The prospective analyses presented were based on men free of ischaemic heart disease at inclusion. A potential weakness of the study is the absence of a detailed history of alcohol consumption behaviour. It has been claimed that “abstainer misclassification error” can at least partially account for an observed lower incidence of coronary heart disease in regular drinkers compared with non-drinkers if a proportion of the non-drinkers has given up on account of ill health (sick quitters).32 This is an unlikely explanation for the associations observed in PRIME because only participants free of disease at baseline were included in the prospective analysis and the pattern of risk factors in table 2 does not suggest that the non-drinkers as a whole were any less healthy than the drinkers.
