“There is no safe level of alcohol consumption.”
That’s the stark, unequivocal conclusion of a massive new study published in the medical journal The Lancet.
It also throws cold water on the much-reported notion that a glass of wine a day is actually good for your health. The new study says that, while that daily drink is good for your heart, the benefit is more than offset by an increased risk of cancer.
But, before you pour that pricey Château Lafite down the drain and embrace temperance, a little context is in order.
There is no question that alcohol use and misuse is a huge public-health issue. Drinking is associated with 2.8 million deaths a year worldwide. Alcohol is known to cause or worsen at least 23 health conditions, from cirrhosis to tuberculosis, as well as several types of cancer, not to mention its role in motor vehicle crashes, sexual assault and suicide.
In Canada, there are an estimated 5,000 alcohol-related deaths and 77,000 hospitalizations annually. And as long ago as 2002, it was estimated drinking cost the economy $14.6-billion a year in health costs and lost productivity.
Those population-level statistics are sobering. But they don’t mean having an occasional drink is going to kill you.
In fact, beyond the alarmist headlines, the new research provides pretty good evidence that moderate drinking poses little serious health risk. The study published in The Lancet is one of the largest conducted and one of the first to directly compare health outcomes of non-drinkers and drinkers.
Worldwide, one in three adults consumes alcohol, but in Western countries it’s in the 80-per-cent to 95-per-cent range. Canada ranks 40th among 195 countries in percentage of drinkers. We are also mid-pack when it comes to consumption.
The statement that there is “no safe level of alcohol consumption” is inarguable. But the important question for individuals is: How much of a risk does drinking pose?
According to the research, 914 in every 100,000 non-drinkers will develop one of the 23 aforementioned health conditions in a given year. Among those who consume the equivalent of one drink a day, that risk increases to 918 in every 100,000. That’s 0.5 per cent more – negligible. At two drinks a day, the risk creeps up to 977 in every 100,000, or 7 per cent more; at five drinks daily, the risk is 1,252 in every 100,000, or 37 per cent higher than a non-drinker.
Let’s return to the risk posed by consuming one drink a day.
David Spiegelhalter, the Winton Professor for Public Understanding of Risk at the University of Cambridge, noted that the absolute risk to a drinker compared with a non-drinker increases by four in every 100,000 (the four comes from 918-914).
What that means, practically, is that 25,000 people would have to drink one alcoholic drink daily for an entire year – the equivalent of 16 bottles of gin each – for one of them to develop an additional one of those 23 health conditions.
That does not exactly scream unsafe. What all that fancy math does is reinforce the adage that the dose makes the poison.
The new research is important because it reminds us that – given the damage done by alcohol misuse – strong public-health initiatives are necessary.
Taxation, minimum pricing, restrictions on advertising, labelling and public education and guidelines are all important measures to reduce the potential harms caused by alcohol.
Cheap, readily available alcohol and buck-a-beer policies are bad for public health. But so, too, is a prohibitionist mindset.
Where the authors of the new research went astray was with the suggestion that public-health officials should promote abstinence. There is no justification for that recommendation in the data. It is gratuitous moralism.
No one drinks alcohol because they think it’s good for their health (the “red wine is good for you”crowd notwithstanding). They drink because it’s sociable, relaxing and fun. When it interferes with daily living, it stops being fun and starts being a health risk.
Very few things in life, especially things that are fun, are risk-free – sex, drugs (including alcohol), rock ‘n’ roll, food, family holidays, swimming, tobogganing, driving, breathing (especially during forest-fire season).
What we need to do is balance the risks of activities against the benefits/pleasures they provide us, not try to live in a risk-free cocoon. The new research may show that the safest level of drinking is none but, ultimately, it’s up to each of us to know our limits.
André Picard