There is a mechanistic explanation. Alcohol is a blood thinner. Blood thinners protect from ischemic heart disease, which is such a large portion of mortality a small improvement can make up for worsening of all other causes. Which is exactly what we see in the observation.
The paper claimed that in addition to a decrease in people dying from heart conditions there were also decreases in deaths from “chronic lower respiratory tract diseases, Alzheimer’s disease, and influenza and pneumonia.”
There is a mechanistic explanation. Alcohol is a blood thinner. Blood thinners protect from ischemic heart disease, which is such a large portion of mortality a small improvement can make up for worsening of all other causes. Which is exactly what we see in the observation.
It’s that simple.
The paper claimed that in addition to a decrease in people dying from heart conditions there were also decreases in deaths from “chronic lower respiratory tract diseases, Alzheimer’s disease, and influenza and pneumonia.”
Since those are rare causes of deaths, they don’t matter and they’re hard to measure. Also, this is a small study, so I trust earlier studies more.
Per the paper’s table 2, deaths in the lifetime abstainer group were, as a fraction of all deaths in the group:
CVD: 13,562 (34%)
Cancer: 8,169 (20%)
CLRT: 2,030 (5%)
Alzheimer’s:1,730 (4%)
Diabetes: 1574: (4%)
Accidents: 1331 (3%)
Flu and pneumonia: 952 (2%)
Kidneys: 895 (2%)
Light drinking mortality relative to lifetime abstainers, with full controls (“model 2”):
CVD: 0.76 (0.73–0.80)
Cancer: 0.86 (0.81–0.91)
CRLT: 0.68 (0.60–0.76)
Alzheimer’s: 0.68 (0.59–0.78)
Diabetes 0.72 (0.61–0.84)
Accidents: 0.96 (0.83–1.11)
Flu and pneumonia: 0.63 (0.52–0.75)
Kidneys: 0.66 (0.54–0.81)
This really doesn’t look like “the study is great, and the underlying effect is entirely alcohol reducing CVD”.
There are 40k lifetime abstainer and 26k light drinker deaths; how much bigger are the studies you prefer?