Alcohol Use Disorders (128) Communicating the benefits of abstinence versus light/moderate drinking (2)

7 March, 2024

Dear Joseph,

Many thanks for your message. It seems the definition of 'moderate' drinking is also unclear. In the USA it is defined as not more that 1 standard drink per day for women and 2 standard drinks per day for men. The UK NHS website is unclear but implies that anything up to 14 units per day is 'moderate'.

Physicians in the US seem to have their own way of defining moderate drinking (!) 'Physicians operationally defined "light" drinking as 1.2 drinks/day, "moderate" drinking as 2.2 drinks/day, and "heavy" drinking as 3.5 drinks/day.' https://pubmed.ncbi.nlm.nih.gov/9726266/

This is further muddled by the fact that a US standard drink contains much more alcohol than a UK unit. 'In the US, a standard drink contains 14 grams of alcohol, in Australia it's 10 grams and in the UK it's about eight grams. In some countries there is separate advice for men and women, while in others – including Australia – there is not.' https://www.theguardian.com/society/2023/jan/15/glass-too-full-why-safe-...

And this describes the situation in just 3 countries.

The Guardian news notes that 'Belgium suggests 21 drinks a week is safe for men, while Australia recommends no more than 10 for anyone. What goes into the decision making?'

'Belgium labels up to 21 drinks a week for men and 14 for women as low risk, while Ireland goes with up to 17 drinks for men and 11 for women, with two alcohol-free days a week. France recommends no more than 10 standard drinks a week – the same as Australia – but never more than two standard drinks a day and at least one alcohol-free day a week. The UK advises no more than 14 units a week, over at least three days, and “some” alcohol-free days, while the US recommends no more than two drinks a day for men and one for women.'

https://www.theguardian.com/society/2023/jan/15/glass-too-full-why-safe-...

Why have different countries come to different conclusions on the same evidence?

What about other countries? I look forward to contributions from others: hifa@hifaforums.org

Given that the definitions in different countries are so muddled, is there potential for more consensus and alignment?

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org