title: Alcohol Consumption Levels and All-Cause Mortality Among Women Veterans and Non-Veterans Enrolled in the Women's Health Initiative.
abstract: OBJECTIVE
  To address research gaps regarding women Veterans' alcohol consumption and mortality risk as compared to non-Veterans, the current study evaluated whether alcohol consumption amounts differed between women Veterans and non-Veterans, whether Veterans and non-Veterans within alcohol consumption groups differed on all-cause mortality, and whether Veteran status modified the association between alcohol consumption and all-cause mortality.
  
  
  METHODS
  Six alcohol consumption groups were created using baseline data from the Women's Health Initiative Program (N = 145,521): lifelong abstainers, former drinkers, less than 1 drink/week (infrequent drinkers), 1-7 drinks/week (moderate drinkers), 8-14 drinks/week (moderately heavy drinkers), and 15 or more drinks/week (heavy drinkers). The proportions of Veteran and non-Veteran women within each alcohol consumption category were compared. Mortality rates within each alcohol consumption category were compared by Veteran status. Cox proportional hazard models, including a multiplicative interaction term for Veteran status, were fit to estimate adjusted mortality hazard (rate) ratios for each alcohol consumption category relative to a reference group of either lifelong abstainers or moderate drinkers.
  
  
  RESULTS
  Women Veterans were less likely to be lifelong abstainers than non-Veterans. Women Veterans who were former or moderate drinkers had higher age-adjusted mortality rates than did non-Veterans within these alcohol consumption categories. In the fully adjusted multivariate models, Veteran status did not modify the association between alcohol consumption category and mortality with either lifelong abstainers or moderate drinkers as referents.
  
  
  CONCLUSIONS
  The results suggest that healthcare providers may counsel Veteran and non-Veteran women in similar ways regarding safe and less safe levels of alcohol consumption.
authors.affiliation: Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle, Washington. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. tracy.simpson@va.gov.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Simpson
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. VA Puget Sound Health Care System, Seattle, Washington.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rillamas-Sun
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. Health Services Research & Development, VA Puget Sound Health Care System, Seattle, Washington.
authors.forename: Keren
authors.initials: K
authors.lastname: Lehavot
authors.affiliation: Health Services Research and Development, Center for Innovation to Implementation, VA Palo Alto Health Care System, California. Stanford University, Menlo Park, California.
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.affiliation: Section of General Internal Medicine and the National Center for PTSD, VA Boston Health Care System, Massachusetts. Boston University, Massachusetts.
authors.forename: Amy
authors.initials: A
authors.lastname: Rubin
authors.affiliation: Center for Mental Health Care and Outcomes Research (CeMHOR), Central Arkansas Veterans Health Care System, Little Rock. University of Arkansas for Medical Sciences, Little Rock.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cucciare
authors.affiliation: Health Services Research & Development, VA Puget Sound Health Care System, Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Williams
authors.affiliation: Stanford University, Menlo Park, California. VA Palo Alto Health Care System, California.
authors.forename: Claudia B
authors.initials: CB
authors.lastname: Padula
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Hunt
authors.affiliation: VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, California. University of California, Los Angeles.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Hoggatt
mesh_terms: D000368:Aged; D064829:Alcohol Abstinence / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology*; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Drinking; Health behavior practices; Mortality risk; Postmenopausal women; Veteran status