Estimated risks by disease outcome
| Study | Comparison | Estimated risk—smoking (95% CI) | Comparison | Estimated risk—alcohol (95% CI) |
|---|---|---|---|---|
| All IPD | ||||
| Kyaw et al16 | – | Not reported | Alcohol abuse* vs no alcohol abuse | 11.4 (5.9 to 21.9)† |
| Nuorti et al17 | Current‡ vs never-smoker with no passive smoking Former smoker‡ vs never-smoker with no passive smoking | OR=4.1 (2.4 to 7.3) OR=1.1 (0.5 to 2.2) | Moderate§ vs none | OR=0.7 (0.5 to 1.0) |
| Pastor et al19 | Current vs non-smoker | OR=2.6 (1.9 to 3.5) (unadjusted) | Heavy alcohol use¶ vs not heavy use | OR=4.1 (2.9 to 6.1) (unadjusted) |
| Watt et al18 | Current** vs never-smoker Former** vs never-smoker | OR=1.1 (0.5 to 2.3) (unadjusted) OR=1.5 (0.8 to 2.8) (unadjusted) | Alcohol use or alcoholism vs no alcohol use††† | OR=2.9 (1.5 to 5.4) |
| Bacteraemic pneumococcal pneumonia | ||||
| Flory et al20 | Current vs not current or never | OR=2.2 (1.7 to 3.0) | – | Not reported |
| Jacups and Cheng21 | Smoking vs not smoking | OR=2.7 (1.9 to 3.7) | Excess alcohol†† vs no alcohol excess | OR=4.8 (2.8 to 8.3) |
| All pneumococcal disease | ||||
| Lipsky et al22 | Current‡‡ vs never Former‡‡ vs never | OR=4.0 (1.4 to 11.6) OR=2.1 (0.8 to 6.0) | Heavy*** vs moderate Abuse*** vs moderate | OR=0.7 (0.5 to 3.5) OR=1.3 (0.4 to 4.3) (unadjusted) |
*Alcohol abuse: men who consumed more than 20 drinks/week and women who consumed more than 16 drinks/week.
†Rate ratio.
‡Current smoker: still smoking or quit within the previous year and former smoker: quit more than 1 year previously.
§ Moderate drinking: more than 0 and fewer than 25 alcoholic drinks per week in the previous month. Heavy drinking was also included in this study but excluded from this analysis because of low numbers (n=2).
¶Heavy alcohol use: daily consumption of alcohol or a diagnosis of alcoholism.
**Current smoking: at least 100 cigarettes in the past year and former smoking (at least 100 cigarettes in the past without current smoking.
††Alcohol excess: average daily consumption greater than 60 g alcohol for men and 40 g for women.
‡‡Current smoker: smoked within the previous 6 months and former smoker: quit more than 6 months previously.
***Heavy alcohol use (at least 5 drinks on at least 5 days a week) and alcohol abuse (documented medical or psychosocial problems caused by alcohol).
†††Uses alcohol: self-reported alcohol use or alcoholism (either a diagnosis of alcoholism in medical record or documentation of conditions due to alcohol use).
IPD, invasive pneumococcal disease.