The Prognostic Value of Combined Smoking and Alcohol Consumption Habits for the Estimation of Cause-Specific Mortality in Middle-Age and Elderly Population: Results from a Long-Term Cohort Study in Lithuania

AIM: To evaluate the prognostic value of combined smoking and alcohol consumption habits for the estimation of cause-specific mortality risk in middle-age and elderly population. METHODS: The study presents data from the four surveys. A random sample of 6,729 subjects aged 35–64 years was selected for statistical analysis. During the follow-up of 31 years (1983–2014), there were 2,158 deaths from any cause. Multivariate Cox's proportional hazards models were used to estimate hazard ratios (HR) for all-cause mortality and Competing Risk Regression analysis was used to estimate subdistribution hazard risk (SHR) for cause-specific mortality. RESULTS: Smoking clearly increased the risk of all-cause mortality and mortality from cancer and cardiovascular disease (CVD), but alcohol use had little effect in men aged 35–64 years. However, heavy alcohol consumption (>14 units/week) increased the risk of all-cause mortality and mortality from external causes in the never-smokers men group who drank alcohol of 1–14 units/week (HR 2 = 1.57 and SHR 2 = 2.40, resp.). CONCLUSIONS: The smoking habits and alcohol consumption are modifiable risk factors, and thus efforts to support abstinence from alcohol and smoking use should be a public health priority.