Alcohol, smoking and lung disease

Alcohol and smoking are two well-known health hazards. Alcohol and tobacco consumption are strongly correlated and heavy drinkers have more trouble qu itting smoking than do light drinkers. Death from tobacco-related causes wa s more common than alcohol-related death in a follow-up study on patients a dmitted to an addiction programme for treatment of alcoholism and non-nicot ine drug dependence. In British male doctors in the middle and elderly age group, a protective effect of light and moderate alcohol consumption (1-3 B ritish units of alcohol per day) compared with abstinence has been shown in one large survey. This protective effect was shown in overall mortality as well as in mortality from respiratory disease. Higher alcohol intakes were associated with an increase in mortality. Tis characteristic U-formed, or J-formed, dose-response curve has been found in most studies with an appare nt beneficial effect of modest alcohol intake and a harmful effect of high intakes. The anti-inflammatory effect of alcohol has been considered to be responsible for its limited protective effect on smoking-related lung funct ion decline. Recently, a hitherto unconfirmed report suggests that the bene ficial effect of alcohol on lung function in men is restricted to subjects with Lewis-negative blood group (10% of the Caucasian population). On the o ther hand, the protective effect in those individuals is large enough to be clinically relevant. Prospective investigations including both men and wom en are needed to elucidate which individuals have a protective effect of li ght and moderate alcohol intake. The major deleterious effect of smoking, i ncluding passive smoking, must be kept in mind-drinking alcohol surrounded by cigarette smoke might not be beneficial for respiratory health.