Sarich, PeterCanfell, KarenEgger, SamBanks, EmilyJoshy, GraceGrogan, PaulWeber, Marianne F.2025-12-172025-12-170033-3506PubMed:39814658WOS:001429067900001ORCID:/0000-0002-4617-1302/work/187110298ORCID:/0000-0002-0718-6368/work/187115445https://hdl.handle.net/1885/733796259Objectives: Despite relatively high alcohol consumption in Australia, local evidence regarding drinking and causespecific mortality is limited. We aimed to quantify the risk of alcohol-related causes of death and to calculate contemporary estimates of absolute risk and population attributable fractions for deaths caused by alcohol consumption in Australia. Study design: Prospective cohort study. Methods: Cox proportional hazards regressions were used to calculate hazard ratios (HR) for cause-specific mortality in relation to overall alcohol consumption and pattern of drinking among 181,607 of 267,357 participants aged >= 45 years (2005-2009) in the New South Wales 45 and Up Study, with linkage to death records to December 24, 2019. Cumulative absolute risks and population attributable fractions were estimated. Results: Over a median 11.4 years, there were 18,193 deaths. Every additional seven drinks/week increased risk of death from: alcohol-related cancers combined by 12 % (HR = 1.12; 95%CI = 1.05-1.18); digestive system disease by 32 % (1.33; 1.22-1.44); falls by 23 % (1.23; 1.03-1.46); cardiovascular disease by 7 % (1.07; 1.03-1.11); alcohol-related causes combined by 10 % (1.10; 1.07-1.12); and from all-cause mortality by 6 % (1.06; 1.04-1.08). By age 85 years, men and women who consumed >10 drinks/week were estimated to have 8.5 % and 4.1 % higher cumulative absolute risk of mortality from alcohol-related causes, respectively, compared to those consuming 0 to <1 drink/week. An estimated 9029 deaths (5.3 % of all deaths) were attributable to alcohol consumption in Australia in 2021. Conclusions: Excess risk of death from alcohol consumption in Australia is substantial. Given relatively high alcohol intake, interventions aimed at reducing consumption may translate into significant public health gains.The authors received no specific funding for this work. PS was funded by a postgraduate research scholarship from Cancer Council NSW, the 45 and Up PhD Scholarship in Cancer Research. Prof. KC is co-principal investigator of an unrelated investigator-initiated trial of cervical screening in Australia (Compass; ACTRN12613001207707 and NCT02328872), which is conducted and funded by the VCS Foundation (VCS), a government-funded health promotion charity. KC is also an investigator of Compass New Zealand (ACTRN12614000714684), which was conducted and funded by Diagnostic Medlab (DML), now Auckland District Health Board. The VCS Foundation received equipment and a funding contribution from Roche Molecular Systems and Ventana USA and DML received equipment and a funding contribution for Compass from Roche Molecular Systems. However, neither KC nor her institution on her behalf receives direct funding from industry for this trial or any other project. EB is supported by the National Health and Medical Research Council of Australia (reference: 1136128) and the Government of Australia. Funding sources did not have any role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.12en© 2024 The AuthorsAlcohol consumptionAustraliaDrinking patternMortalityProspective cohort study202510.1016/j.puhe.2024.12.02285217430032