Alcohol consumption in relation to 20-year COPD mortality and pulmonary function in middle-aged men from three European countries

Alcohol consumption shows a U-shaped relation with all-cause and cardiovasc ular mortality. To determine whether a similar relation exists between alco hol and chronic obstructive pulmonary disease mortality, we analyzed data o n alcohol consumption in 1970 and 20-year mortality from chronic obstructiv e pulmonary disease among 2,953 middle-aged men from Finland, Italy, and th e Netherlands. We also studied alcohol consumption in relation to pulmonary function (FEV1 or FEV0.75) at baseline. We used regression models adjusted for age, height (for pulmonary function only), body mass index, smoking ha bits, energy intake, and country. A smoothed spline-plot showed a U-shaped relation between alcohol and chronic obstructive pulmonary disease mortalit y. Compared with non-drinkers and occasional drinkers, the relative risk of chronic obstructive pulmonary disease mortality was 0.60 (95% CI = 0.33-1. 09) in light drinkers (>1 drink per week, less than or equal to3 drinks per day) and 1.25 (95% CI = 0.47-3.31) in moderate-to-heavy drinkers. Pulmonar y function was lower in nondrinkers compared with occasional and light drin kers in Finland (75 mi, 95% CI = -2 to 151) and the Netherlands (93 ml, 95% CI = 0-186) and lower in very heavy (>12 drinks per day) compared with mod erate-to-heavy drinkers in Italy (99 mi, 95% CI = 9-189). In conclusion, we observed a U-shaped curve between alcohol consumption and 20-year chronic obstructive pulmonary disease mortality in middle aged men that was support ed by cross-sectional data on alcohol and pulmonary function.