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It is well established that alcohol consumption is associated with a range of health risks. Given that many people choose to drink, there is a clear need for harm reduction strategies that minimize potential consequences without requiring complete abstinence. In response, some countries have introduced low-risk drinking guidelines to encourage safer alcohol use. These evidence-based guidelines provide recommendations for limiting alcohol use to levels considered less likely to harm health. Ultimately, they aim to help people make informed and safer decisions about their drinking behavior.
There is no globally agreed-upon definition for low-risk drinking. As such, drinking guidelines can vary significantly by country. In the U.S., the Dietary Guidelines for Americans recommend that healthy adults drink in moderation by limiting their alcohol intake to no more than 2 drinks per day for men, or 1 drink per day for women. Canada’s Guidance on Alcohol and Health advises consuming no more than 2 drinks per week to minimize health risks. The UK’s Low-Risk Drinking Guidelines recommend that people should not regularly consume more than 14 units of alcohol per week. Comparing these guidelines highlights their considerable differences in how they define low-risk drinking, communicate alcohol consumption thresholds (daily versus weekly limits), and factor in sex (or don’t).
Low-risk guidelines aren’t limited to alcohol. For example, Canada’s Lower-Risk Cannabis Use Guidelines outline 10 recommendations for people who use cannabis. These recommendations range from delaying initiation until after adolescence, avoiding combustible cannabis in favor of safer alternatives like vaporizers or edibles, and limiting consumption to occasional use. Canada also provides Lower-Risk Gambling Guidelines, which advise gambling no more than 1% of household income, limiting gambling to no more than 4 days per month, and avoiding gambling regularly on more than 2 types of games.
Low-risk guidelines are valuable public health tools that help people make more informed potentially risky behaviors. But, to be effective, people must actually implement these guidelines in their daily lives. This raises important questions: Are people aware of these guidelines? If they are, are they adhering to them? And if they are not, how can we better communicate these guidelines to the public? How can we avoid confusing people when making evidence-based updates to previous guidelines?
We’ll be exploring these sorts of questions this month in our Special Series on Education to Promote Lower-risk Drinking, Gambling, and Substance Use. The BASIS will feature four science reviews of studies related to this topic. First, for STASH, we will summarize a study that examined young adults’ perceptions of higher-risk cannabis use behaviors outlined in Canada’s Lower-Risk Cannabis Use Guidelines. We will review a study that assessed the level of gambling involvement associated with an increased risk of future harms for The WAGER. Next, for The DRAM, we will summarize a study that investigated low-risk drinking practices and the factors that sustain low-risk drinking. Finally, for ASHES, we will review a study that examines how sexual and gender minorities use tobacco harm reduction strategies to minimize smoking-related harms.
To complement these science reviews, we will share four editorials written by experts in the field. Dr. Daniel Bear will highlight an approach to cannabis education that is centered on mindful consumption and benefit maximization. Dr. Sarah Jackson will explore public confusion about the UK low-risk drinking guidelines, and what can be done about it. Finally, Dr. Lorraine Greaves will discuss the sex- and gender-related factors affecting safer levels of alcohol use.
This Special Series is generously sponsored by the Greater Boston Council on Alcoholism, whose mission is to increase public understanding of the nature, treatment, and prevention of alcohol and other drug use disorders. We thank the Greater Boston Council on Alcoholism for making this Special Series possible.
— Kira Landauer, MPH, Community Health Educator Supervisor, Division on Addiction at Cambridge Health Alliance, a Harvard Medical School teaching hospital
Conflict of Interest Statement
Ms. Landauer has no conflicts of interest to disclose of personal, financial, or other benefits that could be seen as influencing the content of this editorial. The Division on Addiction’s funding sources can be found here.
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