The “sick quitters” effect re-examined

The current study appeared in the media headlines suggesting that moderate consumption of alcoholic beverages or the “odd glass of wine” after all does not confer any health benefits.

What has been done?

The study examined the relationship between the consumption of alcoholic beverages and all-cause, cardiovascular, and cancer mortality among a 4075 adults, aged 18-64, residing in and around a single city in northern Germany.

The authors spent a considerable effort identifying abstainers (individuals who reported not drinking any alcohol in the past year) in order to separate those who would likely be at increased mortality risk due to one or more health risk factors (alcohol use disorder, smoking, or self-rated poor health). Their hypothesis was that abstainers are mostly former drinkers and are more likely to be unhealthy (“sick quitters”); if so, the poor health of the abstainers’ group would make the moderate drinker group appear to have lower risk than it actually has.

The results indicated that both current and former risky drinking was associated with increased mortality risk. Smoking and self-reported fair or poor health were also independently associated with increased risk. The study did not provide an estimate of the independent effect of former heavy drinking, from smoking or health status.

The findings from the current study are generally consistent with a large body of previous research and underscore the importance of separating former drinkers from lifetime abstainers when examining the association between the consumption of alcoholic beverages and mortality or other health outcomes. Results also confirm other studies suggesting a combined effect of heavy drinking and smoking on mortality risk.

However, the results of this study may not be generalizable to other populations with different demographics, drinking patterns, or smoking prevalence. In addition, there was no distinction between the type of alcoholic beverages, drinking patterns (with the meal, alternating with water), diet and other lifestyle factors that may influence the disease and mortality risk were not assessed.

Source: John, U., Rumpf, H. J., Hanke, M., & Meyer, C. (2021). Alcohol abstinence and mortality in a general population sample of adults in Germany: A cohort study. PLoS medicine, 18(11), e1003819. https://doi.org/10.1371/journal.pmed.1003819

For more information about this abstract, click here.