Page last updated: June 12, 2019
Alcohol drinking and risk of hospitalisation for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a major health problem and cause of death throughout the world.  While cigarette smoking is known to be the most important risk factor, there are limited data available on the relation of alcohol consumption to the condition.  Given that moderate alcohol intake has been shown to decrease the risk of many inflammatory conditions, it may also affect the risk of COPD, which is associated with marked inflammation of lung tissues.

In the present study, the investigators related total alcohol consumption and intake of specific alcoholic beverages with the risk of COPD, based on data from more than 44,000 Swedish men in a population-based prospective cohort study.  A total of 2,177 COPD cases were ascertained during follow up that extended up to 17 years.  In their analyses, the authors had data permitting them to evaluate a number of demographic and lifestyle factors as potential confounders (including smoking status and pack-years of smoking, education, physical activity, BMI, and some indices of diet).   However, there were very few ex-smokers or current smokers among the non-drinkers, making it somewhat difficult to adequate adjust for cigarette use as a cause of COPD.

Forum members thought that there are a number of deficiencies in this study that somewhat weaken its conclusions; especially important was the lack of ability to consider the pattern of drinking (regular, moderate versus binge drinking).  Still, there is a strong consistency between the results of this study (indicating a “J-shaped” or “U-shaped” curve for alcohol intake and COPD) and results from extensive previous epidemiologic and experimental research.

Overall, the cumulative research findings now suggest that pulmonary disease might be included among the “diseases of ageing” that show a reduction in risk among moderate consumers of certain alcoholic beverages.  Based on some previous epidemiologic studies and results from numerous experimental studies, data now suggest that, in addition to alcohol, the polyphenols present in wine and some beers may offer protection against COPD.  While in the present study red wine consumption was associated with the lowest risk of COPD, Forum members acknowledge residual confounding by other lifestyle factors may still play a role.

Reference:  Kaluza J, Harris HR, Linden A, Wolk A.  Alcohol Consumption and Risk of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study of Men. Am J Epidemiol  2019;188:907–991.

For the full critique of this paper by the International Scientific Forum on Alcohol Research, please click here.

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