Zero alcohol is the only risk-free approach to alcohol harm; while consumers who do drink should limit themselves to just two drinks a week (down from the current guidance of 15 drinks a week), says the report.
Published yesterday by the Canadian Centre on Substance Use and Addiction (CCSA) and funded by Health Canada, the report wants to push consumers away from the notion that there is an acceptable level of alcohol consumption per week, and instead highlights an increased risk presented by each glass drunk.
"Science is evolving, and the recommendations about alcohol use need to change", says the organization.
Changing Canada's drinking culture
In Canada, a standard drink is 17.05 millilitres / 13.45 grams pure alcohol, equivalent to:
- A bottle of beer (12 oz., 341 ml, 5% alcohol)
- A bottle of cider (12 oz., 341 ml, 5% alcohol)
- A glass of wine (5 oz., 142 ml, 12% alcohol)
- A shot glass of spirits (1.5 oz., 43 ml, 40% alcohol)
Alcohol causes around 18,000 deaths a year in Canada: while the costs associated with alcohol use come in at $16.6bn ($12.3bn USD), with $5.4bn ($4bn USD) of that sum spent on health care, according to 2017 data.
Canada’s current ‘low risk’ drinking guidelines say women should limit alcohol to no more than 10 standard drinks per week and men should keep consumption within 15 standard drinks per week.
(That's broadly in line with the US ‘moderate’ drinking recommendations of max 2 drinks a day for men and 1 drink a day for women; or the UK recommendations of max 14 units a week).
But the new report, 'Canada's guidance on Alcohol and Health,' says research and knowledge has developed since these guidelines were created in 2011.
It intends to replace these current guidelines, as well as ‘contributing to an evidence base for future alcohol policy and prevention resources, with a view to changing Canada’s drinking culture and curbing the normalization of harmful alcohol use in society’.
The report bases its recommendations on an assessment of risk from alcohol-related harm: starting from the baseline that zero alcohol is the only risk-free approach.
The risks of harm (whether from causes ranging from cancer or heart disease to violence) is then calculated for each drink.
“This project’s estimates make it possible to put forward a clear continuum of risk whereby the risk for those who consume 2 standard drinks or less per week is low, it is moderate for those who consume between 3 and 6 standard drinks per week, and it is increasingly high for those who consume above 6 standard drinks per week, with increasing risk conferred by every additional drink,” reads the report.
The new guidance is 'based on the principle of autonomy in harm reduction and the fundamental idea behind it that people living in Canada have a right to know that all alcohol use comes with risk.'
Key points from the guidance says:
- 0 drinks per week — Not drinking has benefits, such as better health, and better sleep.
- 2 standard drinks or less per week — You are likely to avoid alcohol-related consequences for yourself or others at this level.
- 3–6 standard drinks per week — Your risk of developing several types of cancer, including breast and colon cancer, increases at this level.
- 7 standard drinks or more per week — Your risk of heart disease or stroke increases significantly at this level.
- Each additional standard drink radically increases the risk of alcohol-related consequences.
- Consuming more than 2 standard drinks per occasion is associated with an increased risk of harms to self and others, including injuries and violence.
- When pregnant or trying to get pregnant, there is no known safe amount of alcohol use.
- When breastfeeding, not drinking alcohol is safest.
- No matter where you are on the continuum, for your health, less alcohol is better.
Policy change
While the report focuses on driving the message of alcohol-related harm to consumers, it says its recommendations should serve as a base for policy changes to help create a healthier society.
“To support people living in Canada who will want to drink less, governments, working in close collaboration with employers, healthcare providers and community stakeholders, need to implement policies that promote public health.
"Such policies include strengthening regulations on alcohol advertising and marketing, increasing restrictions on the physical availability of alcohol, and adopting minimum prices for alcohol.
“As a priority, people living in Canada need consistent, easy-to-use information at the point of pour to track their alcohol use in terms of standard drinks. They also have a right to clear and accessible information about the health and safety of the products they buy.
"A direct consequence of the current project is that a particular effective policy change could be the mandatory labelling of all alcoholic beverages with the number of standard drinks in a container, Canada’s Guidance on Alcohol and Health and health warnings.”
Has process lacked transparency?
Data from Statistics Canada shows that around $25.5bn ($18.9bn USD) worth of alcoholic beverages were sold in the year ending March 31, 2021 (a 4.2% rise representing the largest sales increase in over a decade, although liquor authorities do attribute this growth to the pandemic).
Beer has long been the most popular drink: although it is losing market share to spirits, ciders and coolers. The legal drinking age is 19-years-old in every province and territory except Quebec, Manitoba and Alberta where it us 18+.
Beer Canada, which represent the nation's brewers and around 90% of beer brewed in the country, says it has (and continues) to support Canada’s 2011 Low-Risk Drinking Guidelines (LRDGs) as a useful tool for Canadians who choose to drink.
While it supports the need to review guidelines periodically, it says the current project 'has lacked full transparency and to date has not included the essential rigour of an expert technical peer review'.
"In order for the Ministry to properly assess the CCSA’s final report and in recognition of the importance of the credibility of all public health messages, Beer Canada continues to call for an expert technical peer review of the work undertaken to-date to ensure its validity and conformity with international standards, best practices and the preponderance of scientific and health evidence," it says in a statement sent to BeverageDaily.
"Beer Canada believes the decision whether to drink, and if so how much, is a personal one. Responsible, moderate consumption can be part of a balanced lifestyle for most adults of legal drinking age. Over-consumption and alcohol abuse, however, should be avoided because they are associated with elevated health risks that have long been common knowledge. For some people, even moderate consumption may be associated with health risks. We believe consumers should consult with their primary health care provider to understand their personal risk profile and whether moderate consumption is consistent with their overall diet and health plan."
Beer Canada says it remains committed to working with the Ministry of Mental Health & Addictions and the Ministry of Health: highlighting Canadian brewers' long history in promoting moderation and responsible consumption.
The CCSA report, 'Canada's guidance on Alcohol and Health', can be found in full here.