The European Journal of Public Health Advance Access published online on September 30, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp153
Influence of smoking and alcohol consumption on admissions and duration of hospitalization
Ulla A. Hvidtfeldt1,2, Søren Rasmussen1, Morten Grønbæk1, Ulrik Becker3 and Janne S. Tolstrup1
1 National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, DK-1399 Copenhagen K, Denmark
2 Department of Public Health, Social Medicine Section, University of Copenhagen, Oester Farimagsgade 5, P.O. box 2099, DK-1014 Copenhagen K, Denmark
3 Department of Medical Gastroenterology, Hvidovre Hospital, Kettegaards Alle 30, DK-2650 Hvidovre, Denmark
Correspondence: Ulla Arthur Hvidtfeldt, Department of Public Health, Social Medicine Section, University of Copenhagen, Oester Farimagsgade 5, P.O. box 2099, DK-1014 Copenhagen K, Denmark, tel: +45 3532 7142, fax: +45 3535 1181, e-mail: u.a.hvidtfeldt{at}pubhealth.ku.dk
Received April 22, 2009 , accepted September 7, 2009
Background: Previous studies have linked smoking and alcohol consumption to a considerable disease burden and large healthcare expenditures. However, findings from studies based on individual level data are sparse and inconclusive. Our objective was to assess the association between alcohol consumption, smoking and patterns of hospitalization, defined as admission and duration of hospitalization. Methods: The study was based on 12 698 men and women, aged 20 years or more, enrolled in the Copenhagen City Heart Study. We related smoking and alcohol to hospital admission from any cause, smoking- and alcohol-related diseases and duration of hospitalization in a two-part random effects model. Results: Smoking status was strongly associated with admission and duration of hospitalization. For smoking-related admissions, odds ratios (OR) of 2.77 (95% CI 2.13–3.59) in men and 6.30 (95% CI 4.80–8.26) in women were observed among smokers of >20 g/day compared to never-smokers. For any admission (excl. smoking-related causes), corresponding ORs were 1.32 (95% CI 1.15–1.51) and 1.80 (95% CI 1.58–2.06), respectively. In men, a U-shaped association between alcohol consumption and risk of admission was found, both regarding any admission and admissions due to alcohol-related diseases. Alcohol was associated with alcohol-related admissions in women but not with duration of hospitalization. Conclusions: Smoking was associated with increased risk of hospital admission and duration of hospitalization. A U-shaped relation was observed for alcohol consumption and risk of hospitalization in men, but no effect on duration was observed. In women, however, alcohol consumption was only vaguely associated with admission and duration of hospitalization.
Keywords: alcohol consumption, epidemiology, hospitalization, length of stay, smoking.