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Chief Medical Officers: There is no ‘safe’ level of drinking

Any level of alcohol can give you cancer, warn new drinking guidelines

The UK’s Chief Medical Officers (CMOs) have published new guidelines for alcohol consumption, advising that men should now not drink more than 14 units of alcohol each week. This is lower than the weekly equivalent for the previous daily guidelines (21 units) for men [illustrated], and brings their recommended limits in line with women’s. They also warn that drinking any level of alcohol raises the risk of a range of cancers.

The new advice follows a detailed review of the scientific evidence since the previous guidelines in 1995. Work on the review has been underway since 2013, led by a panel of experts in public health, behavioural science and alcohol studies.

CMO for England Dame Sally Davies said: “Drinking any level of alcohol regularly carries a health risk for anyone, but if men and women limit their intake to no more than 14 units a week it keeps the risk of illness like cancer and liver disease low.

“What we are aiming to do with these guidelines is give the public the latest and most up to date scientific information so that they can make informed decisions about their own drinking and the level of risk they are prepared to take.”

Rationale

Strengthening evidence of the link between alcohol and cancer is just one of a number of reasons behind the tighter guidelines. The full extent of the links between alcohol and cancer were not previously understood when the original guidelines came out in 1995. But it has since been confirmed that the risks of developing several types of cancers start from any level of regular drinking and rise with the amount being drunk. Therefore, the new guidelines have been set at a level to keep the risk of mortality from cancers or other diseases low.

Alongside this come the latest findings from the Committee on Carcinogenicity (CoC), which support the significant links from alcohol to cancer outlined by the CMOs. The CoC review found that drinking even a small amount of alcohol increases the risk of some cancers compared with people who do not drink at all.

Professor David Phillips, King’s College London, chairman of the CoC, said: “Even alcohol intake of below 1.5 units a day, or 10.5 units a week, gives an increased risk of cancer of the mouth, throat and gullet. This level of drinking also increases the risk of breast cancer in women. When alcohol consumption is above around 1.5 units a day, or 10.5 units a week, there is an increased risk of cancer of the voice box and large bowel.

“If alcohol intake is above about six units a day, or 42 units a week, there is an increased risk of cancer of the liver and pancreas.

“The risk of getting cancer increases the more alcohol a person drinks. We found that between 4% and 6% of all new cancers in the UK in 2013 were caused by alcohol consumption. Limiting alcohol consumption, as recommended by the CMOs’ new guidelines, will help to limit the increase in cancer risk to low levels.”

The panel of experts involved in the drafting of the CMO report also found that the benefits of alcohol for heart health only potentially apply for women aged 55 and over, a smaller proportion of the population than was previously thought, and were outweighed by the cancer risks raised in regular drinking.

In addition to weekly limits, the guidelines recommend spreading unit consumption over three or more days, having several alcohol free days a week [illustrated], and for pregnant women to avoid drinking any alcohol.

 

Reaction

The guidelines received a lot of media attention ahead of release, in part due to a leak to the press. ‘Men will be advised to drink no more than a pint and a half of beer a day in a nanny state New Year crackdown’ decried the Sun newspaper on 31 December 2015.

Industry expressed disappointment at not being consulted. Wine and Spirit Trade Association chief executive Miles Beale complained that the CMOs’ new guidelines rendered “all labelling advice out of date overnight”. Henry Ashworth, chief executive of drinks trade lobbyists Portman Group was surprised that “the UK is breaking with established international precedent” in recommending parity of drinking levels between the sexes. The BBPA and CAMRA were also concerned that the reduced guidelines classify a whole new group of male drinkers as being “at risk”.

However, a range of health bodies and charities have lined up to support the CMOs’ new recommendations. Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: “This is a real step in the right direction on alcohol in the UK. We welcome the CMO’s recommendation as we’ve known for some time that regularly drinking alcohol increases your risk of developing breast cancer.

“There is unfortunately no ‘safe’ alcohol limit when it comes to increasing one’s cancer risk. It’s imperative that men and women fully understand the risks involved and that clear information about the alcohol content of all drinks is now provided. Importantly, while you cannot change some things that affect your breast cancer risk, such as getting older, alcohol is not only one of the most important factors but it is one you really can do something about.”

According to Katherine Brown, director of the Institute of Alcohol Studies, too many people are currently unaware of the risks they are exposing themselves to by drinking too much. Writing in The Guardian, she said “[the] new guidelines are purely a tool to enable drinkers to make fully informed decisions about their health. But it’s up to the government to ensure the message is carried loud and clear to the majority of Brits who regularly drink... However, public opinion polls show that half of Britons don’t associate the nation’s favourite drug with cancer, which makes the case for publicising this relationship even more urgent.”