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Government Alcohol Limits Aren't Meant To Limit Your Alcohol Intake

Health and risk experts argue that the goal of the CMO's new guidelines is not to change behaviour, but rather to make sure people know the risks of their actions. "Public health advice should treat people like grown-ups."

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The Chief Medical Officer (CMO)'s guidelines on drinking have been released, and they're pretty conservative.

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The "safe" level of drinking for men has been lowered from 21 units – about 10 pints of beer – to 14 units, about seven pints. The guidelines also recommend not drinking alcohol at all while pregnant or planning pregnancy.

The CMO, Dame Sally Davies, has also rejected the idea of a protective effect from drinking. It was previously thought that a moderate amount of alcohol protects against heart disease, stroke and some cancers. But the new guidelines say that if this effect is real at all, it applies only to older groups, and that it may have just been a statistical illusion.

The 14-unit limit is based on a risk level. If you drink this much, the evidence suggests, you'll have a 1% chance of dying of an alcohol-related cause, according to the new guidelines.

BuzzFeed News spoke to several public health experts, and they broadly agree that these guidelines are in line with the evidence.

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"It's certainly the case that risk starts to increase at a low level of consumption," Dr James Nicholls, a director of research at Alcohol Research UK, told BuzzFeed News.

Professor Theresa Marteau of Cambridge University, who worked on the guidelines, told BuzzFeed News that the review is "based on the latest evidence", particularly the information on the risk of cancer.

Professor Peter Anderson of Newcastle University, who specialises in substance use and abuse, told the Science Media Centre that "The scientific basis for the guidelines is correct and revision of the drinking guidelines was long overdue."

But these experts agreed that while important, the guidelines are unlikely to make people drink less.

"There's very little evidence of impact of any guidelines, for alcohol or food, changing people's behaviour," Marteau said. "Information is important, but it's a weak way of changing behaviour." The report itself says that experts "found little evidence regarding the impact of any guidelines in changing health behaviours".

Nicholls agreed. "No, there isn't evidence. It's a difficult one, because it's hard to capture exactly what the effects of guidelines are.

Another public health doctor, who preferred not to be named, told BuzzFeed News: "Information deficit is not the reason why people are drinking too much. No one goes into McDonald's thinking they're going to have a healthy diet."

The experts said the guidelines are not really intended to force changes in behaviour.

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"The stated aim is to provide an update on the evidence, not to change behaviour per se," said Marteau. The idea is, according to the report, "to inform individuals so that they can take informed decisions about their own drinking", rather than to push overall drinking down.

That said, a lot of people have interpreted it otherwise.

Simon Jenkins in the Guardian and Christopher Snowdon of the Institute of Economic Affairs think tank, among others, have accused the CMO of scaremongering. The experts said that is not the intention here, however.

"I can see why it's perceived as telling people what to do," said Nicholls. "It's coming from the leading medical authority in the land, and it's backed by government."

Nicholls said that even people who work in public health are confused about it too. "A lot of us don't think this through adequately, in terms of what these guidelines are trying to do," he says. "They're not telling anyone what they must do.

"It's advice to individuals that, if they want to reduce risk, here's a safe threshold. The nanny state thing isn't valid."

But the advice is meant to change the public conversation about alcohol consumption, and perhaps change drinking habits that way, the experts said.

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"It's pure speculation," said Nicholls,"but the last 10 years has seen a lot more discussion on alcohol units and alcohol harms, and that has coincided with a long decline in consumption. Whether that's causation or correlation we don't know."

Marteau pointed out that in an environment where the harms of alcohol are widely known, other policy changes may become easier. "From [people knowing the evidence] may flow a variety of other consequences. It could, for example, increase the acceptability of other interventions that could change behaviour," for instance changes to pricing or advertising laws.

Nicholls also said that changes to the thresholds of what is "safe" drinking also change the statistics – so many people who were previously drinking "safely" according to official guidelines are now not – and that may put pressure on government to change things.

It's also worth noting that the recommended safe limits are very safe, by the standards of these things.

David Spiegelhalter, a professor of the understanding of risk at Cambridge University, told BuzzFeed News: "I'd say that [the 1% risk level] is an acceptable risk, comparable to things we might undertake things we take for pleasure. In terms of lifestyle – exercise, diet and so on – this is not a substantial risk at all." He says that an hour of watching TV a day, or a bacon sandwich a couple of times a week, is more dangerous to your long-term health – although you'd have to do 1,000 parachute jumps to reach the same risk.

So the question is what you consider an acceptable risk — and how much you enjoy drinking.

Spiegelhalter said "What I like about the guidelines is they've explicitly said what they mean by low-risk. They're not saying this is safe, they're saying this is the level of risk.

"Personally, I'd have liked to see a higher threshold, something you really want to avoid. But it's great that they're pegging what the risk is, enabling people to make up their own minds. Public health advice should treat people like grown-ups."

Tom Chivers is a science writer for BuzzFeed and is based in London.

Contact Tom Chivers at tom.chivers@buzzfeed.com.

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