Thursday, 12 December 2013

Teetotallers still dying earlier

I've written about this before. There's already a mountain of evidence for it but it's always nice to have some more. A study published in Alcoholism: Clinical and Experimental Research followed 1,824 people over two decades and found that teetotallers died at twice the rate of moderate drinkers. No surprise there—let's face it, they haven't got much to live for. More interesting is the fact that even heavy drinkers lived longer than teetotallers.

Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk.

The usual objection to this finding is that some teetotallers are ex-alcoholics or sickly and therefore more likely to die anyway. This is the 'Sick Quitter Hypothesis' that Ben Goldacre mentions in Bad Science. Since he wrote that book, several studies have tested the hypothesis by excluding former drinkers and found that moderate drinkers still live longer. The authors of this new study do the same...

A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers.

Surely it is now time for the 'evidence-based' public health lobby to campaign for cheaper alcohol? How many more people are they prepared to see die?

Merry Christmas!


Ben said...

Interesting result. But how can I become a moderate drinker and at the same time avoid becoming a light drinker. I haven't found any clear definition.

nisakiman said...

A valid point, Ben. What, exactly, is the definition of a 'moderate' drinker? Moderate by whose standards? Alcohol Concern would probably peg 'moderate' at three glasses of wine a week, whereas I consider my average of one bottle of red wine during the course of an evening as 'moderate'.

Steve Kelly said...

Indeed booze must be subsidized by the public health establishment. It should be free. Here's to your health!

JD said...

A blast from the past. Note that one of the authors is Archie Cochrane the founding guru of EBM...

Dan said...

The definitions used in the paper are as follows in grams of ethanol per day (ethanol is 789 g/litre)

Abstiner: 0
Light: 0 to 14
Moderate: 14 to 42
Heavy: 42 or more.

One unit of alcohol is 7.9 grams, or 10 ml of pure ethanol. The definition of a moderate drinker is therefore between just under 2 units up to just over 5 units per day.

By contrast, Government health advisories on alcohol recommend regular consumption of alcohol should be below 3 to 4 units per day for men, or 2 to 3 for women. As you are no doubt aware, these figures were arrived at not through evidence or experimentation, but by asking a panel of experts to pull figures out of the air (to put it politely).

The study clearly demonstrates the utter futility of this approach.