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Alcohol consumption and mortality among middle-aged and elderly U.S. adults
1Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30329-4251, USA.
The New England Journal of Medicine
|December 11, 1997
Summary
Moderate alcohol consumption slightly reduced mortality in middle-aged and elderly adults. However, this benefit was smaller than the increased risk associated with tobacco use.
Area of Science:
- Epidemiology
- Public Health
- Cardiovascular Disease Research
Background:
- Alcohol consumption presents complex effects on survival, with both adverse and beneficial impacts.
- Understanding the net effect of alcohol on mortality is crucial for public health guidance.
Purpose of the Study:
- To investigate the balance between adverse and beneficial effects of alcohol consumption on mortality in a large U.S. adult population.
- To quantify the association between alcohol intake, cause-specific mortality, and overall survival.
Main Methods:
- A prospective study involving 490,000 U.S. adults (mean age 56) who reported alcohol and tobacco use.
- Follow-up over nine years included 46,000 deaths, with analysis of cause-specific mortality rates adjusted for risk factors.
- Examination of the relationship between drinking/smoking habits and the cumulative probability of death between ages 35 and 69.
Main Results:
- Alcohol consumption was linked to increased mortality from cirrhosis, alcoholism, specific cancers (mouth, esophagus, liver, breast in women), and external causes in men.
- Moderate daily alcohol intake (at least one drink) was associated with a 30-40% lower risk of death from all cardiovascular diseases in both men and women.
- Overall mortality rates were lowest with approximately one daily drink, with increased mortality observed at higher consumption levels, especially in younger adults with lower cardiovascular risk.
- Smoking approximately doubled the overall risk of death, a significantly larger impact than alcohol's effect.
Conclusions:
- Moderate alcohol consumption demonstrated a slight reduction in overall mortality among middle-aged and elderly individuals.
- The observed mortality benefits of alcohol were modest and contingent on factors like age and baseline cardiovascular risk.
- The risk increase associated with tobacco use was substantially greater than any potential mortality reduction from moderate alcohol intake.