title: Alcohol drinking and overall and cause-specific mortality in China: nationally representative prospective study of 220,000 men with 15 years of follow-up.
abstract: BACKGROUND
  Regular alcohol drinking contributes both favourably and adversely to health in the Western populations, but its effects on overall and cause-specific mortality in China are still poorly understood.
  
  
  METHODS
  A nationally representative prospective cohort study included 220,000 men aged 40-79 years from 45 areas in China in 1990-91, and >40,000 deaths occurred during 15 years of follow-up. Cox regression was used to relate alcohol drinking to overall and cause-specific mortality, adjusting for age, area, smoking and education.
  
  
  RESULTS
  Overall, 33% of the participants reported drinking alcohol regularly at baseline, consuming mainly distilled spirits, with an estimated mean amount consumed of 372 g/week (46.5 units per week). After excluding all men with prior disease at baseline and the first 3 years of follow-up, there was a 5% [95% confidence interval (CI) 2-8] excess risk of overall mortality among regular drinkers. Compared with non-drinkers, the adjusted hazard ratios among men who drank <140, 140-279, 280-419, 420-699 and ≥ 700 g/week were 0.97, 1.00, 1.02, 1.12 and 1.27, respectively (P < 0.0001 for trend). The strength of the relationship appeared to be greater in smokers than in non-smokers. There was a strong positive association of alcohol drinking with mortality from stroke, oesophageal cancer, liver cirrhosis or accidental causes, a weak J-shaped association with mortality from ischaemic heart disease, stomach cancer and lung cancer and no apparent relationship with respiratory disease mortality.
  
  
  CONCLUSIONS
  Among Chinese men aged 40-79 years, regular alcohol drinking was associated with a small but definite excess risk of overall mortality, especially among smokers.
authors.affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. ling.yang@ctsu.ox.ac.uk
authors.forename: Ling
authors.initials: L
authors.lastname: Yang
authors.forename: Maigeng
authors.initials: M
authors.lastname: Zhou
authors.forename: Paul
authors.initials: P
authors.lastname: Sherliker
authors.forename: Yue
authors.initials: Y
authors.lastname: Cai
authors.forename: Richard
authors.initials: R
authors.lastname: Peto
authors.forename: Lijun
authors.initials: L
authors.lastname: Wang
authors.forename: Iona
authors.initials: I
authors.lastname: Millwood
authors.forename: Margaret
authors.initials: M
authors.lastname: Smith
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Hu
authors.forename: Gonghuan
authors.initials: G
authors.lastname: Yang
authors.forename: Zhengming
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality*; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology