title: Worsening of health and a cessation or reduction in alcohol consumption to special occasion drinking across three decades of the life course.
abstract: BACKGROUND
  Ex-drinkers suffer from worse health than drinkers; however, whether a worsening of health is associated with a change in drinking status from early adulthood has not been previously investigated. We assess whether a worsening of health is associated with a cessation in consumption or reduction to special occasion drinking from early adulthood to middle age.
  
  
  METHODS
  Multinomial logistic regression assessing whether a change in self-reported limiting longstanding illness (LLI) was associated with ceasing alcohol consumption, or a reduction to special occasion drinking compared with being a persistent drinker from age 23 in separate models at ages 33, 42, and 50. All models adjusted for sex, poor psychosocial health, education, marital status, and children in the household. Sample included participants from Great Britain followed longitudinally in the National Child Development Study from ages 23 to 33 (N = 5,529), 42 (N = 4,787), and 50 (N = 4,476).
  
  
  RESULTS
  Developing an LLI from the previous wave was associated with ceasing alcohol consumption at ages 33 (odds ratio [ORs] = 2.71, 95% confidence interval [CI] = 1.16-4.93), 42 (OR = 2.44, 95% CI = 1.24-4.81), and 50 (OR = 3.33, 95% CI = 1.56-7.12) and a reduction to special occasion drinking at ages 42 (OR = 2.04, 95% CI = 1.40-2.99) and 50 (OR = 2.04, 95% CI = 1.18-3.53). Having a persistent LLI across 2 waves increased the odds of ceasing consumption at ages 42 (OR = 3.22, 95% CI = 1.06-9.77) and 50 (OR = 4.03, 95% CI = 1.72-9.44) and reducing consumption to special occasion drinking at ages 33 (OR = 3.27, 95% CI = 1.34-8.01) and 42 (OR = 2.25, 95% CI = 1.23-4.50). Persistent drinkers at older ages had the best overall health suffering less from previous poor health compared with those who reduced or ceased consumption at an earlier time point.
  
  
  CONCLUSIONS
  Developing an LLI was associated with a cessation in alcohol consumption and a reduction in consumption to special occasion drinking from early adulthood. Persistent drinkers who drank at least till 50 were the healthiest overall. Health selection is likely to influence nondrinking across the life course.
authors.affiliation: Department of Epidemiology and Public Health, UCL, London, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Ng Fat
authors.forename: Noriko
authors.initials: N
authors.lastname: Cable
authors.forename: Nicola
authors.initials: N
authors.lastname: Shelton
mesh_terms: D000328:Adult; D000375:Aging; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000846:Anniversaries and Special Events; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol; Life Course; Limiting Longstanding Illness; Nondrinking