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Alcohol consumption over time and mortality in the Swedish Women’s Lifestyle and Health cohort
  1. Idlir Licaj1,
  2. Sven Sandin2,
  3. Guri Skeie1,
  4. Hans-Olov Adami2,3,
  5. Nina Roswall4,
  6. Elisabete Weiderpass1,2,5,6
  1. 1Department of Community Medicine, Faculty of Health Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
  2. 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  4. 4Danish Cancer Society Research Center, Copenhagen, Denmark
  5. 5Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
  6. 6Genetic Epidemiology Group, Folkhälsan Research Centre, Samfundet Folkhälsan, Helsinki, Finland
  1. Correspondence to Dr Idlir Licaj; idlir.licaj{at}


Background Alcohol consumption is steadily increasing in high-income countries but the harm and possible net benefits of light-to-moderate drinking remain controversial. We prospectively investigated the association between time-varying alcohol consumption and overall and cause-specific mortality among middle-aged women.

Methods Among 48 249 women at baseline (33 404 at follow-up) in the prospective Swedish Women's Lifestyle and Health cohort, age 30–49 years at baseline, we used repeated information on alcohol consumption and combined this method with multiple imputation in order to maximise the number of participants and deaths included in the analyses. Multivariable Cox regression models were used to calculate HRs for overall and cause-specific mortality.

Results During >900 000 person/years, a total of 2100 deaths were recorded through Swedish registries. The median alcohol consumption increased from 2.3 g/day in 1991/1992 (baseline) to 4.7 g/day in 2004 (follow-up). Compared with light drinkers (0.1–1.5 g/day), a null association was observed for all categories of alcohol consumption with the exception of never drinkers. The HR comparing never with light drinkers was 1.46 (95% CI 1.22 to 1.74). There was a statistically significant negative trend between increasing alcohol consumption and cardiovascular and ischaemic heart diseases mortality. The results were similar when women with prevalent conditions were excluded.

Conclusions In conclusion, in a cohort of young women, light alcohol consumption was protective for cardiovascular and ischaemic heart disease mortality but not for cancer and overall mortality.

  • time-varying alcohol consumption
  • multiple imputation
  • overall and cause specific mortality
  • prospective cohort study

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  • Contributors IL, SS and EW conceptualised the study and defined the analytical strategy. IL and SS performed statistical analyses. IL, SS, GS, H-OA and EW provided preliminary interpretation of findings. IL, SS, GS, H-OA, NR and EW contributed by drafting the manuscript and played a key role in the acquisition of data. With respect to this work, they all critically helped in the interpretation of results, revised the manuscript and provided relevant intellectual input.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was approved by Institutional/Ethics Review Boards at Uppsala University and Karolinska Institutet.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Statistical code is available from the corresponding author by emailing