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Furthermore, it is used as a\u00a0disinfectant for medicinal purposes and as a\u00a0cultural asset it is also part of religious rituals. However, it is also an intoxicant and an addictive substance. The deleterious side of alcohol is reflected in the fact that around 3\u00a0million people worldwide die every year as a\u00a0direct or indirect result of alcohol consumption. For several decades, epidemiological studies suggested that drinking alcohol in moderate quantities was beneficial. This was referred to as the \u201cFrench paradox,\u201d which described differences in mortality between France and Finland mainly, but also other countries, that were found in epidemiological studies. The difference in the levels of alcohol consumption was found to explain the differences in mortality in view of the otherwise similar risk factors. When alcoholic drinks per day were plotted against all-cause mortality this led to a\u00a0J-shaped curve. This finding represented a\u00a0window of benefit for moderate alcohol consumption. However, the recent publication by Zhao et\u00a0al. in 2023 revisited the relationship between the quantity of alcohol consumed and mortality risk and led to a\u00a0paradigm change, which has influenced not only the recommendations of <jats:italic>Canada\u2019s Guidance on Alcohol and Health<\/jats:italic> but also the recommendations and guidelines of major health organizations: \u201cNo alcohol is better than a\u00a0little.\u201d The J\u2011shaped curve as an explanation of the French paradox became a\u00a0linear relationship between the amount of alcohol consumption and the increasing mortality from tumors and cardiovascular diseases. The renewed review of several control groups in previous epidemiological studies revealed a\u00a0recruitment error due to the inclusion of abstinent ex-drinkers. Taking this bias into account, the alcohol-friendly view of small amounts of alcohol being cardioprotective had to be revised. The combined misuse of alcohol and other risk factors for carcinogenesis and heart diseases still needs further attention. The misuse of both alcohol and cocaine led to the conclusion that when the two risky substances are consumed together, it is even more detrimental than the mere sum of the two.<\/jats:p>","DOI":"10.1007\/s00059-024-05280-z","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T15:03:06Z","timestamp":1730732586000},"page":"409-419","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Alcohol consumption\u2014none is better than a\u00a0little","Alkoholkonsum\u00a0\u2013 keiner ist besser als wenig"],"prefix":"10.1007","volume":"49","author":[{"given":"Bernhard","family":"Maisch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"5280_CR1","volume-title":"ICD-10 classification of mental and Behavioural disorders: clinical descriptions and diagnostic guidelines","author":"GO Simms","year":"1992","unstructured":"Simms\u00a0GO (1992) ICD-10 classification of mental and Behavioural disorders: clinical descriptions and diagnostic guidelines. 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