1. Alcohol Abstainers versus Drinkers: Changes in Health Outcomes after 20 Years
Kelly S. Marczynski, Ph.D.
Center for Health and Social Research
Institute for Community Health Promotion
Buffalo State College, CLAS A203
(716)

2. Overview
What is the j-shaped curve, and what do abstainers have to do with it?
The Buffalo Longitudinal Study – Drinking and Delinquency among Young Men
Some findings
Controversies surrounding the j-shaped curve
Results and significance

3. The J-shaped Curve
“There are more old wine drinkers than old doctors.”
- German proverb

4. Alcohol Abstainers Abstainers are rarely the focus of research
It appears that abstainers suffer from some of the same negative outcomes as do drinkers
Alcohol is therefore not an independent predictor of health problems

5. The Study Sample “Drinking and Delinquency Among Young Men”
● 625 young men aged selected from Buffalo,
NY by RDD in ; interviewed three times
initially, and then did Wave years later
● Over-sampled high crime areas
● Data collected: Demographics, drinking and drug
use, degree of family stability, physical health
problems, and personality characteristics and
psychiatric symptoms.

6. Abstainers Lifetime abstainers:
● Defined by the question, “Have you ever had a drink of beer, malt liquor, wine cooler, fortified wine, wine, liquor, or any other beverage containing alcohol, not counting small tastes?”
“Current” abstainers/former drinkers:
● If answered yes to above, repeated the question for the past 12 months.

7. Further Delineation of Abstainers
Lifetime abstainers
Long-term abstainers
Former drinkers as a group
Former light drinkers
Former moderate drinkers
Former heavy drinkers
Former problem drinkers
Former alcoholic drinkers

8. Mental Health Brief Symptom Inventory (BSI) ● Depression ● Anxiety
● Obsessive-compulsive disorder
● Psychoticism

9. Strict Abstainers Former Drinkers F Sig.
Mental Health of Strict Abstainers vs Former Drinkers as a Group: Wave 1
Strict Abstainers Former Drinkers F Sig.
BSI (mean+SD) (mean+SD)
Dimension
Anxiety ns
Psychoticism ns
OCD
Depression ns
Total ns
n=156

10. Strict Abstainers Former Drinkers F Sig.
Mental Health of Strict Abstainers vs Former Drinkers as a Group: Wave 4
Strict Abstainers Former Drinkers F Sig.
BSI (mean+SD) (mean+SD)
Dimension
Anxiety ns
Psychoticism ns
OCD ns
Depression ns
Total ns
n=35

11. Controversies Surrounding the j-shaped Curve
Well-documented by Jayasekara et al (AJE, Vol 179(9), May 2014):
Quality of the epidemiologic evidence
Choice of reference group
Most cohort studies measure alcohol consumption only at baseline, but it’s likely to vary over life
Misclassification of intake
Consumption over prolonged time correlates more with biological processes with chronic health effect, compared with current drinking, which correlates more with acute alcohol effects
Does not address whether low-dose drinking in young adulthood renders a benefit when you’re older

12. Results and Significance
Abstainers should not be analyzed as a group, but rather broken down into lifetime and various categories of former drinking
Infrequent drinkers (less than 12 drinks in any year of life) should not be aggregated with strict abstainers or with other drinkers, but analyzed as a separate group
Significance:
Represents a first step in leading to a better understanding of why certain people choose not to drink alcohol, and how this may impact their overall well-being as measured by other (non-alcohol) constructs in the data
This understanding is imperative in light of recent literature suggesting a positive association between some alcohol and better physical health