Moderate drinking or abstinence? Exploring the association of drinking status with multimorbidity in China

Aim To investigate the association between drinking patterns and multimorbidity in Chinese adults.Methods In this 2022 nationwide cross-sectional study of 30,505 participants from 31 provinces, drinking status was categorized as: nondrinkers (never consumed alcohol), constant drinkers (individuals with regular uninterrupted use), current drinkers (individuals with recently initiated), and ex-drinkers (with no alcohol consumption in the past 12 months). Multimorbidity was defined as ≥2 concurrent chronic conditions. Associations were assessed using binary and multinomial logistic regression. Subgroup analyses were conducted among constant drinkers to evaluate age at initiation, daily intake, and beverage type; furthermore, a dedicated analysis was performed among those with alcohol use disorder (AUD) to identify specific risk factors within this subgroup.Results Compared with individuals who never drank, individuals who were constant drinkers, current drinkers, and ex-drinkers had higher odds of having multimorbidity (AORs = 1.41, 95%CI:1.29–1.56; AORs = 1.24, 95%CI:1.08–1.41; AORs = 2.04,95%CI:1.85–2.26). Additionally, individuals who were ex-drinkers also exhibited the highest risk for a greater number of chronic conditions (AORs = 2.00; 95%CI:1.82–2.19). Among individuals who were constant drinkers, the presence of AUD was associated with higher odds of multimorbidity (AORs = 1.69, 95% CI:1.35–2.21). In a dedicated analysis of this AUD subgroup, moderate daily consumption was linked to lower odds, while retirement and former smoking were linked to higher odds. In this comprehensive model, factors such as age at drinking initiation and other sociodemographic factors were not independently associated with risk (p > 0.05).Conclusions This study confirms the association between alcohol use and multimorbidity in China, identifying former drinkers and individuals with AUD as high-risk groups. The findings suggest that interventions for these groups should address broader health and social risks, beyond alcohol consumption alone.