Social Pressure to Reduce Alcohol Drinking and Mortality 20 years Later in a General Population Sample: A Cohort Study.

Introduction: Little is known about whether liking a person to reduce alcohol drinking (social pressure) might be related to mortality. Objectives: To analyze whether social pressure and an intention to reduce alcohol drinking may be related to time to death in an adult general population sample. Methods: Among the general population in northern Germany at age 18 to 64, a random sample had been drawn. Included in this study were persons who had consumed alcohol 3 or more times a week or drank 27 g pure alcohol per drinking day or had 1 or more alcohol dependence criteria or problems fulfilled. These persons provided data about social pressure and an intention to reduce alcohol drinking and were known to be alive or deceased 20 years later. Associations between social pressure and time to death were calculated. Results: Among the sample, 4075 (69.9%) residents participated at baseline, and 2060 fulfilled the inclusion criteria for this study. High social pressure to reduce alcohol drinking was related to a short time to death (hazard ratio 1.78; 95% confidence interval 1.17-2.73) after adjustment for the amount of alcohol drinking, an intention to reduce it, age, and sex. Conclusion: The finding suggests that social pressure to reduce alcohol drinking in addition to the amount of alcohol drinking is part of a trajectory of alcohol consumption leading to death in this general population sample.