Smoking, alcohol consumption, and risk of recurrent falls in community-dwelling Japanese people aged 40–74 years: The Murakami cohort study

Abstract

Aim

Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people.

Methods

Participants of this cohort study were 7542 community-dwelling Japanese people aged 40–74 years. The baseline self-administered questionnaire survey was conducted in 2011–2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history.

Results

The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted P for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20–3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57–4.81), suggesting a potential interaction (P for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150–299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33–0.98) compared with no consumption in men.

Conclusions

Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. Geriatr Gerontol Int 2025; 25: 67–74.