Associations between self‐reported illness and non‐drinking in young adults

Fat, Linda Ng; Shelton, Nicola

doi:10.1111/j.1360-0443.2012.03878.x

Cited by 55 publications

(59 citation statements)

References 21 publications

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“…Thus, if occasional drinkers were used as the reference group (as recommended by some epidemiologists, e.g., Rehm et al, 2008), low-volume drinkers would have RRs close to unity in each of these models (i.e., not be experiencing health protective effects). Evidence that lifetime abstainers have poorer health even before their peers begin drinking (Ng Fat & Shelton, 2012) also provides some support for choosing occasional drinkers as the reference group and is consistent with the observation of increased mortality risk for abstainers (RR = 1.19, 95% CI [1.12, 1.27]) versus occasional drinkers shown in Table 2.…”

Section: Summary Of Evidencesupporting

confidence: 74%

Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Stockwell

Zhao

Panwar

et al. 2016

J. Stud. Alcohol Drugs

434

350

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ABSTRACT. Objective: Previous meta-analyses of cohort studies indicate a J-shaped relationship between alcohol consumption and allcause mortality, with reduced risk for low-volume drinkers. However, low-volume drinkers may appear healthy only because the "abstainers" with whom they are compared are biased toward ill health. The purpose of this study was to determine whether misclassifying former and occasional drinkers as abstainers and other potentially confounding study characteristics underlie observed positive health outcomes for lowvolume drinkers in prospective studies of all-cause mortality. Method: A systematic review and meta-regression analysis of studies investigating alcohol use and mortality risk after controlling for quality-related study characteristics was conducted in a population of 3,998,626 individuals, among whom 367,103 deaths were recorded. Results: Without adjustment, meta-analysis of all 87 included studies replicated the classic J-shaped curve, with low-volume drinkers (1.3-24.9 g ethanol per day) having reduced mortality risk (RR = 0.86, 95% CI [0.83, 0.90]).Occasional drinkers (<1.3 g per day) had similar mortality risk (RR = 0.84, 95% CI [0.79, 0.89]), and former drinkers had elevated risk (RR = 1.22, 95% CI [1.14, 1.31]). After adjustment for abstainer biases and quality-related study characteristics, no significant reduction in mortality risk was observed for low-volume drinkers (RR = 0.97, 95% CI [0.88, 1.07]). Analyses of higher-quality bias-free studies also failed to find reduced mortality risk for low-volume alcohol drinkers. Risk estimates for occasional drinkers were similar to those for low-and medium-volume drinkers. Conclusions: Estimates of mortality risk from alcohol are significantly altered by study design and characteristics. Meta-analyses adjusting for these factors find that low-volume alcohol consumption has no net mortality benefit compared with lifetime abstention or occasional drinking. These findings have implications for public policy, the formulation of low-risk drinking guidelines, and future research on alcohol and health. (J. Stud. Alcohol Drugs, 77, 185-198, 2016)

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Section: Summary Of Evidencesupporting

confidence: 74%

Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Stockwell

Zhao

Panwar

et al. 2016

J. Stud. Alcohol Drugs

434

350

View full text Add to dashboard Cite

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“…Effective programs to combat alcohol abuse should address an array of factors [49][50][51]. Socially relevant competencies including family, peers, neighborhood climate, geographical location and association between alcohol and other substances, beliefs, attitudes, self-efficacy, and environmental factors need to be further explored regarding Hispanic young adults' involvement in alcohol use [41,52,53].…”

Section: Discussionmentioning

confidence: 99%

Social Determinants of Alcohol Use and Heaving Episodic Drinking Among Hispanic Young Adults

King¹,

Frank²,

Vidourek³

et al. 2018

J Behav Health

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Background: Although there are numerous preventive measures in the literature, a vast percentage of Hispanic young adults continue to engage in alcohol use and heavy episodic drinking. The purpose of the study was to examine social determinants of recent alcohol use and heavy episodic drinking among Hispanic young adults 18-25 years of age. Methods: In 2016, a secondary analysis (N = 3,452) was performed of 2012 National Survey on Drug Use and Health data. A series of logistic regression analyses were performed to determine whether recent alcohol use and heavy episodic drinking differed based on sex, education level, family income, employment status, location of residence (type of metro area), self-reported health status, first use of alcohol before age 21, first use of tobacco before age 21 and first use of marijuana before age 21. Results: Regarding alcohol use, 51.8% of Hispanic young adults reported that they had consumed alcohol in the past month and 35.0% reported that they had engaged in heavy episodic drinking. Hispanic young adults at highest risk for recent alcohol use were male, had some college or more, had high family income, were employed, lived in a large metropolitan area, had excellent/very good health status, and had early initiation of substance use. Those at highest risk for heavy episodic drinking were male, were employed, and had early initiation of substance use. Conclusion:The present study found that a sizeable percentage of Hispanic young adults are involved in recent alcohol use and heavy episodic drinking. Since Hispanic young adults are disproportionately at risk for substance use and scarce resources are available to effectively address the needs of this population, further interventions are warranted. Findings may aid prevention scientists in developing, implementing and evaluating alcohol use programs for this population.

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“…[4,5]). Other recent contributions include (i) the demonstration of systematic bias early in the life span caused by young adults who choose to be totally abstinent also having poorer health and lower incomes [6]; and (ii) the finding of apparent health benefits associated with moderate drinking from a large and improbably diverse range of diseases, including even liver cirrhosis [7]. Naimi et al [1] also suggest that the lowest risk of all-cause mortality is at a consumption level of only 7 g for men and 5 g for women, involving mainly a frequency of drinking unlikely to confer significant physiological benefits.…”

Section: How Do We Formulate Low-risk Drinking Guidelines If Zero Conmentioning

confidence: 99%

“…It would indeed be remarkable if a cognitive benefit could actually arise from prenatal exposure to a known neurotoxin, particularly when RCTs of supplementation with nutrients essential for development such as folate or docosahexaenoic acid (DHA) have not found significant benefit to the cognitive development of offspring [6]. Perhaps even more remarkable, after controlling for a large range of commonly reported confounders, observational data on drinking and health status appears to indicate that the protective effect is not limited to the moderate drinkers themselves but extends its beneficence to the health of the offspring of mothers and fathers who drink [7]. Surely, when such overtly suspect outcomes appear, we should be less inclined to bow to post-hoc rationalizations about plausible biological pathways and more inclined to look for residual confounding from social, economic, psychological and genetic sources.…”

Section: Fishy Cur Ves: a Case Of Bias And Confounding?mentioning

confidence: 99%

How do we formulate low‐risk drinking guidelines if zero consumption is lowest risk?

Stockwell

2013

Addiction

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HOW DO WE FORMULATE LOW-RISK DRINKING GUIDELINES IF ZERO CONSUMPTION IS LOWEST RISK?This thought-provoking paper by Naimi and colleagues [1] packs a great deal into a few short pages. The meat comprises elegant analyses which (i) demonstrate why drinking more frequently may not be better for the health of 'moderate' drinkers and (ii) illustrate further the serious confounding in uncontrolled observational studies of alcohol consumption and health. The discussion, however, also serves a generous helping of relish by raising sharp questions about whether health benefits from moderate drinking exist, at what dosage they may be optimal and what this all means for the formulation of low-risk drinking guidelines. Naimi et al. [1] conclude that such guidelines should advise drinkers to not exceed about half of one standard drink per day on average. I will make one comment on the empirical findings, and then suggest a difficulty with their broader argument about low-risk drinking guidelines. In a restricted sample of people who on average drink within the US Dietary Guidelines, the authors report an inverse relationship between quantity of alcohol consumed on a drinking day and drinking frequency. This should not be surprising because, as they acknowledge, if the total consumption of a sample of drinkers is restricted in this way such a relationship is mathematically inevitable. What is important, however, is that this inevitable relationship has also influenced findings in other studies, which appear to show that increased frequency of drinking is associated with improved health (e.g. [2,3]). Thus they illustrate why such empirical observations should not be interpreted as evidence to encourage people who drink a little to do so more often. It is also important that Naimi's sample of drinkers comprise not just a small subsample, but 87.2% of all current drinkers in this large representative US national survey. The so-called 'moderate' drinking category for average consumption per day used in such studies contains the great majority of people who drink and who evidence substantial heterogeneity in drinking patterns and health risk profiles. The additional finding, that infrequent drinkers have significantly elevated health risk factors, adds further to worries about systematic biases in longitudinal studies of alcohol and health. Just one such worry is the bias introduced by the common practice of including 'occasional drinkers' in the abstainer reference group [4], e.g. anyone who drinks less than once a month.Naimi et al. [1] contribute to a groundswell of scepticism about the veracity of observed health benefits of light to moderate drinking thought to underlie the observation of a J-shaped risk relationship between level of drinking and risk of all-cause mortality (e.g. [4,5]). Other recent contributions include (i) the demonstration of systematic bias early in the life span caused by young adults who choose to be totally abstinent also having poorer health and lower incomes [6]; and (ii) the finding of apparent hea...

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Associations between self‐reported illness and non‐drinking in young adults

Abstract: Young adults who have a limiting long-standing illness are more likely not to drink alcohol even after adjusting for a range of social and demographic measures. Studies on the putative health benefits of moderate alcohol consumption later in life need to take account of early life history.

Cited by 55 publications

References 21 publications

Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality

Social Determinants of Alcohol Use and Heaving Episodic Drinking Among Hispanic Young Adults

How do we formulate low‐risk drinking guidelines if zero consumption is lowest risk?

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