Alcohol and Alcoholism Advance Access originally published online on February 1, 2008
Alcohol and Alcoholism 2008 43(3):376-386; doi:10.1093/alcalc/agn003
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Alcohol consumption, abstaining, health utility, and quality of life – a general population survey in finland
1 National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland,
2 National Public Health Institute, Department of Health and Functional Capacity, Helsinki, Finland,
3 Helsinki University Central Hospital, Department of Psychiatry, Helsinki, Finland,
4 University of Helsinki, Department of Public Health, Helsinki, Finland and
5 Finnish Foundation for Alcohol Studies, Helsinki, Finland
* Author to whom correspondence should be addressed at: National Public Health Institute, Department of Mental Health and Alcohol Research, Helsinki, Finland. Tel: +358 40 5746119; Fax: +358 9 47448478; E-mail: samuli.saarni{at}helsinki.fi
Received 20 November 2007; first review notified 17 December 2007; in revised form 20 December 2007; accepted 21 December 2007
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Abstract |
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Aims: To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress. Methods: Representative general population survey in Finland, with 5871 persons aged 30–64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire. Results: Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude. Conclusions: Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.