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 quest ions on their usual weekly alcohol consumption. Main outcome measures Mortality from all causes, coronary heart disease, st roke, and alcohol related causes over 21 years of follow up related to unit s of alcohol consumed per week. Results Risk for all cause mortality was similar for non-drinkers and men d rinking up to 14 units a week. Mortality risk then showed a graded associat ion 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). Adjust ment for risk factors attenuated the increased relative risks, but they rem ained significantly above 1 for men drinking 22 or more units a week. There was no strong relation between alcohol consumption and mortality from coro nary heart disease after adjustment A strong positive relation was seen bet ween alcohol consumption and risk of mortality from stroke,with men drinkin g 35 or more units having double the risk of non-drinkers, even after adjus tment. Conclusions The overall association between alcohol consumption and mortali ty is unfavourable for men drinking over 22 units a week, and there is no c lear evidence of any protective effect for men drinking less than this.