No Amount of Alcohol Is Safe

Laura A. Stokowski, RN, MS

Disclosures

April 30, 2014

In This Article

Warning: Drinking Is Hazardous to Your Health

Alcohol is no ordinary consumer commodity[18]; it requires extensive public policy in the form of regulation, taxation, and human services to cope with the damage that it causes. As one might expect, the interests of public health and the alcohol industry are sharply divided on alcohol policy.[18] Contributors to the WCR consider certain forms of alcohol policy in the best interest of the public.

"The prevalence of harmful use of alcohol," says Dr. Puska, "is closely related to the level of alcohol consumption in the general population." Accordingly, he believes that interventions should not be confined to high-risk alcohol users, but should address general alcohol consumption and be population-based.

Dr. Rehm suggests that in a modern society with consumer rights, a warning label mentioning cancer risk associated with alcohol consumption should be considered for all alcohol products. Some countries already have warning labels, but they typically mention only avoidance of alcohol during pregnancy. Warning labels should convey the risks associated with alcohol consumption in a language that is informative to the consumer.

Controlling the affordability of alcohol through pricing and taxation can reduce the volume of alcohol consumed, and thereby alcohol-related health and social harms, including cancer and mortality.[1] Increasing the price of alcohol affects all drinkers, from young people to heavy or problem drinkers. Dr. Puska explains:

The most cost-effective way to reduce alcohol problems in any country is reduction of total alcohol consumption. The more that alcohol is consumed in any country, the more alcohol-related problems there are. The experts and the World Health Organization are quite clear that price and availability are the most effective policy instruments to influence alcohol consumption. Price is usually regulated by taxation. Availability relates to such issues as to whom, where, and when alcohol is sold. In addition, drunk-driving policies and mini-interventions in health services have some effect. Health information campaigns alone are not effective, but they are valuable as background for alcohol control measures (Table).

In summary, any level of alcohol consumption increases the risk of developing an alcohol-related cancer, and that the risk rises in accordance with the level of consumption. That is a discouraging message. However, the flip side is that any reduction in alcohol consumption will lower the cancer risk. Although no absolutely safe level of alcohol intake can be promoted, a return to the days of prohibition is not necessary to derive the health benefits of reduced cancer risk. However, what is essential is to increase public awareness about alcohol-related cancer risk and seek sensible ways to reduce that risk.

As Dr. Puska points out, "The risks associated with alcohol are not limited to cancer. Alcohol is related to multiple health problems. Patients should be informed about these, and should be concerned about the overall risk to their health. The clear relationship between alcohol and cancer is news for most people. However, that is only one component of the overall health message that should be delivered about alcohol."

Table. 10 Strategies to Reduce the Personal and Public Costs of Alcohol[19]

Personal health behaviors:

  • Monitor your alcohol intake ("know your number"). This is similar to knowing your blood pressure, cholesterol level, or calorie intake.

  • Limit consumption to 20 g daily for men and 15 g daily for women (1.5 drinks for men and 1 drink for women, by US standards).

  • Less is more: Lower alcohol consumption leads to greater health and longevity.

  • Take a day off. Not drinking for 1-2 days each week can help the liver recover from the effects of alcohol and reduce the risk for liver complications.

Government intervention:

  • Apply a minimum pricing policy to alcohol to reduce consumption of cheap alcohol, especially by young people.

  • Label the amount of alcohol in grams (like food labeling) to allow consumers to track the exact amount of alcohol they are consuming.

  • Limit the times and places alcohol can be purchased to reduce impulse buying, and avoid contact with alcohol in shops and supermarkets.

  • Provide treatment to benefit individuals and society; offer to all people with an alcohol dependence problem.

  • Invest in research to develop new approaches to addiction.

  • Develop alternatives to alcohol -- investigate new drugs that mimic the milder effects of alcohol; simulate relaxation without the negative side effects of alcohol.

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