Shield, Kevin and Paradis, Catherine and Butt, Peter and Naimi, Tim and Sherk, Adam and Asbridge, Mark and Myran, Daniel and Stockwell, Tim and Wells, Samantha and Poole, Nancy and Heatley, Jennifer and Hobin, Erin and Thompson, Kara and Young, Matthew (2024) New perspectives on how to formulate alcohol drinking guidelines. Addiction, 119, (1), pp. 9-19. https://doi.org/10.1111/add.16316.
External website: https://onlinelibrary.wiley.com/doi/10.1111/add.16...
BACKGROUND Low-Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low-risk' thresholds employed by different countries.
ARGUMENT/ANALYSIS Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low-risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age-specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so-called protective effects of alcohol on health, presenting cause-specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous.
CONCLUSIONS National LRDGs should be based on years of life lost and should be neither age-specific nor cause-specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum.
B Substances > Alcohol
J Health care, prevention, harm reduction and treatment > Harm reduction > Substance use harm reduction
J Health care, prevention, harm reduction and treatment > Prevention approach > Prevention through information and education
J Health care, prevention, harm reduction and treatment > Health related issues > Health information and education
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use > Harm reduction policy
N Communication, information and education > Information use and impact
N Communication, information and education > Information transfer / dissemination > Information transfer from research evidence to practice
N Communication, information and education > Recommendations
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
VA Geographic area > International
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