Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: Results from a prospective cohort study of Scottish men with 21 years of follow up

Objectives To relate alcohol consumption to mortality. Design Prospective cohort study. Setting 27 workplaces in the west of Scotland. Participants 5766 men aged 35-64 when screened in 1970-3 who answered questions on their usual weekly alcohol consumption. Main outcome measures Mortality from all causes, coronary heart disease, stroke, and alcohol related causes over 21 years of follow up related to units of alcohol consumed per week. Results Risk for all cause mortality was similar for non-drinkers and men drinking up to 14 units a week. Mortality risk then showed a graded association with alcohol consumption (relative rate compared with non-drinkers 1.34 (95% confidence interval 1.14 to 1.58) for 15-21 units a week, 1.49 (1.27 to 1.75) for 22-34 units, 1.74 (1.47 to 2.06) for 35 or more units). Adjustment for risk factors attenuated the increased relative risks, but they remained significantly above 1 for men drinking 22 or more units a week. There was no strong relation between alcohol consumption and mortality from coronary heart disease after adjustment A strong positive relation was seen between alcohol consumption and risk of mortality from stroke,with men drinking 35 or more units having double the risk of non-drinkers, even after adjustment. Conclusions The overall association between alcohol consumption and mortality is unfavourable for men drinking over 22 units a week, and there is no clear evidence of any protective effect for men drinking less than this.