BACKGROUND AND AIMS: Low-risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Lifetime mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts.

METHODS: The maximum acceptable voluntary premature mortality risk was determined to be 1 in 1,000, with sensitivity analyses of 1 in 100. Lifetime mortality risks for different alcohol consumption levels were estimated by combining disease-specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy, and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta-analyses, and mortality information from the World Health Organization.

RESULTS: The variation in the lifetime mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of 1 in 1,000 ranged from 20.6% to 32.9% for women and from 35.4% to 54.0% for men. Lifetime risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1,000 women in Finland and Estonia respectively, and from 2.9 to 35.8 deaths per 1,000 men in Finland and Estonia respectively. If based upon an acceptable risk of 1 in 1,000, guideline maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men.

CONCLUSIONS: If low-risk alcohol guidelines were based on an acceptable risk of 1 in 1,000 premature deaths, then maximums for Europe should be 8-10 g/day for women and 15-20 g/day for men, and some of the current European guidelines would require downward revision.