Updated alcohol consumption guidelines giving new advice on low risk levels of alcohol consumption were issued by The UK Chief Medical Officers in January. Dame Sally Davies, Chief Medical Officer for England, said: “What we are aiming to do with these guidelines is give the public the latest and most up to date scientific information so that they can make informed decisions about their own drinking and the level of risk they are prepared to take”.
The new advice follows a two year review of the scientific evidence used for the guidelines in 1995. This work has been underway since 2013, led by a panel involving public health, behavioural science and alcohol studies, mainly from the University of Sheffield. The development of the new guidelines was chaired by Professor Mark Petticrew, Professor of Public Health Evaluation at the London School of Hygiene and Tropical Medicine and by Professor Sally Macintyre, Professor Emeritus at the University of Glasgow.
In justifying the new guidelines, the CMO warned that drinking any level of alcohol increases the risk of a range of cancers. The statements are supported by a review from the Committee on Carcinogenicity (CoC) on alcohol and cancer risk. According to the Department of Health, “it is now known that the risks start from any level of regular drinking and increase with the amount being drunk, and the new guidelines are aimed at keeping the risk of mortality from cancers or other diseases low (under 1%). The links between alcohol and cancer were not fully understood in the original guidelines, which came out in 1995”.
The review, surprisingly, found that the benefits of alcohol for heart health only apply for women aged 55 and over. The greatest benefit is seen when these women limit their intake to around 5 units a week, the equivalent of around 2 standard glasses of wine. The group concluded that there is no justification for drinking for health reasons. These issues prompted changes to alcohol guidelines for men. Men are now advised that they should not drink more than 14 units of alcohol each week, the same level as for women. The previous guidelines were 2-3 units for women (8g) and 3-4 units for men with up to 21 units for men and 14 units for women per week.
An additional recommendation states that drinkers do not ‘save up’ the 14 units for 1 or 2 days, but to spread them over 3 or more days. According to the guidelines, people who have 1 or 2 heavy drinking sessions each week increase the risk of death from long-term illnesses, accidents and injuries. The guidelines suggest that a good way to reduce alcohol intake is to have several alcohol free days a week.
Advice on single episodes of drinking is included in the guidelines for the first time. “To keep the shortterm health risks low: limit the total amount of alcohol drunk on any one occasion, drink more slowly, with food and alternate with water”. Guidance about a set number of units for a single occasion or day is not currently included. Whether the new guidelines should include a specific number of units, as a simple number can be easier to follow than more general advice, is included in the consultation.
The guidelines for pregnant women have also been updated to clarify that no level of alcohol is safe to drink in pregnancy. The previous advice for pregnant women to limit themselves to no more than 1 to 2 units of alcohol once or twice per week has been removed to provide greater clarity as a precaution. For a summary of the new guidance www.alcoholeducationtrust.org/wp-content/ uploads/2016/01/AETguidelines.pdf
For details of the new guidance and to give views on the UK Chief Medical Officers’ proposed new guidelines until 1 April 2016 see www.gov.uk/ government/consultations/health-risks-fromalcohol- new-guidelines The new Guidelines are subject to limited consultation. This will only be on whether the proposals are sufficiently clear and well communicated. Therefore the exact wording of the guidance may still be subject to change pending the results of this consultation. Media commentaries have challenged the new guidelines and the research findings on which they are based: www.theguardian.com/society/2016/jan/14/inanityand- incoherence-on-safe-alcohol-levels www.dailymail.co.uk/health/article-3394679/ Why-killjoy-new-alcohol-rules-just-plain-wrongdevastating- critique-award-winning-writer-alcoholaffects- health.html www.dailymail.co.uk/health/article-3389673/Evenone- glass-wine-day-raises-cancer-risk-No-alcoholcalled- safe-says-NHS-chief.html www.telegraph.co.uk/news/nhs/12092571/Whyare- health-chiefs-playing-petty-politics-instead-oftackling- obesity.html
The WSTA and other trade associations were not consulted ahead of the change and the Department of Health has not provided any information over the immediate implications of the new guidance or details of any transition period.
In response the WSTA has written to the Minister of State for Health to seek clarity over these issues and to outline the significant uncertainty that has been created with their approach. As the industry has ensured that 80% of labels contained the previous guidelines, and these products are being sold and new labels printed every day, the WSTA have ask for an urgent meeting to discuss this and for a clarification statement to be issued.