Daily Drinking Is Associated with Increased Mortality

Abstract

Background: There is evidence that low-level alcohol use, drinking 1–2 drinks on occasion, is protective for cardiovascular disease, but increases the risk of cancer. Synthesizing the overall impact of low-level alcohol use on health is therefore complex. The objective of this paper is to examine the association between frequency of low-level drinking and mortality. Methods: Two datasets with self-reported alcohol use and mortality follow-up were analyzed: N=340,668 individuals from the National Health Interview Survey (NHIS); and N=93,653 individuals from the Veterans Health Administration (VA) outpatient medical records. Survival analyses were conducted to evaluate the association between low-level drinking frequency and mortality. Results: The minimum risk drinking frequency among those who drink 1–2 drinks per occasion was found to be 3.2 times weekly in the NHIS data, based on a continuous measure of drinking frequency, and 2–3 times weekly in the VA data. Relative to these individuals with minimum risk, individuals who drink 7 times weekly had an adjusted hazard ratio (HR) of all-cause mortality of 1.23 (p<0.0001) in the NHIS data, and individuals who drink 4–7 times weekly in the VA data also had an adjusted HR of 1.23 (p=0.01). Secondary analyses in the NHIS data showed that the minimum risk was drinking 4 times weekly for cardiovascular mortality, and drinking monthly or less for cancer mortality. The associations were consistent in stratified analyses of men, women, and never-smokers. Conclusion: The minimum risk of low-level drinking frequency for all-cause mortality appears to be approximately 3 occasions weekly. The robustness of this finding is highlighted in two distinctly different datasets: a large epidemiological dataset, and a dataset of veterans sampled from an outpatient clinic. Daily drinking, even at low-levels, is detrimental to one’s health.

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