The study formed part of a public health survey of cancer and cardiovascular disease and examined the association between alcohol consumption and mortality, as mortality and life style differ substantially in Japan from Western countries.

Subjects who reported serious disease at baseline were excluded. Men in the age group 40-59 years who reported their alcohol intake were followed from 1990 - 1996 and 548 deaths were documented.

The association between all cause mortality and alcohol consumption was J - shaped. The lowest risk was observed for men who consumed 1 - 149 g/week of alcohol, while the highest risk was seen for men who consumed greater than or equal to 450 g/week, after adjustment for possible confounders. After excluding deaths that occurred in the first 2 years of follow - up the association did not change.

The association was however modified by smoking, and the beneficial effects of moderate drinking were largely limited to non smokers.

The risk of cancer death showed a similar trend, but increased more in heavy drinkers. Moderate drinkers had healthier background characteristics than non drinkers or heavy drinkers.

The conclusion was made that moderate consumption of alcohol was associated with the lowest risk of all - cause and cancer mortality, especially among non smokers. (Authors Abstract)

Tsugane S et al, American Journal of Epidemiology, Vol 150, No 11, 1999, pp1201-1207