Alcohol

Summary

• Alcohol can shorten life mainly by increasing risk of cancer, cardiovascular disease, liver disease, and injuries (including crashes, falls, and poisoning).
• In large multicohort data (ages 40 to 75), heavy + binge drinking is linked to about 2.7–2.8 fewer disease-free years compared with moderate, non-binge drinking.
• In the same analysis, alcohol poisoning / problem drinking is linked to about 5.7–6.3 fewer disease-free years compared with never-drinkers.
• The pattern matters: binge episodes and unstable high-risk drinking are more harmful than small amounts spread out over the week.

Factor description

This factor measures your typical alcohol intake over time, usually as the number of standard drinks per week over the last 12 months. It may also capture risky patterns such as binge drinking and a history of alcohol problems (for example, alcohol poisoning or alcohol abuse). Alcohol intake is typically self-reported (not a lab test). A “drink” is often defined as roughly 10–14 g of pure alcohol, depending on the country and serving size.

Impact on all-cause mortality

1. Chronic disease pathways (long-term risk) Higher alcohol intake is associated with higher all-cause mortality because it raises risk of several major causes of death, especially cardiovascular disease, multiple cancers, and liver disease. Alcohol can also worsen blood pressure, triglycerides, sleep quality, and weight, which can indirectly increase long-term mortality risk.

2. Injury and acute risk pathways (short-term risk) Alcohol increases the risk of injuries and early death through impaired reaction time and judgement (for example, road injuries, falls, drowning, and violence). Alcohol poisoning and severe intoxication patterns can cause sudden death and also signal longer-term dependence risk.

3. Dose-response and thresholds More alcohol generally means higher risk, and recent genetic and better-controlled cohort studies often do not show a clear protective effect from “light–moderate” drinking once biases are addressed. Many studies find the biggest risk jump at higher intakes and with binge drinking, rather than a safe “benefit zone.”

4. Why older “protective” findings may be misleading Earlier observational studies sometimes reported a J-shaped curve (moderate drinkers seeming to have lower risk than abstainers). This can be explained by confounding (healthier lifestyle and higher socioeconomic status among moderate drinkers) and “sick quitter” bias (some abstainers are former drinkers who stopped due to illness).

5. Years lived without major disease A large multicohort analysis reported fewer years lived without major chronic disease among people with heavy + binge drinking, and even larger losses among those with alcohol poisoning / problem drinking. This supports the idea that alcohol can shorten not only lifespan but also healthy lifespan.

Patterns

• Binge drinking is a high-risk pattern and is strongly linked to injuries and acute cardiovascular events, even if weekly average intake is not extremely high.
• People with a history of alcohol poisoning or alcohol use disorder are typically at much higher risk than people who drink small amounts without binge episodes.
• Lower socioeconomic groups often experience more harm at similar or even lower average intake (sometimes called the alcohol harm paradox), partly due to co-occurring risks (smoking, stress, limited access to care) and more harmful drinking patterns.
• Alcohol risk often clusters with other factors (smoking, high blood pressure, poor sleep, obesity). Combined risks tend to raise all-cause mortality more than any single factor alone.

KamaLama scoring

KamaLama treats alcohol as a risk-only factor: more alcohol does not add health benefit, and risk increases with higher intake and binge/problem patterns. The scoring is a hybrid rule: it uses dose-response for increasing weekly intake, with extra penalty for binge drinking and a larger penalty for alcohol poisoning / alcohol abuse history. Best category is very low or no alcohol without binge drinking and without a history of alcohol problems. If you reduce intake and especially eliminate binges, your score can improve even if you do not go fully to zero.

Practical tips

• Start with the easiest: add alcohol-free days (for example, 3–4 days per week) and keep alcohol out of the home if it triggers extra drinking.
• If you binge, make binge prevention your first target (set a hard cap per occasion, plan a non-alcoholic drink you like, and avoid “round buying” situations).
• Reduce the biggest-risk moments: do not drink before driving, swimming, cycling, or any activity where mistakes can be fatal.
• Replace the habit, not just the drink: swap “alcohol time” with a walk, gym class, sauna, movie, or a dessert/tea ritual.
• Track your weekly drinks for 4–6 weeks (notes app is enough). Many people improve just by measuring consistently.
• If you struggle to cut down, drink to manage emotions, or others are worried about your drinking, consider professional support (brief counselling and structured programs can help).

References

• Authoritative guidelines / evaluations (if applicable)

  • World Health Organization (2023). Alcohol. https://www.who.int/news-room/fact-sheets/detail/alcohol

• Peer-reviewed / indexed research

  • Nyberg et al. (2022). Association of alcohol use with years lived without major chronic diseases: IPD-Work consortium and UK Biobank. https://doi.org/10.1016/j.lanepe.2022.100417
  • Kassaw et al. (2024). Alcohol consumption and all-cause and cause-specific mortality (Mendelian randomization). https://doi.org/10.1093/ije/dyae046
  • Millwood et al. (2023). Alcohol intake and cause-specific mortality: conventional and genetic evidence in 512,000 adults in China. https://doi.org/10.1016/S2468-2667(23)00217-7
  • Di Castelnuovo et al. (2021). Alcohol intake and total mortality in 142,960 individuals (MORGAM Project). https://doi.org/10.1111/add.15593
  • Probst et al. (2020). Alcohol use, drinking patterns, and socioeconomic inequalities in mortality (systematic review). https://doi.org/10.1016/S2468-2667(20)30052-9