Institute of Epidemiology & Health Care


Investigating the health of non-drinkers, the sick-quitter and sick non-starter hypotheses

Author L. Ng Fat
Author N.J. Shelton
Author N. Cable
Author J. Kneale
Author M. Marmot
Abstract Non-drinkers have been consistently found to have worse health outcomes than moderate drinkers in later life. Explanations for this include a protective effect of moderate alcohol consumption on health, or alternatively that some non-drinkers are ex-drinkers who may have had to stop drinking because of poor health hence suffering from a pre-existing poor health bias. Another factor, which has been unexplored in the literature, is the early life health and social circumstances of non-drinkers; this is the subject of investigation in this thesis The Health Survey for England was used to explore the early life social, health and health behaviours of non-drinkers aged 18 to 34 years. The National Child Development Study and the 1970 British Cohort Study were used to investigate the childhood health characteristics of non-drinkers in early adulthood. Binary logistic regression was carried out to assess whether poor health from an early age and persistent poor health was associated with being a persistent non-drinker across time at different ages, adjusting for sex, highest qualification, mental health and marital and parental status. Poor health from an early age and persistent poor health were associated with being a lifetime abstainer, consistently between two cohorts, which is an original contribution to knowledge. Non-drinkers from an early age had higher rates of emotional and behaviour problems than drinkers; this may contribute to greater risk of cognitive decline. Furthermore non-drinkers in early adulthood had higher rates of health conditions in adolescence, and had lower educational levels from early adulthood. This might increase the risk of mortality among non-drinkers in later life through persistent multiple disadvantage from an early age. The health and social characteristics of non-drinkers in early life need to be considered when comparing health outcomes of non-drinkers with drinkers in later life. The worse health and lower social circumstances of non-drinkers from an early age may be why non-drinkers consistently have worse health outcomes than drinkers across a broad range of conditions.