Introduction: The effect of a history of competitive sports on later use of alcohol and occurrence of alcohol-related diseases is poorly known. We investigated how a history of elite level sports was associated with alcohol consumption in middle-age and with alcohol-related morbidity and mortality.

Methods: The occurrence of alcohol-related diseases and deaths were followed using national registers from 1970 to 2008 among Finnish male former elite athletes (n = 2202) and matched controls (n = 1403) alive in 1970 (mean age = 45.1 yr). Hazard ratios were calculated by Cox proportional hazards model. In 1985, surviving participants questionnaire-reported their alcohol consumption and engagement in physical activity/sports.

Results: The risk of any alcohol-related diseases or deaths did not differ between former athletes and controls (hazard ratio = 0.93, 95% confidence interval [CI] = 0.73–1.20, P = 0.59), although the risk was higher among both combat sports athletes and weightlifters compared with endurance sports athletes, shooters or jumpers, and hurdlers (P < 0.05). In 1985, athletes consumed more alcohol (417 g·month-1, 95% CI = 386–447) compared with controls (397 g·month-1, 95% CI = 355–441) (P < 0.05). Consumption was lower among endurance sports athletes than among controls (P < 0.05). Team sports athletes consumed more alcohol (P < 0.05), especially beer (P < 0.01), compared with other athletes and controls. Athletes no longer engaged in leisure-time sports consumed more alcohol than those who continued to be physically active (P < 0.05).

Conclusions: Overall, former athletes reported higher alcohol consumption than controls. There was no difference in alcohol-related morbidity, but the risk varied between different sports groups. Alcohol consumption after top sports career was greater if participation in leisure-time sports was discontinued.