Cirrhosis mortality and per capita consumption of distilled spirits, United States, 1949-94: trend analysis

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Abstract
Objective: To describe, evaluate, and suggest interpretations for an observed aggregate level relation between trends in mortality from cirrhosis and per capita consumption of distilled spirits in the United States. Design: Trend analysis using data on US cirrhosis mortality and per capita alcohol consumption. Results: There is a consistent long term trend relation between mortality from cirrhosis and per capita consumption of distilled spirits in the United States from 1949 to 1994. Two instances of comparatively sharp drops in the consumption of spirits earlier in the 1940s generated mixed results in predicting changes in cirrhosis mortality. Conclusions: An aggregate level relation between trends in long term cirrhosis mortality and the consumption of spirits falls considerably short of establishing a direct causal link between the two for individuals. Moreover, two sharp drops in the consumption of spirits generated only mixed results with respect to the short term trend in cirrhosis. Nevertheless, the observed relation between the consumption of spirits and cirrhosis mortality merits further investigation. US cirrhosis mortality peaked in 1973 but alcohol consumption did not peak until the early 1980s Both shifts in the distribution of US drinking patterns (which are not reflected in per capita consumption statistics) and the increase in the availability of treatment for alcoholism have been suggested as potential sources of the decline in cirrhosis The trend in the consumption of distilled spirits from 1949 to 1994 shows a close, aggregate level association with cirrhosis mortality This aggregate level relation suggests that research is needed into the link between the effects of specific alcoholic beverages and cirrhosis