title: Changes in drinking status, serious illness and mortality.
abstract: OBJECTIVE
  We studied the relationship of drinking and abstaining with all-cause mortality in a two-measurement-point prospective study to assess the importance of drinking change versus stability among the healthy and seriously ill.
  
  
  METHODS
  The National Health and Nutrition Examination Survey I (NHANES I) and follow-up of men and women (age 22-49 and 50+) at first measurement (1971-74) who survived until second measurement (1982-84) were followed in death records for 10 years (1993). Cox proportional hazards models evaluated those with and without serious illness.
  
  
  RESULTS
  We found no elevated mortality risk for consistent never drinkers, but consistent heavier drinkers were at higher all-cause risk among men. Groups of abstainers significantly differed for mortality risk, and illness was implicated in these differences. New drinkers who formerly abstained did not improve their chances for longevity. Heavier drinking men who decreased consumption increased their chances for survival.
  
  
  CONCLUSIONS
  Abstinence per se is not a risk factor for all-cause mortality, but heavier drinking is a risk factor among men. Adoption of drinking among former abstainers does not improve chances for survival. Reduction in consumption among heavier drinking men improves chances for survival.
authors.affiliation: Department of Social and Behavioral Science, University of California, San Francisco, Box 0612, San Francisco, California 94143-0612, USA. kmfalc@itsa.ucsf.edu
authors.forename: Kaye Middleton
authors.initials: KM
authors.lastname: Fillmore
authors.forename: William C
authors.initials: WC
authors.lastname: Kerr
authors.forename: Alan
authors.initials: A
authors.lastname: Bostrom
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000401:mortality; D002908:Chronic Disease / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013695:Temperance / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology