Alcohol-selling outlets and mortality in Switzerland—the Swiss National Cohort


Correspondence to: Anke Huss, Institute for Risk Assessment Sciences, Utrecht University, Jenalaan 18D, 3508 TD Utrecht, the Netherlands. E-mail:



To examine the association of alcohol-related mortality and other causes of death with neighbourhood density of alcohol-selling outlets for on-site consumption.

Design, setting and participants

Longitudinal study of the adult Swiss population (n = 4 376 873) based on census records linked to mortality data from 2001 to 2008.


Sex-specific hazard ratios (HR) for death and 95% confidence intervals (95%CI) were calculated using Cox models adjusting for age, educational level, occupational attainment, marital status and other potential confounders. The density of alcohol-selling outlets within 1000 m of the residence was calculated using geocodes of outlets and residences.


Compared with >17 outlets within 1000 m the HR for alcohol-related mortality in men was 0.95 (95%CI: 0.89–1.02) for 8–17 outlets, 0.84 (95%CI: 0.77–0.90) for 3–7 outlets, 0.76 (95%CI: 0.68–0.83) for 1–2 outlets and 0.60 (95%CI: 0.51–0.72) for 0 outlets. The gradient in women was somewhat steeper, with a HR comparing 0 with >17 outlets of 0.39 (95%CI: 0.26–0.60). Mortality from mental and behavioural causes and lung cancer were also associated with density of alcohol-selling outlets: HRs comparing 0 outlets with >17 outlets were 0.64 (95%CI: 0.52–0.79) and 0.79 (95%CI: 0.72–0.88), respectively, in men and 0.46 (95%CI: 0.27–0.78) and 0.63 (95%CI: 0.52–0.77), respectively, in women. There were weak associations in the same direction with all-cause mortality in men but not in women.


In Switzerland, alcohol-related mortality is associated with the density of outlets around the place of residence. Community-level interventions to reduce alcohol outlet density may usefully complement existing interventions.