Abstract
A simple but questionable view holds that alcohol-related mortality is directly and closely related to the total consumption of alcohol in a country. To study how uniform this relationship is, trends and changes by age and diagnosis in alcohol-specific deaths were studied in Finland between the years 2007-2022, a period when both alcohol consumption and alcohol-specific mortality showed a decreasing trend. Alcoholic liver disease mortality trends deviated markedly from those for the other diagnoses. Among those aged 64 years or less, there was a consistent decreasing trend for the other categories while liver disease showed a slight increase after the initial decrease. Among the population aged 65 years or more both liver disease and other groups showed an increasing trend. Alcohol poisoning decreased in both age groups. Mortality in all other diagnostic groups decreased in the younger age group and increased in the older group. Age-adjustment or gender did not explain differences. The different mortality trends were not consistent with the assumed uniform effect of alcohol consumption on alcohol-related harms. Other risk factors than alcohol may play a significant role. These are discussed and need to be considered to yield better estimates than the simplistic assumption of a 100 % attributable fraction of alcohol in these diagnoses.
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