Informing low-risk drinking guidelines: a secondary, cross-sectional data analysis of alcohol use and health utility

BACKGROUND: Low-risk drinking guidelines seldom incorporate quality of life (QOL). This secondary data analysis explores the relationship between drinking patterns and QoL. METHODS: We estimate the relationship between specific drinking behaviors and QoL, as measured by health utility, which reflects individuals' preferences for living in states of health. We use cross-sectional data from the US nationally representative National Epidemiologic Survey on Alcohol and Related Conditions-III dataset. We modeled individuals' health utility as quadratic functions of the typical frequency of drinking and either the typical quantity consumed or the maximum quantity consumed on a single occasion in the past year. All analyses were limited to the target population for most low-risk drinking guidelines-current drinkers with no history of alcohol use disorder. All analyses were stratified by biological sex. RESULTS: For females, health utility is concave in the frequency of consumption and decreasing in quantity. For males, the relationship is flatter, possibly increasing in frequency, and decreasing in quantity. Results suggest that the greatest health utility is associated with no more than 1 drink per day for women and no more than 3 drinks per day for men, and that, for both sexes, the greatest health utility is associated with drinking on fewer than 7 days per week. CONCLUSIONS: When the health utility of drinkers is considered, the optimal level of drinking is the same or less than many low-risk drinking guidelines. Although descriptive, our results suggest that accounting for drinkers' health preferences will reinforce current recommendations.