title: Mortality from alcohol consumption and alcohol use disorder: Findings from the Vietnam Experience Study.
abstract: BACKGROUND
  To examine the relationship of alcohol consumption, alcohol use disorder and mortality.
  
  
  METHODS
  A cohort of 4316 male former Vietnam-era US army personnel participating in telephone survey and medical examination in middle age (mean age 38.3 years) in 1985-1986 was used. Alcohol consumption was reported in face-to-face interview on medical history and information on DSM-III alcohol use disorder was obtained from structured psychiatric interview (using the Diagnostic Interview Schedule). Mortality hazard during 15 years of follow-up was assessed with Cox proportional hazard regression modeling.
  
  
  RESULTS
  A total of 4251 individuals participated in the psychiatric interview and the medical history interview. Of these 998 were abstainers, and for the remaining 3253 we calculated weekly average consumption and monthly frequency of binge drinking. A total of 1988 had alcohol dependence, abuse or both. There were 237 deaths during follow up. A J-shaped association was found for both consumption and binging. In multivariable analysis jointly modeling average consumption and disorder, and binging and disorder, increased mortality remained significant for both very high consumption (Hazard Ratio (HR) 1.62, 95% Confidence Intervals [1.02-2.57]) for drinking 29 or more drinks per week, and frequent bingeing HR 1.81 [1.03-3.18] for bingeing 16 or more times per month).
  
  
  CONCLUSIONS
  This study showed that alcohol consumption measures were associated with mortality, partly independent from the potential confounding effect of alcohol use disorder, which is an established risk factor for mortality. This further highlights the importance of alcohol consumption measures in public health.
authors.affiliation: Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm SE-171 76, Sweden. Electronic address: andreas.lundin@ki.se.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lundin
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Laust Hvas
authors.initials: LH
authors.lastname: Mortensen
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000401:mortality*; D000437:Alcoholism / Q000453:epidemiology / Q000401:mortality*; D063425:Binge Drinking / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D047829:Vietnam Conflict
keywords: Alcohol consumption; Alcohol use; Alcoholism; Binge drinking; Dependence; Heavy drinking