ALCOHOL AND MORTALITY IN BRITISH MEN: EXPLAINING THE U-SHAPED CURVE
Abstract
In a prospective study of 7735 middle-aged 7 British men, 504 of whom died in a follow-up period of 7.5 years, there was a U-shaped relationship between alcohol intake and total mortality and an inverse relationship with cardiovascular mortality, even after adjustment for age, cigarette smoking, and social class. These mortality patterns were seen in all smoking categories (with ex-smoking non-drinkers having the highest mortality) and were observed in manual but not in non-manual workers. The alcohol-mortality relationships (total and cardiovascular) were present only in men with cardiovascular or cardiovascular-related doctor-diagnosed illnesses at initial examination. The data suggest that the observed alcohol-mortality relationships are produced by pre-existing disease and by the movement of men with such disease into non-drinking or occasional-drinking categories. The concept of a "protective" effect of drinking on mortality, ignoring the dynamic relationship between ill-health and drinking behaviour, is likely to be ill founded.
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Using last-year abstention may bias results by introducing sick-quitters.
“using last‐year abstention may bias results by introducing sick‐quitters 348”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [348]
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- Authors
- Shaper, A. G., Wannamethee, G., & Walker, M.
- Affiliations
- The Royal Free Hospital (GB)
- ORCID
- Walker, Mary
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1988-12
- Volume
- 332
- Issue
- 8623
- Pages
- 1267-1273
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2048919469
- Cited by
- 780
- References
- 32
- Citations by year
- 2026: 19 · 2025: 10 · 2024: 20 · 2023: 14 · 2022: 21 · 2021: 22 · 2020: 22 · 2019: 31 · 2018: 27 · 2017: 19 · 2016: 33 · 2015: 20 · 2014: 28 · 2013: 26 · 2012: 19
- FWCI
- 15.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Keywords
- alcohol consumption, mortality, U-shaped curve, cardiovascular mortality, all-cause mortality, middle-aged men, smoking, social class, blue-collar workers, pre-existing disease, drinking behavior
- MeSH terms
- Alcohol Drinking, Alcoholism, Cardiovascular Diseases, Follow-Up Studies, United Kingdom, Humans, Male, Middle Aged, Risk Factors, Smoking, Social Class
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