Tobacco and alcohol-related mortality in men: estimates from the Australian cohort of petroleum industry workers

Abstract

Objective: To measure the association between major causes of mortality and tobacco use; and the association between major causes of mortality and alcohol use, after adjusting for tobacco use.

Method: Employees of Australian Institute of Petroleum member companies were enrolled in the cohort in four industry-wide surveys between 1981 and 1999. Mortality of 16,547 men was determined up to 31 December 2001 and cancer incidence to 31 December 2000. Relative mortality and cancer incidence rates were computed for smoking categories compared with never smokers, and for alcohol consumption compared with total abstainers.

Results: The highest category of smoking, more than 30 cigarettes per day, was associated with more than a threefold increase in all-cause mortality, a 60% increase in cancer incidence, a 43-fold increase in lung cancer incidence, and a more than fourfold increase in mortality from ischaemic heart disease. There were only four cancers in lifelong non-smokers. Moderate alcohol consumption provided a protective effect from death from all causes combined, relative to nil or low consumption, and relative to heavy alcohol consumption. The main contributor to the protective effect was protection against death from ischaemic heart disease.

Conclusions: Lifelong avoidance of tobacco and moderate alcohol consumption confer significant improvements on life expectancy.