Beer Drinkers Research Articles

Adolescent Alcohol Beverage Type Choices Reflect Their Substance Use Patterns and Attitudes

Alcoholic beverage type choices were studied in relation to adolescents' substance use patterns and attitudes towards substance use, utilizing the national 1999 Adolescent Health and Lifestyle Survey data (N = 4943) collected among Finns aged 14 and 16 years by mail. Frequencies of drinking, drunkenness and smoking, and chewing tobacco use as well as attitudes towards substance use and exposure to other drugs were all strongly related to beverage type choices. The amount of alcohol consumed was associated with the beverage choice. The relationships between beverage choices and substance use patterns were partly mediated through amounts drunk. Beverage type choices seemed to reflect substance use patterns and attitudes more generally. Wine and cider appeared beverages related to moderation and control in relation to substance use, but beer drinking may be interpreted as a sign of initiation into a substance use pattern favoring smoking and heavier use of alcohol and other drugs.

Energy adjustment methods applied to alcohol analyses

When alcohol consumption is related to outcome, associations between alcohol type and health outcomes may occur simply because of the ethanol in the beverage type. When one analyzes the consequences of consumption of beer, wine, and spirits, the total alcohol intake must therefore be taken into account. However, owing to the linear dependency between total alcohol intake and the alcohol content of each beverage type, the effects cannot be separated from each other or from the effect of ethanol. In nutritional epidemiology, similar problems regarding intake of macronutrients and total energy intake have been addressed, and four methods have been proposed to solve the problem: energy partition, standard, density, and residual. The aim of this study was to evaluate the usefulness of the energy adjustment methods in alcohol analyses by using coronary heart disease as an example. Data obtained from the Copenhagen City Heart Study were used. The standard and energy partition methods yielded similar results for continuous, and almost similar results for categorical, alcohol variables. The results from the density method differed, but nevertheless were concordant with these. Beer and wine drinkers, in comparison with findings for nondrinkers, had lower risk of coronary heart disease. Except for the case of men drinking beer, the effect seemed to be associated with drinking one drink per week. The standard method derives influence of substituting alcohol types at constant total alcohol intake and complements the estimates of adding consumption of a particular alcohol type to the total intake. For most diseases, the effect of ethanol predominates over that of substances in the beverage type, which makes the density method less relevant in alcohol analyses.

Alcohol consumption and the incidence of Parkinson's disease.

Cigarette smoking and caffeine consumption are associated with a decreased incidence of Parkinson's disease (PD). This inverse association may result from neuroprotective effects of cigarette smoke and caffeine, or from a disinclination of future PD patients to engage in habituating behaviors. We investigated the association between consumption of alcoholic beverages, another potentially habituating behavior, and risk of PD in two large prospective cohorts Nurses' Health Study, and Health Professionals' Follow-up Study. We detected 415 new cases of PD during follow-up. Compared with nondrinkers at baseline, the relative rate (95% confidence interval) was 1.0 (0.8-1.3) for drinkers of less than 5 gm/day, 1.0 (0.8-1.4) for 5 to less than 15 gm/day, 1.1 (0.8-1.6) for 15 to less than 30 gm/day, and 0.7 (0.5-1.2) for 30 gm/day or more (p for trend = 0.45). Consumption of wine or liquor was not associated with the incidence of PD. Compared with those who consumed beer less than once per month, the relative rate (95% confidence interval) was 0.7 (0.5-0.9) for one to three drinks of beer per month, and 0.7 (0.5, 0.9) for one or more drinks of beer per week. The risk of PD was similar in individuals who usually consume moderate amounts of alcohol and in abstainers.

Alcohol drinking patterns and risk of type 2 diabetes mellitus among younger women.

To examine the relationship between alcohol consumption and the incidence of type 2 diabetes mellitus among relatively young and middle-aged women. In a prospective study, 109 690 women, aged 25 to 42 years, without a history of coronary heart disease, stroke, cancer, or diabetes mellitus completed a detailed lifestyle and medical history questionnaire in 1989. During 10 years of follow-up, we documented 935 incident cases of type 2 diabetes mellitus. We found a nonlinear relationship between alcohol consumption and risk of type 2 diabetes mellitus after adjustment for multiple confounders, including body mass index, smoking, physical activity, and family history of diabetes mellitus (quadratic trend P =.003). Compared with lifelong abstainers, the adjusted relative risks (95% confidence intervals) were 0.80 (0.66-0.96) for those consuming 0.1 to 4.9 g/d, 0.67 (0.50-0.89) for those consuming 5.0 to 14.9 g/d, 0.42 (0.20-0.90) for those consuming 15.0 to 29.9 g/d, and 0.78 (0.34-1.78) for those consuming 30.0 g/d or more. Further adjustment for dietary factors, including glycemic load, trans-fatty acid, polyunsaturated fat, and total fiber intake, did not appreciably alter these findings. The inverse association with light to moderate drinking was most apparent in women who reported wine or beer drinking. Women who reported 30.0 g/d or more of liquor intake showed a significantly increased risk of diabetes mellitus compared with those who did not report liquor intake (adjusted relative risk, 2.50; 95% confidence interval, 1.00-6.23). Light to moderate alcoholic beverage consumption may be associated with a lower risk of type 2 diabetes mellitus among women aged 25 to 42 years, although this benefit may not persist at higher levels.

Solute loss plays a major role in polydipsia-related hyponatraemia of both water drinkers and beer drinkers.

Polydipsia-related hyponatraemia is generally considered an acute dilutional state. To determine whether solute loss plays a role in the pathogenesis of polydipsia-related hyponatraemia. Prospective uncontrolled study. We studied routine biochemical volume-related parameters before and after 2 l isotonic saline infusion over 24 h, in 10 consecutive hyponatraemic polydipsia patients (mean age 55 +/- 11 years; 6 beer drinkers and 4 compulsive water drinkers) with initial urinary osmolality <220 mosm/kg H(2)O. In five of these patients, we measured balance data over 24 h. Mean initial plasma protein concentration in the 10 studied polydipsia patients was 7 +/- 0.7 g/dl, unexpectedly high for an acute dilutional state. Mean plasma sodium concentration increased from 126 +/- 5 mmol/l before saline, to 135 +/- 5 mmol/l after infusion of 2 l isotonic saline (p < 0.01). Balance data in five polydipsia patients showed a mean decrease of 1.6 kg of their initial body weight and a mean salt retention of 406 mosm. Polydipsia-related hyponatraemia is a mixed disorder, in which about half of sodium decrease is due to solute loss. This explains the apparent paradox of a normal plasma protein concentration, despite the increase in body weight due to water intoxication.

Coercion

Coercion

Drinking Games and Rite of Life Projects

The aim of this article is to present a social comparison of modern youth culture and the local traditions regarding the drinking of alcohol in Italy and Norway. We argue that the use of alcohol in `wet and dry drinking cultures' in northern and southern Europe has grown more similar. Young people, in both countries, drink beer and spirits at weekends, holidays and during the period of their final exams for intoxication, transition to a new phase of life and celebration purposes within the peer group. The modern innovations of practice combine a ritual structure of traditional forms of `rite of passage' (Turner, 1969; Van Gennep, 1960) with modern individualistic rites (Beck, 1997). In the modern local and global youth culture, use of alcohol for intoxication purposes is the key symbol for `free flow' in the phase of transition from childhood to the individual life project of creating one's social identity. This mixing of old ritual structures and modern reflexive individualization rituals has led to us coining a new concept of `rite of life projects'.

Alcoholic beverage preference and characteristics of drinkers and nondrinkers in western New York (United States)

Background and Aim: Dietary and lifestyle characteristics may differ for drinkers of specific alcoholic beverages and nondrinkers which would have important implications for studies of alcohol and disease. Our aim in this study was to describe differences in dietary and lifestyle characteristics associated with alcoholic beverage preference in a population-based sample of healthy study participants. Methods and Results: Data were collected as part of a series of case-control studies of alcohol use, myocardial infarction, and lung, breast and prostate cancer in western New York from 1846 men and 1910 women aged 35 to 79, randomly selected from the general population of Erie and Niagara Counties. Beverage preference was defined for noncurrent vs current drinkers, and drinkers of beer, wine, liquor, and mixed beverages. Generalized linear models for continuous variables and Cochran-Mantel-Haenszel statistics for categorical variables were computed for the entire sample and stratified by gender. Participant characteristics differed by alcoholic beverage preference and drinking status. In general, wine drinkers had higher education and household incomes, lower prevalence of current smoking, higher intakes of dietary fiber, potassium, vitamin E, and total carotenoids, lower total fat intakes and higher amounts of fruits, vegetables, and grain products than consumers of other beverages. Conversely, beer and liquor drinkers had somewhat lower education and household incomes, higher rates of current smoking, higher energy and total fat intakes and consumed lower amounts of fruits, vegetables, and grain products. Finally, current nondrinkers were more likely to be older, less educated, have lower household incomes, and consume diets less consistent with dietary guidelines than current drinkers. Conclusions: These results suggest that usual beverage preference may encompass other health-related behaviors and underline the importance of accurate exposure measurement and use of statistical methods to accommodate these interrelationships.

Lockjaw

Lockjaw Holly Farris (bio) A woman worked with me around 1960, Brenda—and I recall her name well as my own—she had tetanus and lived to tell. Being deathly sick and the miracle that she got better without special medicine was a story she hinted at on our second day together at Shuff's roadside place. "My daddy had horses," she'd said, a pinch of history enough to tease or let me ignore. It was months before I heard all of it. Brenda'd graduated high school, which is why Shuff put her on the store counter; she could count change faster than the dusty metal register. Brenda began each day vowing to come in until August, but already she had a Greyhound ticket to North Carolina. Seems the army expected her at summer's end to be at Fort Bragg training, showing the government she could climb and crawl as well as any other recruit. From there, the army planned to teach her what they wanted her to do for them indoors. I'd quit high school, so I felt for the boys who would sneak down the worn dirt path from the high school to buy beer and soda any Wednesday. They'd lay out back of Shuff's store, tanked with whatever liquid would reward girls riding by to give up a few minutes—whether sharing cigarettes or a screw all the same to them. I know. I'd been screwed by one, a boy lied who said he was twenty-one, him now back attending tenth grade and me fat with the baby he left me. Options. It's what Brenda had and I didn't. May aimed to sag into June without much force, and it was about the Friday of Memorial weekend when Brenda and I got together. We'd been busy all morning, what with it bait day. High school customers loafing off from school who didn't drink beer got fishing crawlers or crickets plus a Pepsi that Brenda traded them across the pocked counter. "Janelle." Brenda called my name when the screen hinge sang for the last time that hot morning. While she'd unlocked the door at eight o'clock, I kicked [End Page 100] gravel mixed with beer caps under a sunnyside-up sun. Nothing over-easy about that day, I reckoned, wondering if I should try a grill job again. Not with those grease smells, I remembered, why I'd left. Cigarettes in Brenda's left hand hooked out the back door. Self-centered, she always took her pack out back of Shuff's over noontime lunch and sproing ed solitary on a set of rusted bedsprings we all used, it left over from when Shuff accepted furniture pawns. "Screw the register, Janelle," Brenda said, making me guess she blamed me for something. Her cigarette-sanded voice floated inside to me kneeling in the dark cornmeal- and white bread-smelling back aisle. When I looked, I caught her jeans hooked up like for wading, knobby kneecaps pointing toward the sun where she'd flopped down. Inside the store, I'd propped the glass cooler door open against my bare upper arm. I laid my cheek right down on the silver grid of the bottom shelf, sucking up refrigeration properly belonging to bait bugs once I had stacked the little packages inside. Crickets rustled at room temperature, tasting or sensing people's smell plugging lid holes of their paper containers, but the Canadian crawlers were quiet inside plastic tubs that chilled and looked like they held onion dip. "Live bait, Brenda," I said, thinking she wanted me to watch the register while she spiffed up her tan. Bob's bait truck had just farted up the hill; Harry, carrying the peanut butter and cheese nabs, was due shortly. Fridays were given over to stocking shelves before fishermen and snackers hit Shuff's. "Like I give a shit," Brenda called, blowing smoke rings through the back door screen mesh and waving one foot's toes free from her sandal. I wondered what I'd done to piss her off. My mornings were rocky, bait most likely to make...

Childhood Acute Lymphoblastic Leukemia Associated With Parental Alcohol Consumption and Polymorphisms of Carcinogen-Metabolizing Genes

Although alcohol metabolism produces reactive oxygen species that conceivably might promote carcinogenesis, little is known of the association, if any, between parental alcohol use before and during pregnancy and the risk of childhood leukemia. The potential role of genetic polymorphisms, such as those associated with genes of the glutathione-S-transferase (GST) gene family, also remains an open question. The authors report a population-based, case-control study of 491 incident cases of acute lymphoblastic leukemia (ALL) in children aged 9 years or younger, matched for age and gender with healthy control subjects. Parents were interviewed separately by telephone about their alcohol consumption. In 186 cases, interaction odds ratios between prenatal exposure and child DNA variants in the GSTMI and CYP2E1 genes, the latter a cytochrome P450 gene, were estimated. ALL was inversely related to maternal alcohol consumption before or during pregnancy; the adjusted odds ratio for any alcohol consumption during pregnancy was 0.7. Comparable results were obtained when wine and beer drinking (but not spirits) were considered separately. The odds ratio for drinking wine or beer at any time was 0.6, and that for consumption during pregnancy was 0.7. This inverse relationship was most evident with small amounts of alcohol intake. The effect was strongest in subjects who drank only during pregnancy. The interaction odds ratio for the GSTM1 null genotype during late pregnancy was 2.4, and that for CYP2E1 variant G-1295C (allele *5) during the time of nursing was 4.9. The risk associated with any type of alcohol exposure increased with the dose. These findings, suggesting that maternal alcohol consumption during pregnancy and nursing might protect against ALL, could reflect the potential chemopreventive effects of flavonoids present in wine and beer. More data are needed, but it seems possible that these effects of alcohol are at least in part genetically determined. Variant polymorphisms of genes that metabolize carcinogens might alter the risk associated with prenatal alcohol exposure.

The Demand for Wine in Australia Using a Systems Approach: Industry Implications

The objective of this study is to explain the factors determining the demand for wine in Australia, based on a systems approach where wine demand is modelled as part of the broader demand for alcoholic drinks (beer, wine and spirits). Time series data on retail price indexes and apparent per capita consumption of alcoholic beverages for Australia for the period 1975/76 to 1998/99 are used for econometric estimation of an Almost Ideal Demand System. The results show that the demand for beer and wine is price inelastic and that both beer and wine are luxury goods. The study also found that current beer and wine consumption strongly follows past consumption patterns. Drink driving campaigns have not had a significant effect on alcoholic consumption, but there seems to have been a structural change in consumer preferences that has had a significant impact on the volume of wine consumption. Finally, there seems to have been an overall upward trend in wine consumption and a downward trend for beer consumption. The study re-confirms the importance of developing a model that considers the impacts of both economic and non-economic variables on wine consumption. Implications for wine industry marketing strategies are suggested.

Image Advertisements’ Influence on Adolescents’ Perceptions of the Desirability of Beer and Cigarettes

The authors examine whether attitude toward the ad (A ad ) and attitude toward the brand (A b ) mediate the effects of visual, image-oriented content in advertisements on perceptions of the desirability of beer and cigarettes, as well as of soft drinks. Adolescents (n = 384) rated either image advertisements with visuals for cigarettes, beer, and soft drinks or comparable tombstone advertisements that had no photographs or drawings. Advertisements with image-oriented visuals were found to directly produce more positive A ad , A b , and attitude toward the product category (A pc ) evaluations than did the tombstone versions. The authors then used structural equation modeling to examine the relationship among A ad , A b , and A pc. The results were generally supportive of the proposed mediating model. Also, little support was found for the assumption of some advocacy groups and policymakers that to be well received by adolescents, cigarette advertisements require human models. The authors discuss implications of findings for advertising research and public policy.

Estimates of per capita exposure to substances migrating from canned foods and beverages

A study was undertaken by European industry to estimate the consumption of canned beverages and foodstuffs. European can production data were used with adjustments for imports into and out of the EU. It was further assumed that can production, with adjustments, equalled consumption. Owing to the lack of actual consumption country-by-country or household-by-household data throughout Europe, only per capita estimates of consumption were possible. Data were compiled country-by-country for seven major can-producing EU Member States and for eight different types of canned food and two types of canned beverage (beer and soft drinks). The per capita consumption of canned foods was 1.1 cans/person/week, and consumption of canned fish was estimated as 2.2 kg/person/year. The estimate of per capita consumption of canned food was 62 g/person/day or 22.6 kg/person/year. Canned beverages account for about 60% of the consumption of canned foodstuffs. The usefulness of per capita consumption of beverages is questionable because consumption habits may vary more widely than those for canned foods. However, as the migration into beverages is insignificant, these data were added for completeness. Per capita consumption of canned beverages is 67 cans/person/year or 61 g/person/day. From the average can sizes, the surface area of the cans consumed was estimated. The per capita surface area exposure was 0.55 dm2 /person/day for canned foods and 0.55 dm2 /person/day for canned beverages, giving 1.1 dm2 /person/day. Migration of a substance at 0.02 mg dm2 gives an exposure of 0.01 mg/person/day assuming a per capita consumption, using a surface area model. Migration at 0.12 mg kg-1 in food gives an exposure of 0.007 mg/person/day using a weight model. Both models assumed migration into all food types at the same level, which is highly unrealistic. Exposure to BADGE from canned foods has been used as a case study. The best estimate for a worst case per capita exposure to BADGE and relevant derivatives was between 6 and 10 μg/person/day, depending upon the approach and assumptions used.

Binge Drinking in Adulthood: The Influence of Gender, Age, and Beverage Exclusivity

Past research has shown that men, young adults, and beer drinkers engage in the highest rates of binge drinking behavior. However, studies of binge drinking have tended to focus on main effects over interactions, especially in samples of college students and other young adults. The present study used the 1994 Canada’s Alcohol and Other Drugs Survey to explore the interactions among gender, age, and beverage exclusivity when studying heavy drinking behavior. The findings replicated prior main effects research and extended the age findings to later adulthood. The interactions, however, revealed that gender differences were smaller in older adults and were entirely absent in wine drinkers; age differences also were found across beverage exclusivity categories. However, the amount of variability explained by the model suggests that other factors have more power in explaining binge drinking behavior. The need to study binge drinking in more heterogenous samples, with other variables, is discussed.

Influence of Moderate Drinking on Purine and Carbohydrate Metabolism

Background We examined the influences of a moderate intake level of three types of alcoholic beverages—beer, whisky, and Shochu (Japanese distilled liquor)—on purine and carbohydrate metabolism and excretion in healthy male volunteers, concerning (1) the extent of contribution of purine bodies contained in beer to uric acid metabolism and (2) a comparison between two types of distilled spirits with (whisky) and without (Shochu) aging in oak wood barrel storage.Methods Three sets of studies were conducted in which 10 to 13 healthy adult men were instructed to drink three types of alcoholic beverages at a slightly higher level (0.8 ml of ethanol equivalent/kg body weight) than moderate drinking (approximately 30.4 ml or less for men). A low purine beer was test‐manufactured by treating nucleosides that were contained in wort and remained in beer with purine nucleoside phosphorylase derived from Ochrobacterium anthropi, thereby converting them into corresponding purine bases that were easily assimilated by beer yeast.Results Although beer intake enhanced the level of serum uric acid by 13.6%, blood glucose by 26.7%, and insulin level by 5.1‐fold, drinking a moderate level of distilled liquor (whisky, Shochu) did not increase the serum uric acid level or the other two parameters. The serum uric acid level observed after drinking beer with a purine body concentration reduced by 28% (68% in nucleosides and purine bases) was almost identical to the level observed after drinking regular beer. Whisky has been found to have a property that decreases the serum uric acid level. Excretion of uric acid from blood is increased by 27% after drinking whisky.Conclusions Moderate drinking of distilled liquors did not enhance serum uric acid level, blood glucose, or insulin level in healthy male subjects. Increased serum uric acid after beer intake could not be explained mostly with their purine body congeners. Whisky showed the eliminative property in serum uric acid through excretion of it from blood to urine. At a moderate drinking level, beer and whisky have different effects on purine metabolism or excretion.

Influence of Moderate Drinking on Purine and Carbohydrate Metabolism

Background We examined the influences of a moderate intake level of three types of alcoholic beverages—beer, whisky, and Shochu (Japanese distilled liquor)—on purine and carbohydrate metabolism and excretion in healthy male volunteers, concerning (1) the extent of contribution of purine bodies contained in beer to uric acid metabolism and (2) a comparison between two types of distilled spirits with (whisky) and without (Shochu) aging in oak wood barrel storage. Methods Three sets of studies were conducted in which 10 to 13 healthy adult men were instructed to drink three types of alcoholic beverages at a slightly higher level (0.8 ml of ethanol equivalent/kg body weight) than moderate drinking (approximately 30.4 ml or less for men). A low purine beer was test-manufactured by treating nucleosides that were contained in wort and remained in beer with purine nucleoside phosphorylase derived from Ochrobacterium anthropi, thereby converting them into corresponding purine bases that were easily assimilated by beer yeast. Results Although beer intake enhanced the level of serum uric acid by 13.6%, blood glucose by 26.7%, and insulin level by 5.1-fold, drinking a moderate level of distilled liquor (whisky, Shochu) did not increase the serum uric acid level or the other two parameters. The serum uric acid level observed after drinking beer with a purine body concentration reduced by 28% (68% in nucleosides and purine bases) was almost identical to the level observed after drinking regular beer. Whisky has been found to have a property that decreases the serum uric acid level. Excretion of uric acid from blood is increased by 27% after drinking whisky. Conclusions Moderate drinking of distilled liquors did not enhance serum uric acid level, blood glucose, or insulin level in healthy male subjects. Increased serum uric acid after beer intake could not be explained mostly with their purine body congeners. Whisky showed the eliminative property in serum uric acid through excretion of it from blood to urine. At a moderate drinking level, beer and whisky have different effects on purine metabolism or excretion.

Intoxication and Rite of Passage to Adulthood in Norway

The author describes young Norwegians' use of alcohol in “russefeiring,” a special rite of passage to adulthood in the form of prolonged graduation parties. In this ritual, the young people wear special clothes, celebrate, and drink beer and spirits from the 1st through the 17th of May. The article argues that young people have invented rites of passage in which expressive individualism is stressed as a value. The article discusses the use of symbolic anthropology and sociology and field methods in research relating to this kind of ritual alcohol use and intoxication. Theoretically, the focus is on studying alcohol use as a ritual practice. Use of alcohol can be defined as a key symbol in these ritual processes, offering an opportunity to communicate meaning between members of the society and culture concerned.

Alcohol Advertising and Youth

This article presents the proceedings of a symposium at the 2001 Research Society on Alcoholism meeting in Montreal, Canada. The symposium was organized and chaired by Joel W. Grube. The presentations and presenters were (1) Introduction and background, by Susan E. Martin; (2) The effect of alcohol ads on youth 15-26 years old, by Leslie Snyder, Mark Hamilton, Fran Fleming-Milici, and Michael D. Slater; (3) A comparison of exposure to alcohol advertising and drinking behavior in elementary versus middle school children, by Phyllis L. Ellickson and Rebecca L. Collins; (4) USC health and advertising project: assessment study on alcohol advertisement memory and exposure, by Alan Stacy; and (5) TV beer and soft drink advertising: what young people like and what effects? by Meng-Jinn Chen and Joel W. Grube.

Alcohol Advertising and Youth

This article presents the proceedings of a symposium at the 2001 Research Society on Alcoholism meeting in Montreal, Canada. The symposium was organized and chaired by Joel W. Grube. The presentations and presenters were (1) Introduction and background, by Susan E. Martin; (2) The effect of alcohol ads on youth 15–26 years old, by Leslie Snyder, Mark Hamilton, Fran Fleming-Milici, and Michael D. Slater; (3) A comparison of exposure to alcohol advertising and drinking behavior in elementary versus middle school children, by Phyllis L. Ellickson and Rebecca L. Collins; (4) USC health and advertising project: assessment study on alcohol advertisement memory and exposure, by Alan Stacy; and (5) TV beer and soft drink advertising: what young people like and what effects? by Meng-Jinn Chen and Joel W. Grube.

Lower risk for alcohol-induced cirrhosis in wine drinkers

Although there is a well-known relationship between total alcohol intake and future risk for cirrhosis, other factors such as the type of alcohol consumed are sparsely studied. The aim of this study was to assess the effects of wine compared with other types of alcoholic beverages on risk for alcohol-induced cirrhosis. In 3 prospective studies, 30,630 participants from the Copenhagen area were followed-up for a total observation time of 417,325 person-years. Information on weekly intake of beer, wine, and spirits, and sex, age, body mass index, smoking habits, and education was obtained from questionnaires. The primary outcome measures were first admission or death, with alcohol-induced cirrhosis obtained from death certificates and from the National Hospital Discharge Register. Data were analyzed by means of multiplicative Poisson regression models. We confirmed the increasing risk for cirrhosis with increasing alcohol intake. Individuals who drank more than 5 drinks per day had a relative risk of 14 to 20 for developing cirrhosis compared with non- or light drinkers. However, compared with individuals who drank no wine (relative risk set at 1.0), individuals drinking 16% to 30% wine of their total intake had a relative risk of 0.4 (95% confidence limits, 0.3-0.6) and those drinking 51% or more of wine had a relative risk of 0.3 (95% confidence limits, 0.2-0.5) for developing cirrhosis. In conclusion, the results suggest that a high intake of all 3 types of alcohol conveys an increased risk for cirrhosis, but wine drinkers are at a lower risk than beer and spirits drinkers. (HEPATOLOGY 2002;35:868-875.)