2.5, and 1.8, respectively.