Alcohol Framework 2018

Annex A

Summary of the UK Chief Medical Officers’ lower-risk drinking guidelines

Impacts of alcohol

1. The impacts that alcohol can have are now well known. The health harms from regular drinking of alcohol can develop over many years. This occurs either from the repeated risk of acute harms (e.g. alcohol-related accidents) or from long-term diseases caused by alcohol, which may take ten to twenty years to develop. These illnesses include various cancers, strokes, heart disease, liver disease, and damage to the brain and nervous system.

2. Alcohol-related harm can take different forms and has the potential to affect us all. Alcohol can be a factor in both physical and mental conditions. We can be affected, either directly or indirectly, by alcohol through anti-social behaviour and violence.

3. And alcohol can impact on those around the drinker too, especially children. This can take the form of violence, accidents, child neglect, partner abuse, relationship problems, harassment, noise and criminal damage, and can happen in public spaces as well as in the home.

4. The latest evidence suggests that the net benefits to the heart from small amounts of alcohol are less than previously thought. Further, they are only applicable to a small group of the population (women over the age of 55, for whom the maximum benefit is gained when drinking around 5 units a week, with some beneficial effect up to around 14 units a week).

5. These developments are reflected in the recently updated lower risk drinking guidelines issued by the UK CMOs^[112], which confirmed that risk increases in line with consumption.

The CMOs’ lower-risk drinking guidelines are summarised below.

Summary of the new guidelines

6. The UK CMOs have agreed three main recommendations:

• a weekly guideline on regular drinking
• advice on single episodes of drinking
• a guideline on pregnancy and drinking

For regular drinking, there is a weekly drinking guideline:

This applies to adults who drink regularly or frequently, i.e. most weeks.

7. The CMOs’ guideline for both men and women is that:

• to keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis;
• if you regularly drink as much as 14 units per week, it is best to spread your drinking evenly over 3 or more days. If you have one or two heavy drinking episodes a week, you increase your risks of death from long term illnesses and from accidents and injuries;
• the risk of developing a range of health problems (including strokes as well as cancers of the mouth, throat and breast) increases the more you drink on a regular basis; and
• if you wish to cut down the amount you drink, a good way to help achieve this is to have several drink-free days each week.

For ‘single occasion’ drinking episodes:

This applies for drinking on any single occasion (not regular drinking, which is covered by the weekly guideline)

8. The CMOs’ advice for men and women who wish to keep their short term health risks from single occasion drinking episodes to a low level is to reduce them by:

• limiting the total amount of alcohol you drink on any single occasion;
• drinking more slowly, drinking with food, and alternating with water; and
• planning ahead to avoid problems e.g. by making sure you can get home safely or that you have people you trust with you.

9. The sorts of things that are more likely to happen if you don’t understand and judge correctly the risks of drinking too much on a single occasion can include:

• accidents resulting in injury (causing death in some cases)
• misjudging risky situations, and
• losing self-control (e.g. engaging in unprotected sex).

10. Some groups of people are likely to be affected by alcohol and should be more careful of their level of drinking on any one occasion for example those at risk of falls, those on medication which may interact with alcohol or where it may exacerbate pre-existing physical or mental health problems.

11. If you are a regular weekly drinker and you wish to keep both your short and long-term health risks from drinking low, this single episode drinking advice is also relevant for you.

On pregnancy and drinking:

12. The CMOs’ guideline is that:

• if you are pregnant or think you could become pregnant, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum.
• drinking in pregnancy can lead to long-term harm to the baby, with the more you drink the greater the risk.

13. The risk of harm to the baby is likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant or during pregnancy. If you find out you are pregnant after you have drunk alcohol during early pregnancy, you should avoid further drinking. You should be aware that it is unlikely in most cases that the baby has been affected. If you are worried about alcohol use during pregnancy do talk to your doctor or midwife.