title: Amount and frequency of alcohol consumption and all-cause mortality in a Japanese population: the JMS Cohort Study.
abstract: BACKGROUND
  Lower mortality has been reported in light-to-moderate alcohol drinkers. We examined the association between the amount and frequency of alcohol consumption and all-cause mortality in a Japanese population.
  
  
  METHODS
  We conducted a prospective cohort study among 8934 Japanese people (3444 men and 5490 women) who completed a baseline survey between 1992 and 1995. We confirmed the date and cause of death by referring to death certificates. The Cox proportional hazards model was used to evaluate the effect of alcohol consumption on risk for all-cause mortality, after adjustment for potential confounding factors.
  
  
  RESULTS
  We identified 637 (397 men and 240 women) deaths during the 12.0 years of mean follow-up. Among men, as compared with non-drinkers, the relative risk was higher in ex-drinkers (hazard ratio [HR], 1.18), lower in light drinkers (HR, 0.95) and moderate drinkers (HR, 0.91), and significantly higher in heavy drinkers (HR, 1.67; 95% confidence interval, 1.10-2.55). Among women, light, moderate, and heavy drinkers were grouped into current drinkers. The relative risk was slightly higher in current drinkers (HR, 1.23), and that in ex-drinkers was near 1.0 (HR, 0.97). In stratified analysis, the harmful effects of heavy drinking were more severe among male smokers and younger men. In terms of frequency, men who drank only on special occasions had the highest mortality (HR, 1.28), regardless of alcohol intake per drinking session.
  
  
  CONCLUSIONS
  In men, a near J-shaped association was identified between alcohol consumption and all-cause mortality. Both the amount and frequency of alcohol consumption were related to mortality.
authors.affiliation: Department of Public Health, Jichi Medical University, Shimotsuke, Tochigi, Japan. a-sadakane@jichi.ac.jp
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sadakane
authors.forename: Tadao
authors.initials: T
authors.lastname: Gotoh
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kayaba
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011446:Prospective Studies; D017678:Sex Distribution; D012959:Socioeconomic Factors