Does the Tail Wag the Dog? Abstainers, Alcohol Dependence, Heavy Episodic Drinkers and Total Alcohol Consumption

Aims To study total alcohol consumption and its correlates, with an emphasis on the direction of causality. Methods The associations among total alcohol consumption, abstaining, alcohol dependence (AD) and heavy episodic drinking were compared in 29 Organization for Economic Cooperation and Development (OECD) countries in 2010. Results Either total alcohol consumption is determined by the number of abstainers and that of alcohol dependents, or the number of alcohol dependents is determined by total alcohol consumption. The number of non-dependent heavy episodic drinkers does not play a role. Conclusion The number of alcohol dependents and abstainers seemingly determines total alcohol consumption and more efforts should be made to reduce AD. Short summary The associations between total alcohol consumption, abstaining, alcohol dependence and heavy episodic drinking were compared in 29 OECD countries in 2010. The number of non-dependent heavy episodic drinkers does not play a role. The number of alcohol dependents and abstainers seemingly determine total alcohol consumption.