Alcohol concentration and risk of oral cancer in Puerto Rico

Alcohol consumption is a major risk factor for cancers of the mouth and pharynx (oral cancer), but the differential risks by beverage type are unclear. In this 1992-1995 study, the authors examined oral cancer risk in Puerto Rico, comparing alcohol intake among 286 male cases aged 21-79 years and 417 population-based male controls, frequency matched by age. Heavy consumers of liquor (>/=43 drinks per week) had strongly increased risks of oral cancer (odds ratio = 6.4, 95% confidence interval: 2.4, 16.8); beer/wine showed only modest effects. Among liquor drinkers, risks were consistently greater for those who drank straight (undiluted) liquor than for those who usually drank mixed (diluted) liquor (odds ratio = 4.0, 95% confidence interval: 2.4, 6.7). Risks associated with combined exposure to tobacco were also more pronounced when subjects drank liquor straight. The elevated risks associated with drinking homemade rum were similar to those for other types of liquor. These results suggest that alcohol concentration is a risk factor for oral cancer independent of the total quantity of alcohol consumed.     

Wine and good subjective health

The association of subjective, self-rated suboptimal (average or poor) health with the intake of beer, wine, and liquor and alcohol intoxication was examined in a general population sample in Finland in 1992. The odds ratios were adjusted for several possible confounders with the use of logistic regression analysis. Compared with subjects who drank no wine, suboptimal health was less frequent among both men and women who imbibed 1-4 drinks of wine, and more common among men who consumed > or = 10 drinks of wine or liquor. Moderate wine drinking seems to be related to good self-rated health.     

Price elasticity of demand for malt liquor beer: findings from a US pilot study

Our objective is to estimate the relative price elasticity of demand for malt liquor beer (MLB), regular beer, hard liquor, and a combined group of all other alcoholic beverages. Three hundred and twenty-nine alcohol consumers (mostly male) in South-Central Los Angeles answered a series of questions pertaining to expected consumption responses to hypothetical price increases. We found that based on a 10% price increase, the mean price elasticity of demand (% change in quantity demanded / % change in price) was -0.79 for MLB drinkers, -1.14 for regular beer drinkers, -1.11 for hard liquor drinkers, and -1.69 for the combined group of all other drinkers. Logistic regression analysis revealed that the personal characteristics significantly related to being a MLB drinker were older age, not working, being homeless, and a daily drinker. Daily (or nearly daily) drinkers were more likely to be married, earning lower incomes, and hard liquor drinkers. This study is the first to investigate the price elasticity of demand for MLB drinkers and other heavy alcohol consumers in poor urban neighborhoods of the US. Future research can use the methods from this pilot study to more rigorously examine and compare the price sensitivity among heavy drinking groups.     

Lifetime alcohol intake and risk of rectal cancer in western New York

The lifetime intake of total alcohol, beer, wine, and hard liquor was measured for 277 males and 145 females with pathologically confirmed, first, single, primary cancers of the rectum in western New York from 1978 to 1986. Controls who were age, sex, and neighborhood matched were also interviewed. Intake of beer and total alcohol was positively associated with rectal cancer risk. Most of the excess risk was found for the heaviest drinkers. Odds ratios for fourth quartile intakes for males were 1.80 (95% CI, 1.12, 2.89) for total alcohol and 1.86 (1.13, 3.06) for beer. No association was found with wine or hard liquor intake. Females drank considerably less in this population; trends were similar although not of as great magnitude as those for males. Adjustment for dietary risk factors did not change risk estimates appreciably. A high lifetime intake of beer and total alcohol was associated with an increased risk of rectal cancer, and this was independent of either socioeconomic status or diet.     

Lifetime alcohol intake and risk of rectal cancer in western New York

The lifetime intake of total alcohol, beer, wine, and hard liquor was measured for 277 males and 145 females with pathologically confirmed, first, single, primary cancers of the rectum in western New York from 1978 to 1986. Controls who were age, sex, and neighborhood matched were also interviewed. Intake of beer and total alcohol was positively associated with rectal cancer risk. Most of the excess risk was found for the heaviest drinkers. Odds ratios for fourth quartile intakes for males were 1.80 (95% CI, 1.12, 2.89) for total alcohol and 1.86 (1.13, 3.06) for beer. No association was found with wine or hard liquor intake. Females drank considerably less in this population; trends were similar although not of as great magnitude as those for males. Adjustment for dietary risk factors did not change risk estimates appreciably. A high lifetime intake of beer and total alcohol was associated with an increased risk of rectal cancer, and this was independent of either socioeconomic status or diet.     

Alcohol consumption and the risk of type 2 diabetes mellitus: atherosclerosis risk in communities study

Evidence regarding the association between alcohol consumption and type 2 diabetes risk remains inconsistent, particularly with regard to male-female differences. The authors conducted a prospective study of type 2 diabetes risk associated with alcohol consumption in a cohort of 12,261 middle-aged participants of the Atherosclerosis Risk in Communities Study (1990-1998), who were followed between 3 and 6 years. Alcohol consumption at baseline was characterized into lifetime abstainers, former drinkers, and current drinkers of various levels. Incident diabetes was determined by blood glucose measurements and self-report. After adjustment for potential confounders, an increased risk of diabetes was found in men who drank >21 drinks/week when compared with men who drank < or =1 drink/week (odds ratio = 1.50, 95% confidence interval: 1.02, 2.20) while no significant association was found in women. This increased diabetes risk among men who drank >21 drinks/week was predominantly related to spirits rather than to beer or wine consumption. The relative odds of incident diabetes in a comparison of men who drank >14 drinks of spirits per week with men who were current drinkers but reported no regular use of spirits, beer, or wine were 1.82 (95% confidence interval: 1.14, 2.92). Results of this study support the hypothesis that high alcohol intake increases diabetes risk among middle-aged men. However, more moderate levels of alcohol consumption do not increase risk of type 2 diabetes in either middle-aged men or women.     

Smokers and non-smokers: differences in alcohol consumption and intake of other health-related substances in Norway: A general population study

Background: This study addresses the problem of clustering ofrisky habits, i.e. the drinking and substance use habits ofsmokers and non-smokers. Methods: A sample survey of the generalnon-hospitalized, Norwegian population (>15 years), excludingabstainers from alcohol was used. We investigated differencesin yearly consumption of beer, wine, liquor and total alcoholconsumption and intake of sedatives, snuff, coffee and tea fora sample of daily smokers (n=763) and non-smokers (n=938) (meanage 38.7 years and SD 16.2 years). Results: Compared to non-smokers,male daily smokers drank significantly more beer, wine and liquorthan non-smokers and used snuff more frequently than non-smokers.Female daily smokers drank more beer than non-smokers, but therewere no significant differences for wine and liquor. For bothgenders, the total yearly intake of alcohol was approximatelytwice as high for daily smokers compared to non-smokers. Dailysmokers also used marihuana more frequently and they drank significantlymore coffee but less tea than non-smokers. There were no significantdifferences in use of sedatives. Conclusion: Increased drinkingand several risky health habits are linked to daily smoking.Smoking cessation should be tried out as a preventive strategyfor alcohol consumption as well.     

Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case–control study

The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95?% confidence intervals (95?%CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among 'pure drinker' who consumed one beverage type exclusively, among 'predominant drinkers' who consumed one beverage type to more than 66?% and among 'mixed drinkers' who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95?%CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among 'pure drinkers' (p value for heterogeneity across beverage types?=?0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among 'predominant drinkers' (p value?=?0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among 'mixed drinkers' (p value?=?0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.     

Type of Alcoholic Beverage and Risk of Head and Neck Cancer--A Pooled Analysis Within the INHANCE Consortium

The authors pooled data from 15 case-control studies of headand neck cancer (9,107 cases, 14,219 controls) to investigatethe independent associations with consumption of beer, wine,and liquor. In particular, they calculated associations withdifferent measures of beverage consumption separately for subjectswho drank beer only (858 cases, 986 controls), for liquor-onlydrinkers (499 cases, 527 controls), and for wine-only drinkers(1,021 cases, 2,460 controls), with alcohol never drinkers (1,124cases, 3,487 controls) used as a common reference group. Theauthors observed similar associations with ethanol-standardizedconsumption frequency for beer-only drinkers (odds ratios (ORs)= 1.6, 1.9, 2.2, and 5.4 for 5, 6–15, 16–30, and>30 drinks per week, respectively; P_trend < 0.0001) andliquor-only drinkers (ORs = 1.6, 1.5, 2.3, and 3.6; P < 0.0001).Among wine-only drinkers, the odds ratios for moderate levelsof consumption frequency approached the null, whereas thosefor higher consumption levels were comparable to those of drinkersof other beverage types (ORs = 1.1, 1.2, 1.9, and 6.3; P <0.0001). Study findings suggest that the relative risks of headand neck cancer for beer and liquor are comparable. The authorsobserved weaker associations with moderate wine consumption,although they cannot rule out confounding from diet and otherlifestyle factors as an explanation for this finding. Giventhe presence of heterogeneity in study-specific results, theirfindings should be interpreted with caution. alcohol drinking; alcoholic beverages; beer; case-control studies; head and neck neoplasms; meta-analysis; wine     

Alcohol use and the risk of prostate cancer: results from the VITAL cohort study

An association between alcohol consumption and prostate cancer risk remains uncertain. Although some studies have found that heavy alcohol consumption is associated with increased risk, a recent study reported that red wine consumption is associated with reduced risk. We examined the association between alcohol use and prostate cancer among 34,565 men, 50-76 yr old, in the Vitamins and Lifestyle (VITAL) cohort in Washington State. Alcohol consumption was ascertained by baseline questionnaire between October 2000 and December 2002. Incident prostate cancers (n = 816) as of December 31, 2004, were identified through the Surveillance, Epidemiology, and End Results cancer registry. Men who consumed more than one drink per month had a small increased risk of prostate cancer (hazard ratio, HR = 1.20; 95% confidence interval, CI = 1.02-1.40) compared with men who drank no alcohol or less than one drink per month. White wine consumption was associated with increased risk (HR for any vs. no white wine consumption = 1.27; CI = 1.08-1.49). Red wine, liquor, and beer were not associated with prostate cancer nor was total alcohol consumed at ages 18, 30, and 45. Associations of alcohol use with prostate cancer are modest and complex. More detailed assessment of specific alcoholic beverages is warranted in future studies.     

Wine,liquor, beer,and mortality

A substantially increased risk for heavy drinkers and a slightly reduced risk for lighter drinkers results in the J-shaped alcohol-mortality curve. Limited data suggest a more favorable mortality experience for drinkers of wine than for drinkers of liquor or beer. To examine these relations, the authors performed a cohort study of participants in a large Northern California prepaid health care program. Demographic and history data were collected from 128,934 adults undergoing health evaluations in 1978-1985, with subsequent death ascertained by an automated linkage system. Cox proportional hazards models with eight covariates were used to determine relative risk estimates according to total alcohol intake and days per week of drinking wine, wine types, beer, or liquor. The J-shaped alcohol-mortality relation was stable for 20 years. Independently, frequency of wine drinking was associated with lower mortality risk (p<0.001) largely because of lower coronary disease risk. Similar risk reductions were associated with red wine, white wine, other types of wine, and combinations of wine types. Much of the lower risk associated with light drinking was related to wine drinking. The authors conclude that drinkers of any type of wine have a lower mortality risk than do beer or liquor drinkers, but it remains unclear whether this reduced risk is due to nonalcoholic wine ingredients, drinking pattern, or associated traits.     

Exposure to televised alcohol ads and subsequent adolescent alcohol use

OBJECTIVE: To assess the impact of televised alcohol commercials on adolescents' alcohol use. METHODS: Adolescents completed questionnaires about alcohol commercials and alcohol use in a prospective study. RESULTS: A one standard deviation increase in viewing television programs containing alcohol commercials in seventh grade was associated with an excess risk of beer use (44%), wine/liquor use (34%), and 3-drink episodes (26%) in eighth grade. The strength of associations varied across exposure measures and was most consistent for beer. CONCLUSIONS: Although replication is warranted, results showed that exposure was associated with an increased risk of subsequent beer consumption and possibly other consumption variables.     

Preference for wine is associated with lower hip fracture incidence in post-menopausal women

Background

Past studies of relationships between alcohol and hip fracture have generally focused on total alcohol consumed and not type of alcohol. Different types of alcohol consist of varying components which may affect risk of hip fracture differentially. This study seeks to examine the relationship between alcohol consumption, with a focus on type of alcohol consumed (e.g. beer, wine, or hard liquor) and hip fracture risk in post-menopausal women.

Methods

The longitudinal cohort consisted of U.S. post-menopausal women aged 50–79 years enrolled between 1993–1998 in the Women’s Health Initiative Clinical Trials and Observational Study (N=115,655).

Results

Women were categorized as non-drinkers, past drinkers, infrequent drinkers and drinkers by preference of alcohol type (i.e. those who preferred wine, beer, hard liquor, or who had no strong preference). Mean alcohol consumption among current drinkers was 3.3 servings per week; this was similar among those who preferred wine, beer and liquor. After adjustment for potential confounders, alcohol preference was strongly correlated with hip fracture risk (p = 0.0167); in particular, women who preferred wine were at lower risk than non-drinkers (OR=0.78; 95% CI 0.64-0.95), past drinkers (OR=0.85; 95% CI 0.72-1.00), infrequent drinkers (OR=0.73; 95% CI 0.61-0.88), hard liquor drinkers (OR=0.87; 95% CI 0.71-1.06), beer drinkers (OR=0.72; 95% CI 0.55-0.95) and those with no strong preference (OR=0.89; 95% CI 0.89; 95% CI 0.73-1.10).

Conclusions

Preference of alcohol type was associated with hip fracture; women who preferentially consumed wine had a lower risk of hip fracture compared to non-drinkers, past drinkers, and those with other alcohol preferences.

     

Alcohol Availability and Neighborhood Characteristics in Los Angeles, California and Southern Louisiana

The objective of this study was to examine the associations between alcohol availability types and community characteristics in randomly selected census tracts in Southern California and Southeastern Louisiana. Outlet shelf space and price by beverage type was collected from all off-sale alcohol outlets in 189 census tracts by trained research personnel. Three aspects of alcohol availability at the census tract level were considered—outlets per roadway mile, shelf space, and least price by beverage type. Using multivariate analyses, we examined the associations between census tract socioeconomic and demographic characteristics and alcohol availability types. Fifteen measures of alcohol availability were calculated—total shelf space and shelf space by beverage types (beer, malt liquor, and distilled spirits); outlets per roadway mile, per tract, and per capita; and least price by beverage type (including wine). In multivariate analyses controlling for state, male unemployment rate was inversely associated with total shelf space (p = 0.03) and distilled spirit shelf space (p = 0.05). Malt liquor shelf space was inversely associated with percent White (p = 0.02). Outlets per roadway mile was positively associated with household poverty (p < 0.0001), whereas percent African American was inversely associated with outlets per roadway mile (p = 0.03). Beverage-specific least prices were not associated with any socioeconomic or demographic community characteristics. Alcohol availability types, but not least price, were associated with some community characteristics. More research exploring how alcohol availability types vary by community and their relationship to alcohol-related harms should be conducted.     

What Do Binge Drinkers Drink?: Implications for Alcohol Control Policy

BACKGROUND: Although binge drinking (drinking five or more drinks on an occasion) is an important public health problem, little is known about which beverage types are consumed by binge drinkers. This knowledge could guide prevention efforts because beer, wine, and liquor are taxed, marketed, and distributed differently. METHODS: Data from 14,150 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge-drinking module in 2003 and 2004 were analyzed. Information pertained to the amount of alcohol consumed during a binge drinker's most recent binge episode, including beverage-specific consumption. RESULTS: Overall, 74.4% of binge drinkers consumed beer exclusively or predominantly, and those who consumed at least some beer accounted for 80.5% of all binge alcohol consumption. By beverage type, beer accounted for 67.1%, liquor for 21.9%, and wine accounted for 10.9% of binge drinks consumed. Beer also accounted for most of the alcohol consumed by those at highest risk of causing or incurring alcohol-related harm, including people aged 18-20 years (67.0% of drinks were beer); those with three or more binge episodes per month (70.7%); those drinking eight or more drinks per binge episode (69.9%); those binging in public places (64.4%); and those who drove during or within 2 hours of binge drinking (67.1%). CONCLUSIONS: Beer accounted for two thirds of all alcohol consumed by binge drinkers and accounted for most alcohol consumed by those at greatest risk of causing or incurring alcohol-related harm. Lower excise taxes and relatively permissive sales and marketing practices for beer as compared with other beverage types may account for some of these findings. These findings suggest that equalizing alcohol control policies at more stringent levels would be an effective way to prevent excessive drinking.     

Alcoholic beverages and myocardial infarction in young men

Previous studies have suggested that people who consume a moderate amount of alcohol have a reduced risk of coronary heart disease compared with nondrinkers. This hypothesis was further tested in the period April 1980-April 1983 in a study of 2,170 men with first nonfatal myocardial infarction and 981 hospital controls, all under 55 years of age. The relative risk estimate for men who drank between one and seven times per week compared with never drinkers was 1.2 (95% confidence interval, 0.8-1.8) when age and cigarette smoking were taken into account and 1.1 (0.7-1.7) when personality type was also taken into account. There was no evidence of a reduced risk for users who drank primarily one type of alcoholic beverage (beer, wine, or liquor) or within categories of dose measured in ounces consumed per week. The findings were not materially changed when other risk factors for myocardial infarction were taken into account. The results of this study suggest that moderate alcohol consumption does not reduce the risk of nonfatal myocardial infarction.     

Alcohol and cigarette advertising on billboards

We report an analysis of 901 billboards in San Francisco, California.Using neighborhood census data, we assessed how billboard advertisingof tobacco and alcohol products differed in Asian, black, Hispanicand white neighborhoods. The data illustrate that: (1) acrossall billboard advertising of products and services, tobacco(19%) and alcohol (17%) were most heavily advertised; (2) blackneighborhoods had the highest rate of billboards per 1000 population;(3) black and Hispanic neighborhoods had proportionately moretobacco and alcohol billboards than white or Asian neighborhoods;(4) black neighborhoods were proportionately more likely thanother neighborhoods to have billboard advertising of mentholcigarettes and malt liquor while advertising of beer/wine wasproportionately higher in Hispanic neighborhoods.     

Alcohol consumption and risk of prostate cancer: The Harvard Alumni Health Study

BACKGROUND: Although many studies suggest that consumption of alcohol increases the risk of several site-specific cancers, the evidence remains unclear for prostate cancer. Few data exist on beverage-specific associations as well as lifetime patterns of alcohol consumption and prostate cancer risk. METHODS: We prospectively followed 7612 Harvard alumni (mean age 66.6 years) from 1988 through 1993, during which 366 cases of incident prostate cancer occurred. Self-reported alcohol consumption was assessed at baseline from wine, beer, and liquor intake. Previous assessments during college and in 1977 were also available. RESULTS: Overall, the mean total alcohol consumption in 1988 was 123.1 g/week, of which 28.6% was from wine, 15.8% from beer, and 55.6% from liquor. Compared to men reporting almost never drinking alcohol in 1988, the multivariate relative risks (95% CI) for 1 drink/month to < 3 drinks/week, 3 drinks/week to < 1 drink/ day, 1 to < 3 drinks/day, and > or = 3 drinks/day were 1.33 (0.88-2.01), 1.65 (1.12-2.44), 1.85 (1.29-2.64), and 1.33 (0.86-2.05), respectively. Wine or beer consumption was unassociated with prostate cancer; however, moderate liquor consumption was associated with a significant 61-67% increased risk of prostate cancer (P, non-linear trend < 0.001). Men initiating alcohol consumption between 1977 and 1988 had a twofold increased risk of prostate cancer compared to men with almost no alcohol consumption at both times. CONCLUSIONS: In contrast to the majority of previous studies, we found a positive association between moderate alcohol consumption and the risk of prostate cancer. Liquor, but not wine or beer, consumption was positively associated with prostate cancer.     

Alcohol consumption in relation to risk of cholecystectomy in women

BACKGROUND: Alcohol consumption has been linked to a lower risk of gallstone disease. However, the magnitude of the association is uncertain, and little is known about the relation of alcohol consumption patterns and individual types of alcoholic beverages to gallstone disease risk. OBJECTIVE: We prospectively examined the association between alcohol intake and cholecystectomy, a surrogate for symptomatic gallstone disease, in a large cohort of women. DESIGN: Women from the Nurses' Health Study who had no history of gallstone disease in 1980 (n = 80,898) were followed for 20 y. Alcohol consumption, which was measured every 2-4 y by food-frequency questionnaires, was used to predict subsequent cholecystectomy through multivariate analysis. RESULTS: We ascertained 7831 cases of cholecystectomy. Relative to subjects who had no alcohol intake, subjects who had alcohol intakes of 0.1-4.9, 5.0-14.9, 15.0-29.9, 30.0-49.9, and >/=50.0 g/d had multivariate relative risks of cholecystectomy of 0.95, 0.86, 0.80, 0.67, and 0.62 (95% CI: 0.49, 0.79), respectively. Relative to subjects who never consumed alcohol, subjects who consumed alcohol 1-2, 3-4, 5-6, and 7 d/wk had multivariate relative risks of cholecystectomy of 0.94, 0.88, 0.87, and 0.73 (0.63, 0.84), respectively. All alcoholic beverage types were inversely associated with cholecystectomy risk, independent of consumption patterns (for quantity of alcohol consumed, P = 0.04, 0.001, and 0.003 for wine, beer, and liquor, respectively; for frequency of alcohol consumption, P = 0.01, 0.07, and <0.0001 for wine, beer, and liquor, respectively). CONCLUSIONS: The intake of all alcoholic beverage types is inversely associated with the risk of cholecystectomy. Recommendations regarding the benefit of consuming moderate quantities of alcohol should be weighed against the potential health hazards.     

Type of alcohol and drinking pattern in 56, 970 Danish men and women

OBJECTIVE: To describe drinking patterns among individuals who prefer drinking wine, beer or spirits. DESIGN: Cross-sectional study obtaining detailed information on intake of wine, beer and spirits and on frequency of alcohol intake. Adjustment for gender, age, smoking habits, educational attainment and body mass index. SETTING: Denmark. SUBJECTS: 27, 151 men and 29, 819 women, randomly selected from Copenhagen and Aarhus, Denmark. MAIN OUTCOME MEASURES: Drinking pattern-steady or binge drinking. RESULTS: A vast majority (71%) of both men and women preferred wine or beer. At all levels of total alcohol intake, beer drinkers were most likely to be frequent drinkers. Thus, light drinkers of beer had an odds ratio for being frequent drinkers of 1.97 (95% confidence limits 1.50-2.58) as compared to light drinkers of wine (total alcohol intake 3-30 drinks per month), while people who preferred beer had an odds ratio of 1. 29 (1.19-1.40) compared with wine drinkers in the moderate drinking category (31-134 drinks per month). There were no significant differences in total alcohol intake between individuals preferring different alcoholic beverages. CONCLUSION: If binge drinking is less healthy than steady drinking, the relation between wine intake and coronary heart disease mortality could be subject to negative confounding, since beer drinkers seem to have the most sensible drinking pattern. SPONSORSHIP: Danish Cancer Society and the Danish National Board of Health. European Journal of Clinical Nutrition (2000) 54, 174-176