Alcohol consumption and mortality in COPD: a population-based cohort study
4 affiliations
- 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark
- 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- 3Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- 4Center for General Practice, Aalborg University, Aalborg, Denmark
Abstract
Background: COPD is characterised by multimorbidity and high mortality. Although alcohol consumption is associated with comorbidities common in COPD, its impact on COPD outcomes is uncertain. We investigated associations between baseline alcohol consumption and 10-year mortality, stratified by COPD status and examined whether comorbidity prevalence differed across alcohol categories.
Methods: COPD was defined by post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <0.7; alcohol as ≤10 versus >10 units·week−1. Comorbidities were ascertained from national registries. Cox models estimated mortality hazard ratios (HRs) adjusting for age, sex, smoking, education, body mass index and comorbidities. Inverse probability weighting addressed confounding. Logistic regression examined alcohol–comorbidity associations with false discovery rate correction.
Results: In 2004–2006, 4528 Danish adults aged 45–84 years were recruited. Among 3468 participants with complete alcohol and COPD data (mean age 64 years; 65% male; 12% COPD), 593 deaths occurred over 10 years. Alcohol >10 units·week−1 was not associated with mortality in unadjusted (HR 0.97 (95% CI 0.80–1.18)) or fully adjusted (HR 0.87 (95% CI 0.71–1.07)) models. COPD was strongly associated with mortality (adjusted HR 2.00 (95% CI 1.64–2.43)). No alcohol×COPD interaction was detected. Cardiovascular comorbidities were generally more prevalent among participants with COPD, although patterns varied. No associations between alcohol and individual comorbidities survived multiple testing correction.
Conclusions: In this cohort with predominantly moderate consumption, alcohol intake >10 units·week−1 was not associated with 10-year mortality in adults with or without COPD, whereas COPD conferred excess risk independent of comorbidity and lifestyle factors. These findings should not be interpreted as evidence that alcohol consumption is safe.
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BibTeX
@article{nielsen2026alcohol,
title = {{Alcohol consumption and mortality in COPD: a population-based cohort study}},
author = {Line Bjerrehave Nielsen and Signe Juul Riddersholm and Peter Ascanius Jacobsen and Jens Georg Hansen and Ulla Møller Weinreich},
journal = {ERJ Open Research},
year = {2026},
month = sep,
doi = {10.1183/23120541.00335-2026},
url = {https://doi.org/10.1183/23120541.00335-2026},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Alcohol consumption and mortality in COPD: a population-based cohort study
AU - Line Bjerrehave Nielsen
AU - Signe Juul Riddersholm
AU - Peter Ascanius Jacobsen
AU - Jens Georg Hansen
AU - Ulla Møller Weinreich
PY - 2026
DA - 2026/09/01
JO - ERJ Open Research
DO - 10.1183/23120541.00335-2026
UR - https://doi.org/10.1183/23120541.00335-2026
AB - Background: COPD is characterised by multimorbidity and high mortality. Although alcohol consumption is associated with comorbidities common in COPD, its impact on COPD outcomes is uncertain. We investigated associations between baseline alcohol consumption and 10-year mortality, stratified by COPD status and examined whether comorbidity prevalence differed across alcohol categories. Methods: COPD was defined by post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <0.7; alcohol as ≤10 versus >10 units·week−1. Comorbidities were ascertained from national registries. Cox models estimated mortality hazard ratios (HRs) adjusting for age, sex, smoking, education, body mass index and comorbidities. Inverse probability weighting addressed confounding. Logistic regression examined alcohol–comorbidity associations with false discovery rate correction. Results: In 2004–2006, 4528 Danish adults aged 45–84 years were recruited. Among 3468 participants with complete alcohol and COPD data (mean age 64 years; 65% male; 12% COPD), 593 deaths occurred over 10 years. Alcohol >10 units·week−1 was not associated with mortality in unadjusted (HR 0.97 (95% CI 0.80–1.18)) or fully adjusted (HR 0.87 (95% CI 0.71–1.07)) models. COPD was strongly associated with mortality (adjusted HR 2.00 (95% CI 1.64–2.43)). No alcohol×COPD interaction was detected. Cardiovascular comorbidities were generally more prevalent among participants with COPD, although patterns varied. No associations between alcohol and individual comorbidities survived multiple testing correction. Conclusions: In this cohort with predominantly moderate consumption, alcohol intake >10 units·week−1 was not associated with 10-year mortality in adults with or without COPD, whereas COPD conferred excess risk independent of comorbidity and lifestyle factors. These findings should not be interpreted as evidence that alcohol consumption is safe.
SN - 2312-0541
ER -