Alcohol abstinence and mortality in a general population sample of German adults: a cohort study

Release date: November 2, 2021

https://doi.org/10.1371/journal.pmed.1003819

DESCRIPTION

Previous studies have suggested that people who abstain from alcohol have higher mortality rates than those who drink small to moderate amounts, but little is known about the factors that may be responsible for this finding.

The purpose of this study was to analyze previous alcohol or drug use disorders, risky drinking, smoking, and poor health among those who reported abstaining from drinking in the past 12 months prior to baseline on 20-year total mortality, cardiovascular mortality, and cancer mortality.

Standardized interviews were conducted in 1996-1997 with a random sample of the general population of northern Germany aged 18-64 years. Baseline assessments included 4,093 individuals (70.2% of the eligible population); vital status and death certificate data were obtained in 2017 and 2018.

Among the abstinence study participants at baseline (447), 405 (90.60%) were found to be former alcohol consumers, and 322 (72.04%) of the abstainers had previous alcohol or drug dependence, abuse and risky drinking of alcohol, attempted to reduce or stop drinking, were daily smokers, and or met one or more of the self-rated criteria for their health status.

Of the abstainers who had one or more of these risk factors, 114 (35.40%) had an alcohol use disorder or risky alcohol consumption in their history, and another 161 (50.00%) were daily smokers, although they had no such alcohol-related risks.

The 322 abstinence study participants with one or more risk factors had a shorter time to death than those with low to moderate alcohol consumption, with a Cox proportional hazard ratio (HR) of 2.44. (95% confidence interval (CI), 1).

The 125 abstainers without these risk factors (27.96% of abstainers) did not show statistically significant differences in cardiovascular, and cancer mortality from low to moderate alcohol consumers.

These analyses showed that the majority of baseline alcohol abstainers were former alcohol consumers and had risk factors that increased the likelihood of early death, and that past alcohol use disorders, hazardous drinking, daily cigarette smoking, and moderate to poor health were associated with early death among alcohol abstainers.

Those with no apparent history of these risk factors had a life expectancy similar to that of low to moderate alcohol consumers. The researchers disagree with the recommendation to drink alcohol for health reasons.