The recent guidelines from the Canadian Centre on Substance Use and Addiction (CCSA) have certainly caused controversy.
The new guidelines, released last month, were blunt: No amount of alcohol is safe to consume. At best, no more than two drinks should be consumed a week. Anything more increases the risk of heart disease, stroke and, of course, cancer.
The link between alcohol and cancer has been well documented, being a key cause of breast, colon, throat, and head and neck cancers. Alcohol is listed by the World Health Organization as a Class One carcinogenic, the same classification as tobacco. Globally, it’s easy to see the problem alcohol consumption causes. A 2014 World Health Organization study says it is responsible for almost six percent of deaths worldwide. This includes not only the diseases caused by alcohol consumption, but the suicides, falls, drownings, traffic collisions and violence associated with it.
As with many things, these health risks have increased due to the pandemic. Alcohol related deaths are up 40 percent according to Health Canada. Feelings of isolation, depression and hopelessness often cause people to turn to alcohol, and are compounded by other societal factors. As alcohol is an addicting substance, finding treatment is difficult. The stigma around alcoholism is also a factor in those needing help not seeking it.
It is for this reason that the timing of these new guidelines is poor.
When addiction is at its highest, when the pandemic is still causing problems, and the public’s appetite for being warned of health risks is at an all-time low, these guidelines are very likely to not reach those who need it most. Add this to the fact that alcohol is so ingrained in our society: it is so easily accessible, so easy to over-consume, and often drinking is encouraged on many levels. It’s so deeply intertwined in public life, that to be told that it’s so harmful so quickly leaves the warning to fall on deaf ears.
Let’s consider what constitutes “one drink”. As a rule, one drink is typically considered as one beer, one glass of wine, or one shot of spirits or hard alcohol. According to Health Canada, a standard drink is 17.05 milliliters of pure alcohol. That is 341 milliliters of beer or cider at 5% alcohol, 142 milliliters of wine at 12% alcohol, or 43 milliliters of distilled alcohol at 40%.
If you take a look at the drinks at any store across Canada, you’ll notice that these numbers are not uniform across the board. Consider that many beers now are sold in the 500 ml “tallboy” cans. Each one of those constitutes two standard drinks, and according to the CCSA, that is your limit if you want to avoid cancer. And that’s when the amount is labelled and measured. In restaurants and bars, measurement isn’t always uniform.
It’s easy to see why these new guidelines may be ignored.
Yet there is hope that education will work in getting people to drink less. The recent call for cancer labels on alcohol has caused some to recall the similar push done with cigarettes. That push has seen cigarette use fall dramatically over the decades, especially as the warnings became more graphic. However, cigarette use is still the leading cause of lung cancer in Canada, and the fight to reduce smoking has been nothing but bumpy. We can only predict the push to label alcohol will be similar.
Another cause to hope is a generational one: younger people are starting to reject alcohol. A report from Berenberg Research is showing that Gen Z is drinking 20 percent less than Millennials, and Millennials are drinking less than their Gen X counterparts. Many point to the health risks associated with alcohol as a reason to drink less. Companies have taken note, with alcohol-free beverages becoming more prevalent in advertising. Hopefully this shift in attitudes will continue as the next generation of consumers opt for alcohol-free substitutes.
At CCSN, we have been open about the risks that things like tobacco and alcohol have posed. But in doing so, we are also mindful of the stigma around those with certain types of cancers, and the effect poverty has on cancer rates. The link between alcohol and poverty has been well documented, with one a symptom of the other and vice versa. Simply saying that no drink is safe, while true, is unhelpful without confronting the ingrained culture of drinking and the societal factors that lead to it.
While it is welcome to put a warning label on alcohol, and to inform the public about its risks, we also need to be mindful that eliminating alcohol use in the name of health is a big ask for many people. While the next steps beyond this are not entirely clear, careful thought behind what comes next could be the key in healthier outcomes and cancer prevention. Otherwise, these warnings may simply be ignored, and the stress of alcohol on our healthcare system will continue.