Alcohol Consumption Levels as Compared With Drinking Habits in Predicting All-Cause Mortality and Cause-Specific Mortality in Current Drinkers

Mayo Clin Proc. 2021 Jul;96(7):1758-1769. doi: 10.1016/j.mayocp.2021.02.011.


Objective: To investigate the joint associations of amounts of alcohol consumed and drinking habits with the risks of all-cause mortality and cause-specific mortality.

Patients and methods: A total of 316,627 healthy current drinkers, with baseline measurements between March 13, 2006, and October 1, 2010, were included in this study. We newly created a drinking habit score (DHS) according to regular drinking (frequency of alcohol intake ≥3 times/wk) and whether consuming alcohol with meals (yes).

Results: During a median follow-up of 8.9 years, we documented 8652 incident cases of all-cause death, including 1702 cases of cardiovascular disease death, 4960 cases of cancer death, and 1990 cases of other-cause death. After adjustment confounders and amount of alcohol consumed, higher DHS was significantly associated with a lower risk of all-cause mortality, cardiovascular disease mortality, cancer mortality, or other-cause mortality (Ptrend<.001, Ptrend=.03, Ptrend<.001, and Ptrend<.001, respectively). We observed that the amount of alcohol consumed have different relationships with the risks of all-cause mortality and cause-specific mortality among participants with distinct drinking habits, grouped by DHS. For example, in the joint analyses, a J-shaped association between the amount of alcohol consumed and all-cause mortality was observed in participants with unfavorable DHS (Pquadratictrend=.02) while the association appeared to be U-shaped in participants with favorable DHS (Pquadratictrend=.003), with lower risks in those consuming greater than or equal to 50 g/wk and less than 300 g/wk.

Conclusion: Our results indicate that alcohol consumption levels have different relationships with the risk of mortality among current drinkers, depending on their drinking habits.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Drinking* / adverse effects
  • Alcohol Drinking* / epidemiology
  • Alcohol Drinking* / physiopathology
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Central Nervous System Depressants / metabolism
  • Central Nervous System Depressants / pharmacology
  • Correlation of Data
  • Ethanol* / metabolism
  • Ethanol* / pharmacology
  • Female
  • Follow-Up Studies
  • Hormesis
  • Humans
  • Male
  • Meals
  • Middle Aged
  • Mortality
  • Neoplasms / mortality*
  • Protective Factors
  • Risk Assessment*
  • Risk Factors
  • United States / epidemiology


  • Central Nervous System Depressants
  • Ethanol