title: Alcohol consumption, problem drinking, abstention and disability pension award. The Nord-Trøndelag Health Study (HUNT).
abstract: OBJECTIVE
  To examine associations of abstention, alcohol consumption and problem drinking with subsequent disability pensioning (DP), and whether previous excessive consumption ('sick-quitting') could explain some of the increased risk for DP among abstainers.
  
  
  METHODS
  Prospective population-based study.
  
  
  METHODS
  Data were from two waves of the Nord-Trøndelag Health Study (HUNT) linked with the national insurance database. The two main analyses included 37,729 (alcohol consumption) and 34,666 (problem drinking) participants.
  
  
  METHODS
  Alcohol consumption was measured by self-reported consumption, while problem drinking was assessed by the Cut down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire. Information on subsequent DP, including diagnosis for which the DP was awarded, was gathered from the national insurance database. Covariates included somatic illness and symptoms, mental health, health-related behaviour, socio-economic status and social activity.
  
  
  RESULTS
  Those reporting the highest level of alcohol consumption were not at increased risk for DP [hazard ratio (HR) 1.12, 95% confidence interval (CI): 0.92-1.38], whereas problem drinking was a strong predictor (HR 2.79, 95% CI: 2.08-3.75) compared to their corresponding reference groups. Alcohol abstainers were also at increased risk for DP, but among them, the previous consumers (HR 1.95, 95% CI: 1.48-2.57) and previous excessive consumers (HR 1.67, 95% CI: 1.01-2.74) were at higher risk for DP than constant abstainers.
  
  
  CONCLUSIONS
  Problem drinking is linked to subsequent requirement for a disability pension but mere alcohol consumption is not. This is partly explained by 'sick-quitting'.
authors.affiliation: Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Bergen, Norway.
authors.forename: Jens Christoffer
authors.initials: JC
authors.lastname: Skogen
authors.forename: Ann Kristin
authors.initials: AK
authors.lastname: Knudsen
authors.forename: Arnstein
authors.initials: A
authors.lastname: Mykletun
authors.forename: Sverre
authors.initials: S
authors.lastname: Nesvåg
authors.forename: Simon
authors.initials: S
authors.lastname: Øverland
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D002908:Chronic Disease; D015986:Confounding Factors, Epidemiologic; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010415:Pensions / Q000706:statistics & numerical data*; D012179:Retirement / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D012923:Social Class; D012943:Social Security / Q000706:statistics & numerical data*; D013695:Temperance / Q000706:statistics & numerical data*; D055815:Young Adult