Alcohol and life expectancy

Abstract

The recent three leading risk factors for global disease burden in the world are, in descending order, high blood pressure, tobacco smoking including second-hand smoke, and alcohol use. Alcohol use increases the risk for many acute and chronic health consequences including cancer, road injury and suicide as well as alcohol use disorder. It is known that there is a U- or J-shaped relationship between alcohol consumption and all-cause mortality. The descending leg of the curve showing this relationship is best explained by a decrease in the risk of cardiovascular disease, especially ischemic heart disease, among light-to-moderate alcohol drinkers. However, this relationship carries risks of confounding and selection bias, including the so-called healthy drinker bias. Furthermore, biogenic compounds other than ethanol present in wine may be partially responsible for the beneficial effect, although this also includes several confounding factors such as the drinking patterns associated with wine preference. While some studies suggest that light-to-moderate alcohol consumption may offer cardiovascular benefits, these findings are likely influenced by confounding factors and do not negate the substantial public health burden associated with alcohol use. In fact, from a population health perspective, reducing harmful alcohol consumption remains a critical priority. Social policies aimed at lowering alcohol intake and limiting drinking opportunities can contribute to longer life expectancy by preventing alcohol-related diseases. Unhealthy alcohol use is one of the four major behavioral risk factors—along with smoking, physical inactivity, and poor diet—that accounted for approximately 50% of all deaths and about six years of life expectancy lost between 2001 and 2008. Targeted interventions are particularly important for men and individuals with lower educational attainment, as alcohol-related mortality is higher in men and contributes more to socioeconomic disparities in life expectancy among men than among women. Alcohol consumption is influenced by socioeconomic factors such as education, income, and occupation. While higher socioeconomic status is associated with more frequent drinking, lower status is associated with higher consumption volume. Given that alcohol-related deaths and life expectancy trends vary across countries and over time, public health strategies should be tailored to specific social and temporal contexts.