Background: Moderate consumption of alcohol reduces general mortality among middle-aged and elderly persons through a reduction in cardiovascular risk. Furthermore, higher consumption of wine is associated with lower cardiovascular mortality in northern Spain. This information may be used to promote moderate consumption of alcoholic beverages in Spain. However, alcohol consumption is influenced by the drinking habits of the individual's social environment. Therefore, we examine the relation between average consumption of alcohol and the prevalence of heavy drinkers, who most often have adverse effects from alcohol, and the prevalence of abstainers, who do not benefit from alcohol, in Spain.
Methods: Spain's 17 administrative regions are the units of analysis. Alcohol consumption data were taken from the 1993 National Health Survey. Data were analyzed using weighted correlation coefficients and linear regression.
Results and conclusions: Mean alcohol consumption among moderate drinkers showed a positive correlation with the proportions of men (r = 0.63; p = 0.007) and women (r = 0.58; p = 0.015) whose alcohol intake was above the 90th percentile of consumption distribution. Similar results were yielded when median rather than mean consumption was used, and when heavy drinking was defined as the consumption of 210 g and 140 g of alcohol per week, in men and women, respectively. The association also was observed across all ages and all types of beverages. However, no statistically significant association was seen between mean and median alcohol consumption and the proportion of abstainers.
Significance: Moderate consumption of alcohol is associated with the prevalence of heavy drinkers in all regions of Spain. Therefore, promotion of moderate consumption of alcohol in Spain might be associated with a rise in the prevalence of heavy drinkers, those who most frequently suffer the harmful effects of alcohol.