In 2023, the World Health Organization (WHO) stated that ‘no safe amount of alcohol consumption for cancers and health can be established’, and that ‘Alcohol consumers should be objectively informed about the risks of cancer and other health conditions associated with alcohol consumption’ [1]. Following this risk assessment, some countries consider taking (moving) it to public health policy in terms of guidelines and recommendations. Furthermore, some European countries have already recommended a total avoidance of alcohol consumption [2]. The manner in which this risk assessment should be translated into policy is a matter of ongoing debate forming a policy spectrum that ranges from informed individual decision-making to a rigid collective-centred precautionary approach.

This viewpoint proposes a foundational policy step common to all jurisdictions: acknowledging the WHO evidence regarding the absence of a ‘safe’ threshold. It should be borne in mind that the risks associated with low-level alcohol consumption are not uniform across populations. A GBD 2020 systematic analysis on alcohol found that the level of consumption that minimizes health loss is close to zero for younger adults across all world regions, while small amounts may be associated with reduced overall risk among older adults in regions with a high cardiovascular disease burden. This heterogeneity argues for age- and context-specific guidance rather than a single population threshold [3]. From this baseline, it presents diverse perspectives along the policy spectrum and calls for an informed debate among public health professionals regarding our collective position on this continuum.