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AIMS: To assess the associations of problem drinking with wellbeing and mortality in Chinese men. DESIGN: Population-based prospective cohort study. SETTING: Ten diverse areas across China. PARTICIPANTS: A total of 210 259 men aged 30-79 years enrolled into China Kadoorie Biobank between 2004 and 2008. MEASUREMENTS: Self-reported alcohol intake and indicators of problem drinking (i.e. drinking in the morning, unable to stop drinking, unable to work due to drinking, negative emotions after drinking, having shakes after stopping drinking) were assessed by questionnaire at baseline, along with stressful life events (e.g. divorce, income loss, violence) and wellbeing-related measures (e.g. life satisfaction, sleep problems, depression, anxiety). Problem drinking was defined as reporting at least one of the drinking problem indicators. Follow-up for mortality and hospitalized events was through linkage to death registries and national health insurance systems. Multivariate logistic regression models assessed cross-sectional relationships between problem drinking and stressful life events/wellbeing. Cox proportional hazards regression models estimated prospective associations of problem drinking with mortality/hospitalized events. FINDINGS: A third of men were current regular drinkers (i.e. drank alcohol at least weekly), 24% of whom reported problem drinking: 8% of all men. Experience of stressful life events in the past 2 years, especially income loss [odds ratio (OR) = 1.86, 95% confidence interval (CI) = 1.45-2.39], was associated with increased problem drinking. Compared with low-risk drinkers (i.e. intake

Original publication




Journal article



Publication Date





850 - 862


Alcohol, China, anxiety, depression, mental health, mortality, problem drinking, sleep problems, stressful life events, wellbeing, Adult, Aged, Alcohol Drinking, Alcoholism, Asian People, Biological Specimen Banks, China, Cohort Studies, Cross-Sectional Studies, Humans, Life Style, Logistic Models, Male, Mental Health, Middle Aged, Mortality, Odds Ratio, Prospective Studies, Risk Factors, Rural Population, Surveys and Questionnaires, Urban Population