No Amount of Alcohol Is Safe

Laura A. Stokowski, RN, MS

Disclosures

April 30, 2014

In This Article

Assessment and Intervention

Alcohol consumption is viewed as a modifiable behavioral risk factor for cancer.[16] Clinicians frequently engage patients in discussions about such health behavior risks, and how to reduce them. How important is alcohol-related cancer risk, compared with all other risk factors for cancer? Is it worth the time and effort to try to convince patients to reduce their alcohol intake? Dr. Rehm explains, "We still don't know what causes 60% of cancers, but people can lower their risk by reducing their intake of alcohol."

Dr. Pekka Puska, former Director General of the National Institute for Health and Welfare of Finland and contributor to the WCR, would not be concerned about the use of alcohol in every patient. "Clinicians should inquire about alcohol use and inform patients about the health risks. For most patients, especially the elderly, if they consume alcohol in moderation, I would not pressure them to stop alcohol altogether. In patients who have health problems related to alcohol, however, clinicians should be very firm in advising them to stop using alcohol and recommend specific cessation services."

People often want to know how much they can drink -- what is a reasonable risk for me? "There is no risk-free level of alcohol consumption," says Dr. Rehm. "There is always some risk, and the risk increases in accordance with the level of consumption." Having said that, Dr. Rehm believes that it would be helpful to have low-risk drinking guidelines, written for the public, so that people who are going to drink anyway would know how much alcohol would increase their risk substantially. Such guidelines should recognize lower drinking limits for women and advise against episodes of heavy drinking.

Alcohol screening and brief clinical interventions by healthcare professionals can successfully and cost-effectively reduce alcohol consumption in many different healthcare settings, from primary care to hospital emergency departments.[17] Many alcohol screening tools are available. Behavior change and positive effects have been observed in adolescents, adults, older adults, and pregnant women following alcohol screening and brief interventions aimed at reducing alcohol intake.[18]

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