Good practice principles low rik drinking EU RARHA

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Core guidelinesUK Chief Medical Officers, August 2016Weekly drinking guidelineThe Chief Medical Officers’ guideline for both men and women is that:• To keep health risks from alcohol to a low level it is safest not to drink more than 14 units aweek on a regular basis.• If you regularly drink as much as 14 units per week, it is best to spread your drinking evenlyover 3 or more days. If you have one or two heavy drinking episodes a week, you increase yourrisks of death from long term illness and from accidents and injuries.• The risk of developing a range of health problems (including cancers of the mouth, throat andbreast) increases the more you drink on a regular basis.• If you wish to cut down the amount you drink, a good way to help achieve this is to haveseveral drink-free days each week.Single occasion drinking episodesThe Chief Medical Officers’ advice for men and women who wish to keep their short term health risksfrom single occasion drinking episodes to a low level is to reduce them by:• limiting the total amount of alcohol you drink on any single occasion;• drinking more slowly, drinking with food, and alternating with water;• planning ahead to avoid problems e.g. by making sure you can get home safely or that youhave people you trust with you.The sorts of things that are more likely to happen if you do not understand and judge correctly the risksof drinking too much on a single occasion can include:• accidents resulting in injury, causing death in some cases• misjudging risky situations, and• losing self-control (e.g. engaging in unprotected sex).Some groups of people are more likely to be affected by alcohol and should be more careful of theirlevel of drinking on any one occasion for example those at risk of falls, those on medication that mayinteract with alcohol or where it may exacerbate pre-existing physical and mental health problems.If you are a regular weekly drinker and you wish to keep both your short- and long-term health risksfrom drinking low, this single episode drinking advice is also relevant for you.A guideline on pregnancy and drinking• If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all,to keep risks to your baby to a minimum.• Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink thegreater the risk.The risk of harm to the baby is likely to be low if you have drunk only small amounts of alcohol beforeyou knew you were pregnant or during pregnancy.If you find out you are pregnant after you have drunk alcohol during early pregnancy, you shouldavoid further drinking. You should be aware that it is unlikely in most cases that your baby has beenaffected. If you are worried about alcohol use during pregnancy do talk to your doctor or midwife.One unit equals 8g or 10 ml of pure alcohol.76Title Report
Guidance on alcohol consumption in SwitzerlandJann Schumacher on behalf of the Federal Commission for Alcohol-Related Issues aIn 2015, the Federal Commission for Alcohol-Related Issues (FCAL) published guidelines for lowriskalcohol consumption in Switzerland, based on epidemiological knowledge and data. Theguidelines are differentiated by age, sex, health status and certain circumstances. To underline theprimary intent to prevent risk and harm, the messages also highlight the need to respect alcoholfreelifestyles and advise against daily drinking.Until 2015 a range of guidelines had been proposed by various bodies, none of them with acomprehensive scientific basis. To remedy this lack of official guidance, the FCAL, in collaboration withthe FOPH, commissioned the independent expert organisation Addiction Switzerland to draw up areport to review recent scientific findings on the health effects of alcohol. Published in 2013, the reportdraws on epidemiological data concerning alcohol-related morbidity and on an analysis of mortality inSwitzerland between 1997 and 2011 [ 1 , 2 , 3 ].Informed by this document, the FCAL set out to formulate nuanced messages rather than a singlerule applicable to everyone. The limits beyond which alcohol consumption is harmful depend on theage, sex, and health of the individual concerned as well as specific circumstances such as beingpregnant, on medication, or engaged in driving or exercise. The aim was to provide guidance tailored toparticular groups and situations.Another aim was to formulate messages that would be interpreted as points of reference for theconsumption of alcohol rather than as firm recommendations. To underline the primary intent toprevent risk and harm, the messages highlight the need to respect alcohol-free lifestyles, and that it isadvisable, even for adults in good health, to abstain from drinking at least two days a week. It is alsopointed out that there are more effective means to prevent cardiovascular disease than drinkingalcohol.The points of reference regarding alcohol consumption and risk of harm were published in early2015 in French, German, Italian and Romansh to cater for the various language groups in Switzerland[4]. A longer version of the guidance also explains the reasoning for the advice. The guidance on alcoholconsumption was published to coincide with the launch of a three-year national campaign under theaegis of the FOPH. The campaign encourages people to think about their own drinking habits and askthemselves “how much is too much?” bReferences1Marthaler M. (2013) Risiken für alkoholbedingte Krankheiten und Mortalität, Grundlagen für eineOrientierungshilfe zum risikoarmen Alkoholkonsum [Risques de maladies et de mortalité liés à l'alcool, Bases pourdes repères de consommation d'alcool à faible risque]. Lausanne: Sucht Schweiz.2Rehm J et al. (2010) Alcohol as a risk factor for liver cirrhosis: a systematic review and meta-analysis. Drug andAlcohol Review Vol. 29, No. 4, pp. 437–445.3Marmet S et al. (2013) Alcohol-attributable mortality in Switzerland between 1997 and 2011. Lausanne: SuchtSchweiz.4Federal Commission for Alcohol-Related Issues. (2015) Messages pour des repères relatifs à la consommationd'alcool à moindre risque [Botschaften für eine Orientierungshilfe zum Alkoholkonsum]. Bern: Federal Commissionfor Alcohol-Related Issues.aThe Federal Commission for Alcohol-Related Issues (FCAL) comprises experts in public health, prevention, careand research and serves the Swiss Federal Council in consultative capacity.bhttp://www.alcohol-facts.ch/77Title Report
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Good practice principlesfor low ris
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Table of contentsExecutive summary
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Executive summaryThe present public
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The Standard Drink concept and cons
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ForewordA recent flagship report by
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IntroductionThe present publication
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Chapter 1Joint Action on Reducing A
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Chapter 2Towards a common approach
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Graph 2. RARHA survey on low risk d
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replaced by daily guidelines in 199
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informed the UK 2016 review of drin
Page 25 and 26: Variability across population group
Page 27 and 28: the interpretation of low risk drin
Page 29 and 30: individual and public health, the r
Page 31 and 32: • Low risk drinking guidelines sh
Page 33 and 34: 35OECD (2015), Tackling Harmful Alc
Page 35 and 36: • A literature review into practi
Page 37 and 38: Graph 1. Uses of the Standard Drink
Page 39 and 40: link health messages to EU or natio
Page 41 and 42: warning in relation to consuming al
Page 43 and 44: in order to rduce risk of harm, the
Page 45 and 46: Chapter 4Guidance to reduce alcohol
Page 47 and 48: available in websites were mentione
Page 49 and 50: Restricting hours of sale and densi
Page 51 and 52: level of compliance with age limits
Page 53 and 54: Chapter 5Guidelines to support earl
Page 55 and 56: There is convincing evidence across
Page 57 and 58: standard routine health assessments
Page 59 and 60: Graph 3. Presence of multidisciplin
Page 61 and 62: 8Heather N. (2006) WHO Collaborativ
Page 63 and 64: ES Ministry of Health, Social Servi
Page 65 and 66: Annex 3Positive health effects of a
Page 67 and 68: Table 1. Changes in alcohol intake
Page 69 and 70: A quarter of a century of alcohol c
Page 71 and 72: The percentages vary depending on t
Page 73 and 74: Review of adult drinking guidelines
Page 75: the addendum to the expert group re
Page 79 and 80: Development of drinking guidelines
Page 81 and 82: 7Maa- ja metsätalousministeriö. (
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