Introduction and Objectives Alcohol consumption is a well-recognised risk factor for a range of diseases, but there is relatively little knowledge on the association between alcohol consumption and respiratory disease risk. We present systematic reviews of alcohol effects on Adult Respiratory Distress Syndrome, asthma, COPD, community acquired pneumonia, obstructive sleep apnoea and tuberculosis.

Methods Systematic reviews identified comparative observational studies listed on Medline, EMBASE and Web of Science, published between 1985 and December 2015, with the exception of tuberculosis, for which we performed a separate search from 2005 to 2017. The reference lists of the eligible studies were also searched. We imposed no language restrictions. Random effects meta-analysis was used to estimate pooled effect sizes with 95% confidence intervals (CI). Heterogeneity was explored using subgroup analyses. Funnel plots and Egger’s asymmetry test were used for the assessment of publication bias.

Results A total of 120 papers were included in these reviews (see Table 1). Our reviews confirmed an approximate doubling in the risk of CAP among drinkers. In addition, we found that there is an 8% increase in the risk of CAP for every 10–20 grams higher alcohol intake per day. Also, heavy alcohol consumption was found to significantly increase the odds of ARDS/ALI. Furthermore, a subgroup analysis indicated that this association was primarily due to alcohol abuse. Alcohol consumption increased the risk of TB between 2 and 3- fold, depending on study design. We found no evidence of an effect of alcohol consumption on the risk of asthma and COPD.

Conclusions Our review highlights that high alcohol intake is linked to the risks of several respiratory diseases, and that reducing alcohol intake may have an important role to play in respiratory disease prevention.