To have a glass of wine or beer or just juice? It's a question that many of us face when we go for a drink after work, when we're relaxing on a Friday night, or when we're at the supermarket thinking about what to buy for the weekend. I'm not here to offer an opinion on drinking philosophy, and how much you should drink is a question you can answer for yourself. But it's worth highlighting the latest advice on alcohol from leading health authorities. Chances are, you'll lean towards one side or the other.
It's well known that excessive drinking is harmful, but what about light to moderate drinking? In January 2023, the World Health Organization issued a strong statement that there is no safe level of drinking for health. The organization highlighted that alcohol causes at least seven types of cancer, including breast cancer, and that ethanol (alcohol) directly causes cancer when broken down by cells.
The WHO points out that after reviewing the current evidence, no studies have shown that the benefits of drinking alcohol outweigh the harm it causes to the body. A key WHO official said the only thing we can say for sure is that “the more you drink, the more harm it causes – or, in other words, the less you drink, the safer you are.” Whether you pay £5 or £500 for a bottle of wine makes little difference to your body or your risk of cancer. Alcohol is harmful in all forms.
Countries are beginning to adopt this position in their national guidelines. For example, Canada introduced new national recommendations in 2023 noting that abstinence is the only risk-free approach and that two drinks (about four units) per week is low risk. This is a change from the guidelines of up to 10 drinks (about 20 units) and 15 drinks (about 30 units) for women and men, respectively. The NHS has adopted the statement that “there is no completely safe level of drinking” and has adopted a guideline of not drinking more than 14 units per week, or about six glasses of wine/six pints of beer.
What about red wine? Isn't that supposed to be good for you? Twenty years ago, studies were published suggesting that red wine, especially as part of the Mediterranean diet, could be good for the heart. But some of these studies didn't take into account the fact that red wine drinkers are more likely to be educated, wealthy, physically active, eat vegetables, and have health insurance. In 2006, a new analysis that took into account variables that affect health found no benefits to drinking red wine. Since then, growing evidence has shown that drinking even one glass of wine a day can increase your risk of high blood pressure and heart disease.
The alcohol industry has been smart in this regard, funding studies that show the benefits of moderate drinking. This is a lesson in why we should always check who is funding research and whether there are any conflicts of interest. Confusion of research by commercial interests (famously used by the tobacco industry as well) has led to statements by economist Emily Oster and others that it is safe to drink one drink a day during pregnancy. This has been proven false. A 2022 fetal brain imaging study showed that drinking just one alcoholic drink a week during pregnancy can have a negative impact on the developing brain of a fetus.
In summary, it is a widely accepted view that alcohol poisons our bodies. This is not a moral judgement, but something that has been shown in large-scale epidemiological studies. This should be reflected in government policies, such as health warnings on alcohol labels, banning bulk-buying promotions, limiting marketing and advertising, and raising awareness of the health risks of drinking alcohol. However, we need to be careful not to fall into austerity. We live in a democracy where people have the freedom to drink and make choices about their health.
I work in public health, and I admit to still drinking alcohol from time to time. We humans make decisions every day about the risks we take. As public health workers, we need to remember that not everyone is interested in just living longer. It's also important to feel good about everyday life. We eat donuts and potato chips even though we know they're bad for us. It's like driving long distances on the highway, knowing there's always a risk of a fatal car accident. And when it comes to alcohol, for many of us, there's a sense of well-being in having a bottle of wine or a few beers with friends.
There is no moral judgement to be made about how people live their lives and the choices they make, but drinking alcohol certainly carries health risks, and it is worth our, and our governments', finally acknowledging this fact, even if we don't want to think about it.
