Clay James M, Callaghan Russell C, Sherk Adam, Naimi Timothy S, Stockwell Tim, Asbridge Mark
Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Drug Alcohol Rev. 2025 Feb;44(2):434-447. doi: 10.1111/dar.13993. Epub 2024 Dec 12.
Alcohol contributes significantly to global disease burden. Over 50 countries, including Canada, have established low-risk drinking guidelines to reduce alcohol-related harm. Canada's Guidance on Alcohol and Health (CGAH) was released in 2023. This study examines the relationship between weekly alcohol consumption, CGAH risk zones and mortality patterns among Canadian drinkers aged 15 and older.
A retrospective cohort study was conducted using data from three cycles of the national, population-based Canadian Community Health Survey (2000-2006) linked to mortality data up to 2017. The sample included 145,760 respondents aged 15 and older who reported alcohol consumption in the past week. Average weekly alcohol consumption was assessed using the Timeline Followback method (i.e., 7-day recall). Outcomes included all-cause mortality, alcohol-related mortality and mortality from conditions with an alcohol-attributable fraction ≥15%.
Alcohol consumption was significantly positively associated with increased risks of all-cause (hazard ratio = 1.01, p < 0.001), alcohol-related (hazard ratio = 1.01, p = 0.001) and alcohol-attributable fraction-related mortality (hazard ratio = 1.02, p < 0.001). Each additional standard drink per week raised mortality risk, with women experiencing a greater increase in risk compared to men.
The findings support the CGAH recommendations, highlighting the importance of lower alcohol consumption limits to reduce health risks. Public health efforts should focus on increasing awareness and adherence to these guidelines, particularly among women who face greater mortality risks at higher consumption levels. Ongoing monitoring of alcohol consumption is critical for tracking and evaluating low-risk drinking guideline effectiveness in reducing alcohol-related harm.
酒精对全球疾病负担有重大影响。包括加拿大在内的50多个国家已制定低风险饮酒指南，以减少与酒精相关的危害。加拿大的《酒精与健康指南》（CGAH）于2023年发布。本研究探讨了15岁及以上加拿大饮酒者每周饮酒量、CGAH风险区域与死亡率模式之间的关系。
采用回顾性队列研究，使用来自全国性、基于人群的加拿大社区健康调查三个周期（2000 - 2006年）的数据，并与截至2017年的死亡率数据相链接。样本包括145,760名15岁及以上的受访者，他们报告了过去一周的饮酒情况。使用时间线追溯法（即7天回忆法）评估每周平均饮酒量。结局包括全因死亡率、与酒精相关的死亡率以及酒精归因分数≥15%的疾病导致的死亡率。
饮酒与全因死亡风险（风险比 = 1.01，p < 0.001）、与酒精相关的死亡风险（风险比 = 1.01，p = 0.001）以及与酒精归因分数相关的死亡风险（风险比 = 1.02，p < 0.001）显著正相关。每周每增加一杯标准饮品，死亡风险就会升高，女性的风险增幅高于男性。
研究结果支持CGAH的建议，强调了降低饮酒限量以降低健康风险的重要性。公共卫生工作应着重提高对这些指南的认识并促进遵守，特别是在饮酒量较高时面临更大死亡风险的女性中。持续监测饮酒情况对于跟踪和评估低风险饮酒指南在减少与酒精相关危害方面的有效性至关重要。
