Association of alcohol consumption to mortality and person-years of life lost in Switzerland ? Measuring the impact of some methodological options

Abstract

The hypothetical situation decisively impacts on the number of deaths attributable to alcohol. In contrast, it has much less influence on the number of alcohol-related PYLL. Thus, mortality is at least a questionable indicator of alcohol-related health outcomes. The study also indicated that more lives and PYLL were saved in the low-risk situation than in the abstinence situation. Public health policies should not concentrate on the promotion of abstinence.

Alcohol-attributable mortality in Switzerland in 2011 – age-specific causes of death and impact of heavy versus non-heavy drinking

“…This indicates that, especially for women, even low levels of alcohol may not be advisable, which is corroborated by the fact that the number of deaths by breast cancer due to non-heavy drinking alone exceeded the total beneficial effects of alcohol in women between 15 and 74 years old. This finding is also consistent with earlier reviews [14] and was confirmed by a recent meta-analysis on light drinking (one drink or less), showing that a relevant share of breast cancer mortality is caused by light to moderate drinking [51]. Thus, particularly for women, preventive actions that target alcohol use at all levels and not only heavy drinking are important.…”

“…Protective effects only occurred in non-heavy drinkers and never outnumbered deaths or YLL in any age group. Protective effects of alcohol consumption have received significant attention in the past and were estimated to be high in earlier studies in Switzerland [14,46]. In the estimate for the year 1998 [14], prevented deaths even outweighed caused deaths over all age groups.…”

“…Protective effects of alcohol consumption have received significant attention in the past and were estimated to be high in earlier studies in Switzerland [14,46]. In the estimate for the year 1998 [14], prevented deaths even outweighed caused deaths over all age groups. This conflicting findings [14] were mainly due to the oldest age group of 75+ years, i.e.…”

“…In Switzerland, there is a good availability of data to estimate alcohol consumption, and the corresponding causes contributing to the overall mortality, and can thus serve as an example for established market economies in Europe. There are earlier estimates of alcohol-attributable mortality for Switzerland [5,14,15] but those estimates have become outdated, the last one using data from the year 2004. As noted above, the methods have received considerable updates; newer relative risk estimates from meta-analyses have been integrated [9], and mortality caused by some diseases, for example tuberculosis, have been shown to be causally attributable to alcohol and are now included in estimates of alcohol-attributable harm [16].…”

Importance of Pattern of Alcohol Consumption

“…[5][6][7] For developed nations, epidemiological studies estimate that a population with more moderate drinkers and fewer abstainers will have lower rates of cardiovascular disease and total mortality. 5,6,8 In fact, guidelines for sensible drinking developed in the United Kingdom suggest that "middle aged or elderly men and post-menopausal women who drink infrequently or not at all may wish to consider the possibility that light drinking might benefit their health." 9 Still, the absence of a clinical trial for the effects of alcohol on cardiovascular disease and mortality forces us to use observational data and studies of the effects of alcohol on risk factors to make recommendations encouraging alcohol use, a condition some physicians remain reluctant to accept.…”