Distilled Spirits Overconsumption as the Most Important Factor of Excessive Adult Male Mortality in Europe

Aims: To explain comprehensively variations in adult male mortality rate in Europe, and in particular, high mortality in some East European countries with particular focus on specific patterns of alcohol consumption. Short summary: Per capita distilled spirits consumption is found to be the strongest determinant of the adult male mortality rate in Europe as soon as the unrecorded alcohol consumption is taken into account. It turns out to be much stronger than the other tested significant determinants such as per capita health expenditures, smoking prevalence, consumption of hard drugs and per capita consumption of vegetables and fruit. Methods: Ordinary least squares (OLS) multiple regression with adult male mortality rate as a dependent variable, and various indicators of alcohol and drug consumption as well as logarithm of gross domestic product (GDP) per capita, logarithm of total per capita health expenditures, latitude (climatic factors), per capita fruit and vegetable consumption, smoking prevalence as independent factors. Results: Per capita distilled spirits consumption turns out to be the strongest determinant of the adult male mortality rate in Europe as soon as the unrecorded alcohol consumption is taken into account. It turns out to be much stronger than the other tested significant determinants of the adult male mortality rate such as per capita health expenditures, smoking prevalence, consumption of hard drugs and per capita consumption of vegetables and fruit. Still, higher per capita wine consumption has turned out to be a marginally significant determinant of the higher adult male mortality rate in some tests. Latitude, beer and soft drug consumption have turned out insignificant in this study. Conclusions: Spirits consumption is a major risk factor of adult male mortality, with significantly greater impact compared to beer and wine. Therefore, reduction in distilled spirits consumption in hard liquor drinking areas should be a major target in health policy.