GIVEN no level of alcohol consumption is safe, it is vital we fine-tune advice based on relative impact, says Barbara O’Donnell
According to the 2013 Scottish Health Survey, adults in Scotland drink an average of 10.1 units of alcohol per week. Ten units is roughly the equivalent of a bottle of wine or four pints of beer. This might not sound like a lot but within this average, there are those who do not drink alcohol at all – 20 per cent of women and 12 per cent of men – as well as those who are drinking at harmful levels. On average, men drink twice as much alcohol as women.
The Scottish Health Survey relies on self-reporting and we know that people tend to under-report how much they drink. This is partly because they cannot accurately recall how much they have consumed, and also because they misjudge the volume and/or the strength of the drinks they serve themselves. For example, reporting consumption as “one glass of wine” could mean anything between one and three units of alcohol depending on the strength of the drink and the size of the glass.
Under-reporting in surveys means there is a gap between the amount of alcohol people say they drink, and the amount of alcohol actually sold in the UK according to official figures.
Researchers at Liverpool John Moores University suggest that some of this gap is due to people turning a blind eye to the drinks consumed on heavier drinking occasions like summer holidays, weddings and other special events. These sessions could be adding a substantial amount of alcohol to annual consumption, at both the individual and population level – up to an extra 12 million bottles of wine a week in England.
It’s likely to be a similar picture in Scotland because the Scottish Health Survey asks people about their “usual weekly alcohol consumption”.
All of this suggests that we are seriously underestimating our individual alcohol consumption and that means many of us are inadvertently putting our health at risk.
Alcohol is linked to a wide range of physical and mental health problems including seven types of cancer, liver damage and cardiovascular disease, as well as violence and suicides. Binge drinking is associated with additional health risks such as accidental injury.
New evidence is emerging all the time about the health risks posed by drinking. In light of this evidence, the UK’s Chief Medical Officer is currently leading a review of alcohol drinking guidelines to see if they should be updated. The review is expected to take account of scientific evidence that there is no safe threshold for alcohol and cancer risk. It is estimated that alcohol is responsible for around 12,500 cancer cases a year in the UK, yet public awareness of the link is lower than for other alcohol-related diseases.
The review will also consider if there could be merit in producing bespoke guidelines for certain groups, like older people, who may be particularly susceptible to alcohol harms.
To date, we have been familiar with official guidance referring to “safe”, “responsible” or “sensible” drinking limits. However, the evidence we now have makes it clear that no level of drinking can be guaranteed “safe”. All drinking carries risk and the degree of risk generally increases in line with how much is consumed.
How any new advice is communicated to the public will be equally, if not more important.
Around half of Scots don’t know how many units are in a pint of beer, measure of spirits or glass of wine, and less than half of Scots can correctly identify the recommended consumption limits for their gender.
Understanding the health risks associated with drinking is necessary if we are to make informed decisions about our health and wellbeing.
Life expectancy is increasing but alcohol is a leading cause of disability in older age.
If we want to live longer and healthier lives then everyone needs to be taking better account of their drinking.
• Barbara O’Donnell is acting chief executive, Alcohol Focus Scotland