I don’t drink alcohol. There are several reasons for it. One is that I just never developed the taste for it and find it unpleasant. Another is that Sri Lanka has a real drinking problem with many people drinking far too much too often and I had considerable first-hand awareness of the negative effects on them and their families and careers, which turned me off at an early age. The third is that on the solitary occasion where I had several drinks, I noticed that I was losing control of what I said and did, and it was not a pleasant feeling. As a result, I only drink wine on very rare occasions when offering a toast or something and have a beer once or twice a year at events where there is no alternative.
But recently there has been a lot of media chatter about the health benefits of moderate drinking, with studies suggesting that abstemious people have higher mortality rates than light drinkers, making me wonder if I should start to drink more.
But a new paper that was published online in the June 2013 issue of Population Research and Policy Review (vol.32: p. 325–352) by Richard G. Rogers, Patrick M. Krueger, Richard Miech, Elizabeth M. Lawrence, and Robert Kemp suggests that it is not that simple and that heterogeneity among nondrinkers plays an important role because mortality rates may also depend on the reasons for not drinking. Their data came from the 1988–2006 National Health Interview Survey Linked Mortality File (N=41,076) of individuals age 21 and above. (The paper is by subscription only but you can read an article based on it here.)
As the authors say in their paper (citations removed):
Alcohol consumption has a well-documented U-shaped relationship with mortality. The risk of death is lowest among light-to-moderate drinkers, slightly higher among abstainers and former drinkers, and much higher among heavy drinkers. Several studies find that the lowest mortality risk occurs among current drinkers who consume on average one drink or less per day. This U-shaped relationship suggests a perplexing question: why do nondrinkers have higher risks of death than light or moderate drinkers? If their elevated mortality results solely from not drinking, then public health policies and clinical guidelines could acknowledge the disadvantages of nondrinking and perhaps even recommend that nondrinkers begin drinking in moderation (in addition to suggesting that heavy drinkers curtail their excesses).
So should nondrinkers like me start drinking? Not so fast, they say. After their statistical analysis, they arrive at the following conclusions.
The commonly reported U-shaped relationship between alcohol consumption and mortality is an oversimplification.
Among abstainers and light drinkers the risk of mortality is the same as light drinkers for a subgroup who report that they do not drink because of their family upbringing, and moral/religious reasons. In contrast, the risk of mortality is higher than light drinkers for former drinkers who cite health problems or who report problematic drinking behaviors.
The heterogeneous mortality experiences among nondrinkers also accounts for the elevated risks of death for former drinkers who quit drinking for health reasons, because they have family members who have problematic drinking behaviors, or because they are problem drinkers. Thus, the nondrinkers who have the highest risks of death relative to light drinkers might have even higher risks of death if they resumed their drinking.
Relatively low levels of education and income also partially explain the elevated mortality among nondrinkers. [I thought it interesting that drinking increases with income and education, something that went counter to my intuition. – MS]
Our results also demonstrate heterogeneous mortality risks when examining detailed causes of death. Compared to light drinkers, family prosocial lifetime abstainers have similar mortality risk for most of the causes of death we examined but 34 % lower risk from cancer mortality.
Perhaps most important, the oft-touted benefits of light alcohol consumption can easily vanish if consumption levels increase.
In summary, the risk that nondrinkers may miss slight potential benefits of drinking must be offset against the risk that light drinkers may increase their consumption levels and thus their overall and cause-specific mortality. Rose (2008) cautions that prevention strategies should consider both the middle and the extremes of distributions. Our results indicate that social policies aimed at reducing mortality can credibly point to the benefits of abstention. Substantial and diverse evidence demonstrates that many nondrinkers have quite positive mortality prospects, on par with those of light drinkers, if not better.
So it looks like I may not need to start drinking after all. That’s a relief because, as I said, I just don’t like the taste and it would be like taking medicine for me.