Systematic differences among never, occasional and moderate alcohol users in southern China, and its use in alcohol research: a cross-sectional study

Abstract

Observations in alcohol epidemiology may be affected by confounding due to contextually specific systematic differences. Results from a particular setting should not be interpreted as causal unless they are verified in different populations and, preferably, in non-observational studies.

Alcohol consumption and cardiovascular diseases in rural China

“…Consistent with other studies [27][28][29], we found that the drinking status was significantly different between men and women. Men had higher rate of alcohol consumption per day and a higher prevalence of being heavy drinkers than women.…”

Aldehyde dehydrogenase 2—a potential genetic risk factor for lung function among southern Chinese: evidence from the Guangzhou Biobank Cohort Study

“…About half the men (48%) were never alcohol users, 28% occasional users, 11% moderate users, 7% heavy users and 6% formers users; 63% of women were never users, 29% occasional users, 3% moderate, 0.4% heavy and 4% former users. Moderate alcohol use is associated with a slightly lower socio-economic position and less healthy lifestyle among men but not women in this study (5). Mean % predicted FEV 1 was 94.4% and FVC 93.4%.…”

“…On the other hand, the use of a setting with different social patterning of alcohol use to verify associations in studies where there are marked differences in health attributes among alcohol users is an alternative way to verify whether these associations are due to residual confounding when randomized controlled trials are not feasible (5). Previous East Asian studies showing positive associations of moderate alcohol use with lung function did not control for ALDH2 (6,8), which may be a potential confounder in Asian populations.…”

“…However, this association is difficult to interpret because moderate alcohol users in western populations tend to have more healthy attributes than never users (4). Replication of these findings in a setting with a different social patterning of alcohol use, such as among Chinese (5), is one way to assess if associations seen in western studies are biologically based or a contextually specific artifact of confounding. In Chinese settings alcohol use is also associated with better lung function and lower mortality from chronic obstructive pulmonary disease (6)(7)(8)(9), suggesting the associations seen may be generic.…”

Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts

“…22 In contrast, alcohol consumption is less normative among the Chinese population, and Chinese moderate drinkers have been shown to have less healthy attributes than abstainers. 20,[23][24][25][26] We sought to examine the longitudinal relation between changes in drinking patterns and changes in physical and mental well-being in the Hong Kong Special Administrative Region, China. We further sought to externally validate our findings in a US population to clarify the relevance of the findings across populations.…”