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LONDON (Reuters) - Rock stars -- notorious for their "crash and burn" lifestyles -- really are more likely than other people to die before reaching old age.
A study of more than 1,000 mainly British and North American artists, spanning the era from Elvis Presley to rapper Eminem, found they were two to three times more likely to suffer a premature death than the general population.
Between 1956 and 2005 there were 100 deaths among the 1,064 musicians examined by researchers at the Centre for Public Health at Liverpool John Moores University.
As well as Presley, the toll of those dying before their time included Doors singer Jim Morrison, guitar hero Jimi Hendrix, T Rex star Marc Bolan and Nirvana's Kurt Cobain.
More than a quarter of all the deaths were related to drugs or alcohol abuse, said the study in the Journal of Epidemial Community Health.
"The paper clearly describes a population of rock and pop stars who are at a disproportionate risk of alcohol and drug related deaths," said Mark Bellis, lead author of the study.
He said the study raised questions about the suitability of using rock stars for public health messages such as anti-drug campaigns when their own lifestyle was so dangerous.
"In the music industry, factors such as stress, changes from popularity to obscurity, and exposure to environments where alcohol and drugs are easily available, can all contribute to substance use as well as other self-destructive behaviors," the report said.
It found that musicians were most at risk in the first five years after achieving fame, with death rates more than three times higher than normal.
Hendrix, Bon Scott of AC/DC and punk rocker Sid Vicious all died within five years of hitting the big time, said Bellis.
Among British artists the risk of dying remains high until around 25 years after their first success, when they return to near normal life expectancy.
That bodes well for rock survivors like The Who's 63-year-old Roger Daltrey, who famously first sang "I hope I die before I get old" in the song "My Generation" back in 1965.
But this trend was not found in North America, where ageing rockers remain almost twice as likely to suffer a premature demise, particularly from heart attack or stroke.
American stars Jerry Garcia of the Grateful Dead, Carl Wilson of the Beach Boys and Johnny Ramone of the Ramones all died in their 50s.
Bellis suggested that the high death rate among older American musicians could be related to the continent's greater appetite for reunion tours, exposing the artists for more years to an unhealthy "rock'n'roll" lifestyle.
It could also be due to the poor medical outlook for impoverished American ex-pop stars who have no health insurance, he said.