The social penalty paid by teetotallers

Background: Recent trends suggest that the proportion of individuals in Britain who do not drink alcohol is increasing. Despite this, British culture is still fairly dominated by alcohol as a cultural norm, and as an instigator/focus of social activities. Little is known about the effects of stopping drinking alcohol on social outcomes, which are important factors that also help protect health. Aims: : Examine if drinking alcohol has a causal effect on an individual’s social life. Methods: : We use data from 11,631 individuals in the UK Household Longitudinal Study (UKHLS) and adopt the outcome-wide longitudinal framework detailed by VanderWeele et al. (2020) to examine the causal relationship between alcohol consumption and social outcomes. Our two exposures are a binary variable for drinking and a categorical variable for frequency of drinking. We look at five binary social outcomes; being able to visit friends when feels like it, feeling isolated, lacking companionship, feeling left out, and feeling lonely. We control for past values of the outcome and exposure, and many covariates. We report E-values, the minimum strength of association that an unmeasured confounder would need to have with both the treatment and the outcome to fully explain away our treatment-outcome association. Results: : We find that being a drinker has a most likely causal protective effect against not visiting friends when feels like it with an odds ratio (OR) of 0.71 (E -value: 2.18) and against feeling isolated often with an OR of 0.71 (E-value: 2.18). We also find evidence that it is not simply about drinking vs. non-drinking, and that the frequency of drinking matters. Drinking monthly or less had no statistically significant effect on social outcomes relative to not drinking, while drinking 2-3 times a week had the biggest protective effect against adverse social outcomes, including against not visiting friends when you feel like it with an OR of 0.59 (E-value: 2.81). Conclusions: : Our results suggest a positive relationship between drinking and social interaction, and that this relationship may be causal. This could be due to alcohol being the norm for socialization in the UK disadvantaging teetotallers.