title: Divergent associations of drinking frequency and binge consumption of alcohol with mortality within the same cohort.
abstract: BACKGROUND
  Observational studies show beneficial effects of moderate alcohol drinking on all-cause and cardiovascular disease (CVD) mortality, while binge drinking has been linked with increased mortality. The aim of this study was to assess the associations of alcohol use with mortality in a population with a hybrid of drinking patterns.
  
  
  METHODS
  Participants in a population based cardiovascular health survey in Finnmark county in 1987-1988, aged 20-62 years, constituted the study cohort. Alcohol use was self-reported by use of questions on frequency of beer, wine and liquor intake, and one question on intake of around five drinks or more per occasion (binge drinking). Information on education, income and use of alcohol in an earlier and in a later survey was linked to the file. Mortality was assessed throughout 2009 by Cox regression, with adjustment for potential confounding factors. In the analysis of mortality by frequency of any alcohol use, we adjusted for binge consumption and vice versa.
  
  
  RESULTS
  Two opposite trends appeared: a higher all-cause mortality in both sexes, and higher CVD mortality in men, with increasing frequency of binge drinking, compared with non-bingers. Second, in both sexes low-frequent use of any alcohol was associated with lower all-cause and CVD mortality, compared with abstention. The combination of any use of alcohol at least weekly and binge consumption at least monthly was common, particularly in men.
  
  
  CONCLUSIONS
  Questions on drinking frequency and a specific question on binge drinking capture different effects of alcohol use on all-cause and CVD mortality.
authors.affiliation: Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway. sgri@fhi.no
authors.forename: Sidsel
authors.initials: S
authors.lastname: Graff-Iversen
authors.forename: Mona Dverdal
authors.initials: MD
authors.lastname: Jansen
authors.forename: Dominic Anthony
authors.initials: DA
authors.lastname: Hoff
authors.forename: Gudrun
authors.initials: G
authors.lastname: Høiseth
authors.forename: Gun Peggy
authors.initials: GP
authors.lastname: Knudsen
authors.forename: Per
authors.initials: P
authors.lastname: Magnus
authors.forename: Jørg
authors.initials: J
authors.lastname: Mørland
authors.forename: Per Trygve
authors.initials: PT
authors.lastname: Normann
authors.forename: Oyvind Erik
authors.initials: OE
authors.lastname: Næss
authors.forename: Kristian
authors.initials: K
authors.lastname: Tambs
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D063425:Binge Drinking / Q000150:complications / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult