The purpose of this study was first to compare 18-19-year-old male abstainers with alcohol consumers, and especially light consumers, regarding degree of sociability as indicated by their (in)security in the company of others, their number of close friends, intimate conversations with friends and their popularity in school. Secondly, we analysed the importance of antecedents to and covariates of abstinence. In addition, the significant antecedents and covariates gave us information as to abstinence patterns. The study was based on a survey of all Swedish males, 18-19 years old, conscripted for military service in 1969-70. Data had been collected by means of questionnaires and psychological interviews, giving measures of each respondent's social background, psychiatric/psychological and psychosomatic health status, substance use, deviant behaviour and degree of sociability. Poor sociability was more common among the abstainers than among all the other categories of drinkers, including the light consumers. The conscripts' social background, and especially their fathers' drinking habits, had the strongest effects in explaining abstinence. Sixty-two per cent of all abstainers had non-drinking fathers, compared to 28% of the light consumers. As to the majority of abstainers, this indicates a link between the social background of temperance and their own reported abstinence. Their poor sociability could be a consequence of abstaining at a young age when abstinence is uncommon. Those who abstained despite a drinking father showed a worsening psychological status, suggesting a link between psychologically impaired health, poor sociability and abstinence. Though the abstainers were the least sociable, the difference between the abstainers, the light consumers and the moderate consumers in other categories were generally small.(ABSTRACT TRUNCATED AT 250 WORDS)
The association between alcohol consumption and 15 year mortality was studied in a cohort of 49,464 Swedish conscripts, mostly aged 18-19. A strong association was found. The relative risk of death among conscripts with a high consumption of alcohol (greater than 250 g/week) was 3.0 (95% confidence interval (2.3 to 4.1) compared with those with moderate consumption (1-100 g/week). After adjustment for social background variables the relative risk was reduced to 2.1 (95% confidence interval 1.4 to 3.2). Among causes of death a strong predominance was found for violent death, suicide or probable suicide being the leading single cause and accounting for 236 (36%) of all deaths. The reported U shaped curve for total mortality was not confirmed, though when violent deaths were excluded a U shaped curve was suggested for other causes of death. These findings provide important epidemiological data on the drinking habits of young people and the consequences for mortality.
The association between level of alcohol consumption and admission for psychiatric care during a 15-year follow-up was studied in a cohort of 49,464 Swedish conscripts. The relative risk for psychiatric admission among high consumers of alcohol (more than 250 g alcohol per week) was 5.3 (95% confidence interval 4.7-6.0) compared with moderate consumers (1-100 g alcohol per week). After control for social background variables in a multivariate model, the odds ratio was 1.8 (1.5-2.1). Abstainers had the same rate of admission as moderate consumers. The association with alcohol was positive in all diagnostic categories studied. Neurotic depression was found to be a risk factor for admission for alcoholism, indicating that a causal association between alcohol and neurotic depression may go in both directions.
BACKGROUND AND PURPOSE: Since stroke is a principal cause of death in elderly people, we analyzed the association between alcohol and stroke mortality in a cohort of 15,077 middle-aged and older men and women. METHODS: Data on alcohol habits were obtained from a questionnaire in 1967. The subsequent 20 years yielded 769 deaths from stroke, of which 574 were ischemic. Relative mortality risks (RR) were estimated from logistic regression analyses with lifelong alcohol abstainers as a reference group. Adjustments were made for age and smoking. RESULTS: No association was found between alcohol intake and hemorrhagic stroke. An elevated risk of ischemic stroke was found for men who drank infrequently, that is, a few times a year or less often (RR, 2.0; 95% confidence interval [CI], 1.3 to 3.2), for those who were intoxicated now and then (RR, 1.8; 95% CI, 1.1 to 2.8), and for those who reported "binge" drinking a few times in the year or less often (RR, 1.6; 95% CI, 1.1 to 2.5). Among women only ex-drinkers had an elevated risk of dying of ischemic stroke (RR, 3.3; 95% CI, 1.5 to 7.2). The risk was reduced for women who had an estimated average consumption of 0 to 5 g pure alcohol per day (RR, 0.6; 95% CI, 0.5 to 0.8); for those who did not drink every day (RR, 0.7; 95% CI, 0.5 to 0.9); and for those who never "went on a binge" (RR, 0.6; 95% CI, 0.5 to 0.8) or became intoxicated (RR, 0.7; 95% CI, 0.5 to 0.9). CONCLUSIONS: Drinking habits were associated only with deaths from ischemic stroke, and the risk patterns were different for men and women. In analyses, ex-drinkers should not be included with lifelong abstainers, since the former tend to run high health risk.
To assess the association between drinking patterns and mortality, and cardiovascular disease in a large cohort of young- and middle-aged men and to assess whether the net balance of harm and protective effect implies protective effect or not.
Information from health examinations, psychological assessments and alcohol use background in a nationally representative birth cohort of 49,411 male military conscripts aged 18-20 years in 1969/1970, were linked to mortality and hospitalization data through 2004. Cox regression analyses were conducted and attributable proportions (APs) calculated. Confounders (baseline social status, intelligence, personality and smoking) were taken into account.
Increasing alcohol use was associated with increasing mortality (2614 deceased) and with decreasing risk for myocardial infarction (MI). The hazard ratio (HR) for mortality was 1.42 [95% confidence interval (CI) 1.10-1.82] with a consumption corresponding to 30 g 100% ethanol/day or more in multivariate analysis. The risk for non-fatal MI was significantly reduced at 60 g 100% ethanol/day (HR 0.37, 95% CI 0.15-0.90), not reduced for fatal MI, and non-significantly reduced for total MI. There was a marked association between alcohol use at conscription and mortality and hospitalization with alcohol-related diagnosis. APs indicate that alcohol caused 420 deaths, 61 cases of non-fatal stroke and protected from 154 cases on non-fatal MI.
Many more deaths were caused by alcohol than cases of non-fatal MI prevented. From a strict health perspective, we find no support for alcohol use in men below 55 years.
In a 20-year follow-up the association between alcohol consumption, social and personal background factors and mortality was studied in a cohort of 49,464 Swedish conscripts. The relative risk of death among high consumers (those consuming more than 250 g alcohol/week at conscription) was 2.8 (95% confidence interval 2.2-3.7) compared with moderate consumers (1-100 g/week). Deaths caused by direct toxic effects of alcohol were few, less than 5%. Instead suicides and accidents predominated. Abstainers had a slightly lower mortality than moderate consumers, with a relative risk of 0.8 (0.6-1.1), due to a significantly lower risk for traffic deaths. High consumers of alcohol had more than twice as many social and personal risk factors for premature death compared with the cohort as a whole. Yet presence of social risk factors added little to the already increased relative risk of death among high consumers.
The role of social, behavioral, and psychological characteristics and other risk indicators for high alcohol consumption in young men was analyzed using a survey of 49,464 Swedish conscripts. A strong association between an increasing weight of adverse social and behavioral risk indicators on the one hand and high alcohol consumption on the other was found. Yet many high consumers had no or few risk indicators. In multivariate analysis, substance use and indicators of deviant behavior came out as the strongest risk indicators for high alcohol consumption. Indicators of poor social background generally had relatively low odds ratios. Poor home wellbeing, for instance, had an odds ratio of 0.9. Social group of father was nonsignificant. Very good family economy had a higher odds ratio, 1.7, than average or poor family economy. Psychosomatic symptoms had relatively low odds ratios. Among psychological variables, low emotional control had a significantly elevated odds ratio of 1.8. Increased odds ratios were found for conscripts who were never anxious or never felt insecure. In conclusion, although many high consumers of alcohol had no or few risk indicators, we identified a high-risk group characterized by high levels of alcohol consumption and several indicators of personality disturbances, early deviant behavior, and social maladjustment.
The association between level of cannabis consumption and mortality during a 15-year follow-up was studied in a cohort of 45,540 Swedish conscripts. The relative risk of death among high consumers of cannabis (use on more than 50 occasions) was 2.8 (95% confidence interval (1.9-4.1)) compared with non-users. However, after control for social background variables in a multivariate model, no excess mortality was found. A high level of consumption of other drugs was also associated with increased mortality; the relative risk of high consumption (greater than 50 times) was 4.6 (2.4-8.5) compared with non-users. After adjustment for social background a relative risk of 1.2 (0.8-1.9) remained; for those having used drugs intravenously more than once, the relative risk was 1.6 (0.9-2.7). Among causes of death a strong predominance was found for violent death, suicide or uncertain suicide being the single most important accounting for 34.4% of all deaths. The proportion of suicides increased sharply with the level of cannabis consumption.
Erratum In: Scand J Soc Med 1990 Jun;18(2):following 158
The association between level of cannabis consumption and development of schizophrenia during a 15-year follow-up was studied in a cohort of 45,570 Swedish conscripts. The relative risk for schizophrenia among high consumers of cannabis (use on more than fifty occasions) was 6.0 (95% confidence interval 4.0-8.9) compared with non-users. Persistence of the association after allowance for other psychiatric illness and social background indicated that cannabis is an independent risk factor for schizophrenia.
There is now strong evidence that cannabis use increases the risk of psychoses including schizophrenia, but the relationship between cannabis and different psychotic disorders, as well as the mechanisms, are poorly known. We aimed to assess types of psychotic outcomes after use of cannabis in adolescence and variation in risk over time.
A cohort of 50 087 military conscripts with data on cannabis use in late adolescence was followed up during 35 years with regard to in-patient care for psychotic diagnoses.
Odds ratios for psychotic outcomes among frequent cannabis users compared with non-users were 3.7 [95% confidence interval (CI) 2.3-5.8] for schizophrenia, 2.2 (95% CI 1.0-4.7) for brief psychosis and 2.0 (95% CI 0.8-4.7) for other non-affective psychoses. Risk of schizophrenia declined over the decades in moderate users but much less so in frequent users. The presence of a brief psychosis did not increase risk of later schizophrenia more in cannabis users compared with non-users.
Our results confirm an increased risk of schizophrenia in a long-term perspective, although the risk declined over time in moderate users.