Population-Level Cohort Studies on Alcohol and Health Harm: What We Know and What We Don't Know

Abstract

Many population-level studies have documented a “health-protective effect” of alcohol use against coronary heart disease and mortality from all causes. This finding has generally been absorbed into the public consciousness as good news. Tempering the public enthusiasm, alcohol investigators have shown concern about the explanatory mechanisms and about conditions where the protective effect may not apply. Studies examining the social isolation hypothesis and the personality hypothesis, for example, which have aspired to demonstrate that the protective effect is an artifact, have shown only weak effects. Mirroring well-established social findings about heavy episodic drinking (HED), the health effects of such a pattern have shown recent promise of a partial explanation of harm from alcohol. Interestingly, this message of the health-hazard effect of alcohol has been slower to be disseminated than was the health-protective effect. Results of current cohort studies on drinking pattern are reviewed.