New Alcohol Guidelines FAQs

In January 2016, the recommended maximum alcohol intake for men was reduced by a third in new official guidelines. What is the new Department of Health guidance?
What do the new guidelines say?

The Chief Medical Officers’ guideline for both men and women in full is that:

  • You are safest not to drink regularly more than 14 units per week, to keep health risks from drinking alcohol to a low level.
  • If you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more. If you have one or two heavy drinking sessions, you increase your risks of death from long term illnesses and from accidents and injuries. 
  • The risk of developing a range of illnesses (including, for example, cancers of the mouth, throat and breast) increases with any amount you drink on a regular basis.
  • If you wish to cut down the amount you’re drinking, a good way to help achieve this is to have several drink-free days each week.

The Alcohol Guidelines Review was put together for the Chief Medical Officers (CMOs) by a guidelines development group of various alcohol and health experts, chaired by Professor Sally Macintyre of the University of Glasgow and Professor Mark Petticrew of the London School of Hygiene & Tropical Medicine.

What are the main changes?
  • The weekly maximum number of units for men has been reduced by a third from 21 to 14 units.
  • There is no daily guidance although you are advised to spread units over at least three days.
  • They also say: ‘there is no level of drinking that can be recommended as completely safe long term’.
Why 14 units?

The Alcohol Guidelines Review estimates that drinking at this maximum level would give you a lifetime risk of dying from an alcohol-related cause of around 1 in 100 (or 1%) ‘or a little below this level’.

This is the net risk for the population taking into account the deaths accelerated by alcohol and the far lower number that might be delayed by it (through, for example, the protective effect on the heart for older women).

But is 1 in 100 a lot of risk or a little risk?

We’re all going to die and there is risk in everything. The report compares the risk to your lifetime risk of dying in a motor vehicle accident which was, in the Department of Transport's 2006 annual report on road casualties, 1 in 240.

The risk of smoking is far higher. Smokers have at least a 1 in 2 (50%) chance of dying from a smoking-related cause or, according to more recent research, even a 2 in 3 chance (66%).

What is a unit?

A unit is 10ml, or one hundredth of a litre of pure alcohol.

The problem is that very few drinks contain a precise whole number of units. A half of 3.6% alcohol by volume (ABV) beer contains one unit but most beers are stronger than this. So, as a rule of thumb, 14 units translates into about six pints.

If you want to do the maths, you can work out how many units there are in any drink by multiplying the total volume of a drink (in ml) by its ABV (which is measured as a percentage) and dividing the result by 1,000.

  • Strength (ABV) x volume (ml) ÷ 1,000 = units.

A pint is 568 ml so for a pint of 5.2% ABV lager, the maths would be:

  • 5.2 (%) x 568 (ml) ÷ 1,000 = 2.95 units
Is this a consultation or not?

Sort of. The new guidelines are out for consultation until April 2016 so you can give your opinion. But, the consultation is not on the evidence or how the CMOs' guidelines development group has used it, it is just on whether the guidelines they’ve come up with ‘are as practical and useful as possible’.

What about binge drinking?

The risks from alcohol, particularly short-term risks of accidents etc, increase if you drink a lot at one session.

The guidelines development group’s suggest drinking more slowly, drinking with food, and alternating with water; avoiding risky places and activities; making sure you have people you know around; and ensuring you can get home safely.

They conclude there is ‘good evidence of risks from occasional, single episodes of drinking and that such risk increases with amounts consumed, particularly above around 5-7 units.’

Are there times I should not drink?

Yes. Pregnancy is the obvious one but the ones that may affect men more directly include:

  • before and during driving or cycling;
  • before, during, or directly after swimming and active physical sport;
  • before using machinery, electrical equipment, ladders or working anywhere where your ‘functioning in work would be adversely affected by alcohol’ (pretty much all jobs really!); or
  • when taking medication, where alcohol is contraindicated.
What is the evidence on alcohol and cancer?

Stronger than it was when the last guidelines were developed in the 1990s. The guidelines development group believe ‘stronger evidence has emerged that the risk of a range of cancers, especially breast cancer, increases directly in line with consumption of any amount of alcohol.’

Alcohol is now recognised as a cause of certain cancers by the International Agency for Research on Cancer including those in the mouth, throat, liver, breast, bowel, head and neck.

What is the evidence on alcohol and heart disease?

Heavy drinking is bad for the heart but there is some evidence that very moderate drinking can reduce heart disease in older people (and may help reduce stroke). 

The guidelines development group commissioned a UK analysis ‘which has found that the net protective effect that may be attributable to drinking regularly at low levels appears now to be significant only for women aged 55+ (with men aged over 55+ showing such a protective effect only of negligible size)’.

So the protective effect is not a lot, if at all. Don’t start drinking if you don’t already.

But don’t moderate drinkers live longer than people who don’t drink at all?

That appears to be true for older people and the report doesn’t address this directly.

Mortality data suggests that, in later life (55+), moderate drinkers (1-2 drinks a day) live longer than non-drinkers and heavy drinkers. It’s not obvious how this ties up with data linking alcohol to the two biggest killers (cancer and, to a lesser extent, heart disease) but it is probably down to the psychological and social benefits of drinking (such as stress-reduction and simple pleasure) and improved appetite. 

Again, though, don’t start drinking if you don’t already.

 

We don't currently post comments online but are always keen to hear your feedback.

MAIN IMAGE: Pint of Challenger by Stephan Ridgway licensed under CC BY 2.0

 

Date published 11/01/16
Date of last review 11/01/16
Date of next review 11/01/19

References

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