Reducing harm caused by alcohol


No completely 'safe' level of drinking

The UK Chief Medical Officers have just published updated alcohol consumption guidelines, following a two year, expert review of the scientific evidence.

Their guidance makes it clear for the first time that there is no “safe” level of alcohol consumption. Any level of drinking raises the risk of developing a range of cancers including breast, bowel and mouth cancer. Although we have known that alcohol is a carcinogen (cancer causing substance) since the 1980s, the full extent of the link was not recognised in the previous recommended limits which were set out in 1995. There is also now no justification for recommending drinking on health grounds as previous evidence is likely to have over-estimated the protective effects of alcohol for the heart.

To keep health risks to a low level, men and women are advised not to regularly drink more than 14 units of alcohol a week. Fourteen units is the equivalent of 6 pints of beer, a bottle and a half of wine, or half a bottle of spirits. Drinking should be spread over three days or more during the week to minimise the risk of accidents and injuries associated with heavy drinking sessions, and having several alcohol-free days each week is a good way to cut down.

Those of us concerned about alcohol and public health have welcomed the new guidelines and in particular that attention has been drawn to alcohol-related cancer. Alcohol is responsible for around 12,500 cancer cases a year in the UK, yet only around half of us are aware of the link.  

However, the reaction from some quarters says a lot about our skewed relationship with alcohol. The revised guidance has been called “an assault on freedom”, “hyperbolic and puritan”, and “nanny state”. Just because we don’t want to hear that something we enjoy carries health risks doesn’t alter the scientific evidence - there is no completely safe level of alcohol consumption. Imagine the public outrage if the government failed to inform people that a product which is cheap, widely available and constantly promoted also causes cancer, liver damage and cardiovascular disease.  

Perhaps this response demonstrates just how normal drinking to excess has become in our society. The health damage is under-estimated or under-played because drinking is so socially acceptable. Alcohol is positioned as an everyday product to be bought and consumed anytime, anywhere. Its toxic, carcinogenic properties are overlooked.

Ultimately – assuming we are not harming anyone else – each of us needs to make up our own minds whether and how much we want to drink. What’s important is that the health risks are clear so we can make an informed choice about the level of risk we are prepared to accept.

Health warnings needed

In order that we can genuinely make an informed choice, the expert group recommended a mass media information campaign.  Crucially they also recommended that health warnings should be on all alcohol labels, advertising and sponsorship. This is long overdue. Existing alcohol labels don’t even provide any information about ingredients, never mind warn of the health risks associated with drinking. While some manufacturers have pledged to include more information on product labels, this varies widely and is entirely voluntary.

Of course alcohol manufacturers resist compulsory labelling, but they are out of step with the public on this issue. A recent opinion poll showed 93% of Scots agree it is important to know how alcohol can affect health, and 87% support better alcohol labelling. The government must recognise that the public want to be better informed and introduce compulsory health warnings – this is a consumer rights issue as well as a public health issue.

The reality is that far too many of us are drinking at levels that endanger our health. But the new guidance also means we need to think more broadly about whether our national approach to reducing alcohol consumption is sufficient to the task. The Scottish Government has committed to refreshing its alcohol strategy this year and will want to consider all the options.  

The Chief Medical Officers would like to know whether you think their recommendations are clear and easy to understand. You can respond online before 1 April.

Alison Douglas, Chief Executive