AIMS: It is generally accepted, but not yet documented that the risk of future alcoholism increases with the amount of alcohol consumed. The objective of this study was to investigate this association using the Copenhagen City Heart Study.
METHODS: Quantity and frequency of alcohol intake was measured in 19 698 men and women randomly drawn from the Copenhagen Population Register in 1976-78. The study population was linked to three different registers in order to detect alcoholism, and average follow-up time was 25 years.
RESULTS: After adjustment for all putative confounders, the risk of alcoholism for women increased significantly at 1-7 drinks per week with a hazard ratio (HR) of 2.02 (95% confidence interval (CI): 1.16, 3.53) compared to never/almost never drinking; the HR for drinking monthly was 1.75 (95% CI: 1.08, 2.85). The risk for men did not increase significantly before 22-41 drinks per week (HR = 3.81, 95 % CI: 2.18, 6.68) or if they had a daily alcohol intake (HR = 3.55, 95 % CI: 2.11, 5.99). Smoking was independently associated with the risk of alcoholism for both men and women.
CONCLUSION: The risk of developing alcoholism increased significantly by very low intakes of alcohol in women, while the risk is only increased significantly in men consuming more than 21 drinks per week.
The objective of this paper was to determine separately the lifetime risk of drinking alcohol for chronic disease and acute injury outcomes as a basis for setting general population drinking guidelines for Australia. Relative risk data for different levels of average consumption of alcohol were combined with age, sex, and disease-specific risks of dying from an alcohol-attributable chronic disease. For injury, combinations of the number of drinks per occasion and frequency of drinking occasions were combined to model lifetime risk of death for different drinking pattern scenarios. A lifetime risk of injury death of 1 in 100 is reached for consumption levels of about three drinks daily per week for women, and three drinks five times a week for men. For chronic disease death, lifetime risk increases by about 10% with each 10-gram (one drink) increase in daily average alcohol consumption, although risks are higher for women than men, particularly at higher average consumption levels. Lifetime risks for injury and chronic disease combine to overall risk of alcohol-attributable mortality. In terms of guidelines, if a lifetime risk standard of 1 in 100 is set, then the implications of the analysis presented here are that both men and women should not exceed a volume of two drinks a day for chronic disease mortality, and for occasional drinking three or four drinks seem tolerable.
BACKGROUND: Studies have indicated an increasing proportion of heavy drinking among middle-aged and older Danes. Trends in consumption are often extremely sensitive to influence from various components of the time trends but only few have explored the age, period and cohort-related influences on late life alcohol consumption. By using age, period, and cohort modeling this study explores the time trends in heavy drinking.
METHODS: Data derive from five National Health and Morbidity Surveys conducted by the Danish National Institute of Public Health in 1987, 1994, 2000, 2003, and 2005. A total of 15,144 randomly selected Danes between the age of 50 and 74 were interviewed about their alcohol intake on the last weekday and their alcohol intake in the last week. By applying the age-period-cohort model the probability of heavy alcohol drinking is estimated to separate the influence of age, period (calendar time) and cohort (year of birth).
RESULTS: The unadjusted probability of heavy drinking declines by age and increases by calendar year and year of birth for both men and women. However, the negative effect of age is attenuated for women when adjusted for birth cohort, indicating that the proportion of heavy drinking women increases in younger birth cohorts. This trend is not observed for men as their drinking pattern mainly increase slightly by calendar year.
CONCLUSIONS: Our Danish observations for older aged individuals correspond to the social and cultural changes in the 1960s and 1970s that possibly have affected the drinking behavior of the cohorts. Time trend analyses, such as this may serve as an excellent opportunity to extrapolate and forecast alcohol mortality and morbidity.