Increased mortality risk among current alcohol abstainers might largely be explained by other factors, including previous alcohol or drug problems, daily smoking, and overall poor health, according to a new by Ulrich John of University Medicine Greifswald, Germany, and colleagues.

Previous studies have suggested that people who abstain from alcohol have a higher mortality rate than those who drink low to moderate amounts of alcohol. In the new study, researchers used data on a random sample of 4,028 German adults who had participated in a standardised interview conducted between 1996 and 1997, when participants were 18 to 64 years old. Hence, baseline data were available on alcohol drinking 12 months before the interview and other health, alcohol, and drug use information. Besides, mortality data were available from follow-up 20 years later.

447 (11.10%) had not drunk any alcohol 12 months before the baseline interview among the study participants. Of these abstainers, 405 (90.60%) were former alcohol consumers, and 322 (72.04%) had one or more other risk factors for higher mortality rates, including a former alcohol-use disorder or risky alcohol consumption  (35.40%), daily smoking (50.00%), or fair to poor self-rated health (10.51%). The 125 alcohol abstinent persons without these risk factors did not show a statistically significant difference in total, cardiovascular or cancer mortality compared to low to moderate alcohol consumers. Those who had stayed alcohol abstinent throughout their life had a hazard ratio of 1.64 compared to low to moderate alcohol consumers after adjustment for age, sex and tobacco smoking.

The results support the view that people in the general population who are currently abstinent from alcohol do not necessarily have a shorter survival time than those with low to moderate alcohol consumption.

However, the findings speak against recommendations to drink alcohol for health reasons. It has long been assumed that low to moderate alcohol consumption might positively affect health based on the finding that alcohol abstainers seemed to die earlier than low to moderate drinkers.

However, the study found that the majority of the abstainers had alcohol or drug problems, risky alcohol consumption, daily tobacco smoking or fair to poor health in their history, i.e., factors that predict early death.

Source: PLOS Medicine