Higher mortality among alcohol abstainers is mostly due to prior health risks, not abstinence itself. Healthy non-drinkers live just as long as moderate drinkers.
Increased mortality risk among current alcohol abstainers might largely be explained by other factors, including previous alcohol or drug problems, daily smoking, and overall poor health, according to a new study published on November 2nd, 2021, in PLOS Medicine by Ulrich John of University Medicine Greifswald, Germany, and colleagues.
Previous studies have suggested that people who abstain from alcohol have a higher mortality rate than those who drink low to moderate amounts of alcohol. In the new study, researchers used data on a random sample of 4,028 German adults who had participated in a standardized interview conducted between 1996 and 1997, when participants were 18 to 64 years old. Baseline data were available on alcohol drinking in the 12 months prior to the interview, as well as other information on health, alcohol, and drug use. Mortality data were available from follow-up 20 years later.
Most Abstainers Had Past Alcohol or Health Problems
Among the study participants, 447 (11.10%) had not drunk any alcohol in the 12 months prior to the baseline interview. Of these abstainers, 405 (90.60%) were former alcohol consumers and 322 (72.04%) had one or more other risk factor for higher mortality rates, including a former alcohol-use disorder or risky alcohol consumption (35.40%), daily smoking (50.00%), or fair to poor self-rated health (10.51%). The 125 alcohol-abstinent persons without these risk factors did not show a statistically significant difference in total, cardiovascular or cancer mortality compared to low to moderate alcohol consumers, and those who had stayed alcohol abstinent throughout their life had a hazard ratio of 1.64 (95% CI 0.72-3.77) compared to low to moderate alcohol consumers after adjustment for age, sex and tobacco smoking.
“The results support the view that people in the general population who currently are abstinent from alcohol do not necessarily have a shorter survival time than the population with low to moderate alcohol consumption,” the authors say. “The findings speak against recommendations to drink alcohol for health reasons.”
John adds, “It has long been assumed that low to moderate alcohol consumption might have positive effects on health based on the finding that alcohol abstainers seemed to die earlier than low to moderate drinkers. We found that the majority of the abstainers had alcohol or drug problems, risky alcohol consumption, daily tobacco smoking or fair to poor health in their history, i.e., factors that predict early death.”
Reference: “Alcohol abstinence and mortality in a general population sample of adults in Germany: A cohort study” by Ulrich John, Hans-Juergen Rumpf, Monika Hanke and Christian Meyer, 2 November 2021, PLoS Medicine.
DOI: 10.1371/journal.pmed.1003819
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