Two drinks a week: Significant shift in alcohol guidelines raises questions for Australia

Australia still has a long way to go in improving alcohol culture, according to some experts.

Cups of beer sitting on a bar.

New guidelines on alcohol consumption have been released in Canada. Source: Getty / Cameron Spencer

Key Points:
  • Health authorities in Canada have released new guidelines on alcohol consumption.
  • The guidelines also recommend mandatory labelling of all alcoholic beverages with health warnings.
  • Public health experts in Australia welcomed the move as a step in the right direction.
Health authorities in Canada have released new guidelines on alcohol consumption, recommending one to two standard drinks per week as "low risk".

The guidelines, issued in a report released this week, also recommend mandatory labelling of all alcoholic beverages with health warnings.

They're a significant shift from the country's previous 2011 guidelines, which limited alcohol to 10 standard drinks for women and 15 for men, and were in line with Australia.

Some public health experts in Australia welcomed the move as a step in the right direction which reflects the current evidence base on alcohol-related harms.

What are Canada's new guidelines?

Canada's '' is based on a two-year project by the Canadian Centre on Substance Use and Addiction (CCSA) which looked at almost 6,000 peer-reviewed studies and involved 23 scientists.

It offers a "continuum of risk" with weekly alcohol consumption, where the risk of harm from alcohol is low for those who have two standard drinks or less in that time.

That risk is moderate for those who have between three and six standard drinks per week, and the risk of developing several types of cancer increases. For those who have seven or more drinks, the risk is "increasingly high" and the risk of heart disease or stroke increases.
Under the guidelines, a standard drink is defined as a 341 millilitre bottle of beer (five per cent alcohol), a 142ml glass of wine (12 per cent alcohol) or 43ml of spirits (40 per cent alcohol).

In Australia, one standard drink is defined as containing 10 grams of alcohol.

What's behind the shift?

Researchers in Canada said the new guidelines are based on evolving evidence that less consumption means less risk of harm from alcohol.

“The evidence is clear that every drink counts. It's also clear that it's never too late to make changes," CCSA chief executive and physician Alexander Caudarella said. "Any reduction in alcohol use can be beneficial."

Professor Emmanuel Kuntsche, director of the Centre for Alcohol Policy Research at La Trobe University, said the new guidelines are a "step in the right direction".

"It's not only that they lowered the amount of drinking, but also acknowledging that any alcohol consumption is harmful," he told SBS News. "Both recommendations are really important from a public health perspective."

He said there is growing evidence into low-level drinking constitutes a certain level of risk. A , published in the Lancet Public Health journal earlier this month, also concluded no level of alcohol consumption is safe for our health.
Professor Simone Pettigrew, from the George Institute for Global Health, agreed the evidence continues to mount.

"Large scale meta-analyses are providing new evidence supporting the risks associated with alcohol consumption," she told SBS News.

Clare Hughes, chair of the Cancer Council's nutrition, alcohol and physical activity committee, said experts are learning more about the risks associated with cancer.

"This seems to be providing much more of a direction as to the advice the community is getting around the amount of alcohol they can or should be consuming," she said.

"At the core of the entire discussion is what level of risk is acceptable?" Professor Kuntsche said.

What do Australia's guidelines say?

Australia's guidelines to reduce the risks associated with drinking alcohol were revised in December 2020. They recommend healthy men and women should drink no more than 10 standard drinks a week and no more than four on any one day.

"The less you drink, the lower your risk of harm from alcohol," they state.

Professor Kuntsche said these revised guidelines are more restrictive than the previous ones.

"But countries like Canada are further ahead in that game. I really welcome their approach towards even more conservative guidelines," he said.

Ms Hughes said the 2020 revisions reflect an "enormous piece of work" and that Cancer Council is not calling for a review.
People clinking glasses.
The new guidelines represent a major shift from Canada's previous 2011 guidelines. Source: Pixabay

Calls for mandatory alcohol labelling

The report also recommends mandatory labelling of all alcoholic beverages with health warnings.

It states evidence has shown that added warnings can increase public awareness of the causal link with cancer and reduce consumption.

Professor Pettigrew said this has been proposed for some time in Australia but has yet to come to fruition.

"It took more than a decade to get a pregnancy warning label approved for alcoholic beverages in Australia," she said, adding plans are currently underway to implement warnings on alcoholic beverages in Europe.

"There is much to gained from ensuring drinkers are informed," she said.
Ms Hughes said Cancer Council is aware of the role warning labels can play in improving community awareness, but that this shouldn't be the only way consumers are made aware of alcohol-related risks.

"It's not just the label - that would need to be part of a bigger strategy to raise awareness of alcohol-related harms," she said.

What's next for Australia?

Professor Pettigrew said she hopes Australia "will continue to move in the same direction with our guidelines to ensure the community understands the risks associated with alcohol consumption".

For Professor Kuntsche, ongoing discussion about guidelines and new evidence is crucial to change drinking norms in the long run.

"When it comes to alcohol, one thing that should not be forgotten is we don't have to drink. But we have our consumption norms. And that's the big problem," he said.

Analysis from the 2019 National Drug Strategy Household Survey found that about three in four Australians aged 14 and over had consumed alcohol in the previous 12 months.

Almost one in two people (45 per cent) approved of regular use of alcohol by adults - higher than for any other drug.

"If we keep the discussion going, I hope the cultural norms will shift towards more restrictive consumption norms - and in this context, the guidelines are very important," he said.
Ms Hughes said raising awareness of the guidelines and investing in promotion is crucial.

"There is still a big way to go to tackle the alcohol culture in Australia," she said.

In a statement, the Department of Health said it is important to ensure that consumers "have access to accurate and clear information about what they consume and its impacts, in order to make informed decisions."

"Alcohol is identified as a priority substance in the National Drug Strategy, with the consumption of alcohol contributing toward a range of adverse health outcomes, and significantly increasing Australia's burden of disease," it said.

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6 min read
Published 20 January 2023 5:40am
By Emma Brancatisano
Source: SBS News



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