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June 23/30, 2004

Modifiable Behavioral Factors as Causes of Death

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(24):2941. doi:10.1001/jama.291.24.2941-a

To the Editor: Dr Mokdad and colleagues1 reported that the leading cause of mortality in the United States is tobacco use, followed by poor diet/inactivity and alcohol use. I believe that the authors should also address the beneficial effects on mortality, if any, of these modifiable factors. Some may be beneficial in small quantities and may thus have a U-shaped relationship to mortality. One example is the well-documented beneficial effect of low levels of alcohol consumption on the health of populations with a high risk of cardiovascular disease.2-4