Long-Term Alcohol Use and Mortality Among Swedish Women

In a follow-up analysis of 49,259 women aged 30-49 at baseline in the Swedish Women’s Lifestyle and Health cohort, researchers used self-reported information on alcohol consumption* on 2 occasions, 12 years apart, to estimate the effects of alcohol on overall and cause-specific mortality. There were 2100 deaths during follow-up.

• Compared with participants with “light” average consumption, there was an inverse association between greater amounts of alcohol consumption and mortality from cardiovascular disease, but no significant effect on the risk of death from cancer or overall mortality.
• There was an increased risk of cardiovascular and total mortality for abstainers.
• Women who stopped drinking had higher mortality.

* Authors specified 5 categories of alcohol consumption (0.1–1.49 g per day [“light,” reference group], 1.5–4.9, 5–9.9, 10–14.9, and ≥15).

Comments: The relatively narrow ranges of alcohol intake meant that the numbers of participants in many groups were quite small, which may explain some of the non-significant differences in risk. Researchers reported average consumption (not actual consumption in a day or heavy drinking days), did not include type of beverage, or whether or not alcohol was usually consumed with meals; such information may have better delineated the true effects of alcohol. Importantly, the reasons that caused participants to change their intake are unknown; if due to the development of a serious disease, it may be the disease that relates to subsequent mortality and not the drinking. However, given the inherent problems in assessing change, the results of this study are consistent with others that have reported increased mortality for people with “moderate” drinking who stop their alcohol consumption.

R. Curtis Ellison, MD

Reference: Licaj I, Sandin S, Skeie G, et al. Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort. BMJ Open. 2016;6:e012862.