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Alcohol consumption and mortality: modelling risks for men and women at different ages

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7357.191 (Published 27 July 2002) Cite this as: BMJ 2002;325:191

Rapid Response:

Re: Alcohol consumption and mortality: modelling risks for men and women at different ages

In their recently published paper, White, Altmann and Nanchahal, BMJ
2002 (1) reported the existence of a direct dose-response relationship
between alcohol consumption and risk of death in women aged 16-54 and in
men aged 16-34, whereas at older ages the relation is U shaped.

However a significant methodological issue related to the assessment
of lifetime alcohol consumption that may affect the conclusions was not
discussed in the paper.
The non-drinkers group could be mainly composed of ex-heavy drinkers (2)
(3), who became abstainers. And this is more likely to be true with the
"old ages" group, where due to alcohol related health issues ex-drinkers
may become "non-drinkers" (3).
If the data used allows it, the "non-drinking" group should be separated
into "ex-heavy drinkers", "ex-moderated drinkers", and "lifetime
abstainers" or any other classification assessing former drinking
patterns.
If the data does not allow assessing former drinking behavior in the "non-
drinking" group, the authors should discuss this as a limitation of they
study.

1. White IR, Altmann DR, Nanchahal K. Alcohol consumption and
mortality: modelling risks for men and women at different ages. British
Medical Journal 2002: 325: 191.

2. Shaper AG. Alcohol and mortality: a review of prospective studies.
Br J Addict 1990;85:837-47.

3. Sarr M. Re: "Alcohol consumption and coronary heart disease
morbidity and mortality." (Letter). Am J Epidemiol 1999;149:682-3.

Competing interests: No competing interests

02 August 2002
Moussa Sarr
Senior Study Director
Westat, Inc., 1441 West Montgomery Blvd, WB466