title: Alcohol consumption, abstaining, health utility, and quality of life--a general population survey in Finland.
abstract: OBJECTIVE
  To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress.
  
  
  METHODS
  Representative general population survey in Finland, with 5871 persons aged 30-64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire.
  
  
  RESULTS
  Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude.
  
  
  CONCLUSIONS
  Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.
authors.affiliation: National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland. samuli.saarni@helsinki.fi
authors.forename: Samuli I
authors.initials: SI
authors.lastname: Saarni
authors.forename: Kaisla
authors.initials: K
authors.lastname: Joutsenniemi
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.forename: Jaana
authors.initials: J
authors.lastname: Suvisaari
authors.forename: Sami
authors.initials: S
authors.lastname: Pirkola
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Kari
authors.initials: K
authors.lastname: Poikolainen
authors.forename: Jouko
authors.initials: J
authors.lastname: Lönnqvist
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D013695:Temperance / Q000523:psychology