The Association Between Heavy Alcohol Use and Lung Function: A Clinical Study of Adult-Onset Asthma

Background: In animal studies, alcohol exposure has been reported to damage lungs. However, no human studies exist on the association between alcohol consumption and lung function in asthma. Objective: To evaluate the association between heavy alcohol consumption and lung function decline in patients with adult-onset asthma. Methods: In the Seinäjoki Adult Asthma Study, 201 patients were observed for 12 years after the diagnosis of new-onset asthma. Based on detailed questionnaires and laboratory indices of heavy drinking, patients were classified as heavy alcohol consumers or non-heavy alcohol consumers. Spirometry evaluation points were (1) baseline before the initiation of inhaled corticosteroids (ICS), (2) maximum lung function during the first 2.5 years after diagnosis and start of ICS treatment (Max_0-2.5), and (3) after 12 years. Results: Between the asthma diagnosis and follow-up, median (interquartile range) annual decline in FVC was –30 mL (–51 to –11 mL) in heavy alcohol consumers and –5 mL (–26 to 25 mL) in non-heavy alcohol consumers (P < .001). This was largely explained by a decline in FVC between Max_0-2.5 and follow-up (P = .041) and perhaps by a diminished effect of ICS. Annual decline in FEV₁ was –26 mL (–52 to 0 mL) in heavy alcohol consumers and –17 mL (–31 to 6 mL) in non-heavy alcohol consumers (P = .022). In multivariate regression analysis, heavy alcohol consumption was a significant predictor of accelerated decline in FVC. Conclusion: In patients with objectively verified adult-onset asthma, heavy alcohol consumption is associated with accelerated loss of lung function.