Good practice principles low rik drinking EU RARHA

Introduction
The present publication synthesizes work done in the EU co-funded Joint Action on Reducing Alcohol
Related Harm (RARHA) to identify good practice principles for formulating and communicating low risk
drinking guidelines to help reduce risk of harm. Such guidelines show considerable variation between
European countries in the quantity of alcohol consumption considered low-risk. As information on
alcohol risk levels is increasingly accessible across country and language borders, discrepancies may
lead to miscommunication of research findings and health advice.
Low risk drinking guidelines have been introduced by countries individually, without coordination.
National experts have drawn upon the internationally shared knowledge on the risks and effects of
alcohol, yet come to somewhat different conclusions when formulating national guidelines. One of
Joint Action RARHA’s work packages focussed on providing insight into the current practices and the
science underpinnings, and to explore whether some degree of consensus could be achieved.
The discussion in this synthesis publication draws on published literature and on work done in
RARHA. While each chapter is credited to named authors, the findings and conclusions presented arise
fom a collective endeavour of the partnership (Annex 1). Views of an even wider range of experts and
stakeholders were sought through two separate Delphi surveys, by means of an open online survey,
and in expert meetings in which preliminary findings were presented and discussed. A range of working
papers and background reports were produced to present and summarize the work done (Annex 2).
References to individual RARHA papers and reports providing detailed information are included in the
various chapters of this publication.
Chapter 1 describes briefly Joint Action RARHA and how the work around drinking guidelines was
carried out. The next chapters summarize key points from the work.
Chapter 2 begins by describing current variation in national low risk drinking guidelines and moves on
to discuss methodological choices in defining low risk from alcohol. The results of a calculation of the
lifetime risk of alcohol-attributable mortality in seven European countries are then briefly presented.
The components, key messages, purposes and public health relevance of low risk drinking guidelines
are examined in light of published literature and in light of the views of the Delphi expert panel.
Adoption of the cumulative lifetime risk of alcohol related mortality is suggested as a common metric
for assessing the risks from alcohol to inform the setting of guidelines on low risk drinking. Good
practice principles for the use and formulation of low risk drinking guidelines are presented to foster a
common concept and approach.
Five country snapshots describing how national drinking guidelines have evolved over time are
presented as an annex (Annex 4).
Chapter 3 presents and overview of the uses of the Standard Drink (SD) and summarizes research
findings regarding people’s understanding of SDs. The usefulness of an agreed EU definition of SD – as
opposed to the current variation in the size of SD from one country to another – is then discussed as
well as the usefulness of indicating on alcoholic beverage labels the number of SDs in the container.
Given the lack of a common EU SD definition, a statement of the alcohol content in a bottle or can in
grams of pure alcohol is suggested as a feasible alternative. Finally, consumers’ and experts’ views of
useful health relavant on-pack information on alcoholic beverages are presented.
Chapter 4 is focussed on guidance to reduce alcohol related harm for young people and draws on
published literature, information gathered from European countries on current guidelines regarding
drinking by young people, and on expert views identified by means of a Delphi survey. Based on expert
agreement, the chapter lays out main lines regarding guidance to be provided to young people, parents
and professionals and regarding effective interventions and policies to protect young people.
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Good practice principles for low risk drinking guidelines