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The UK Health Departments first introduced the concept of sensible drinking to the public in 1981, and in 1987, the "sensible limits" for drinking were defined as 21 units of alcohol a week for men and 14 for women—guidelines that were endorsed by the medical Royal Colleges.
By the early 1990s, scientific evidence had emerged suggesting that alcohol consumption might reduce the risk of coronary heart disease (CHD), prompting a review of the guidelines. The resulting 1995 report Sensible Drinking, which has formed the basis of individual drinking guidelines since, concluded the evidence showed that low daily intake of alcohol conferred protection from CHD mortality. It therefore recommended that drinking guidelines should be couched in daily terms: men should not regularly drink more than three to four units a day and women no more than two to three units a day. We found a lack of expert consensus over the health benefits of alcohol. We are sceptical about using the purported health benefits of alcohol as a basis for daily guidelines for the adult population, particularly as it is clear that any protective effects would only apply to men over 40 years and post-menopausal women.
While public awareness of the existence of guidelines was high, a deeper understanding of what the guidelines were and of what a unit of alcohol looked like was lacking. Because there is very little evidence that the guidelines have been effective at changing behaviour, the Government should treat the guidelines as a tool for informing the public. Efforts should be focused on helping people to understand the guidelines and how to use them.
The Government is working with the drinks industry to ensure that over 80% of alcoholic products will have labels with alcoholic unit content and the drinking guidelines by 2013. The Government should remain mindful that sensible drinking messages may conflict with the business objectives of drinks companies and exercise proper scrutiny and oversight. The Government should conduct an interim assessment of the pledge in December 2012 rather than waiting for the target date of December 2013.
There are sufficient concerns about the current drinking guidelines to suggest that a thorough review of the evidence concerning alcohol and health risks is due. The Department of Health and devolved health departments should establish a working group to review the evidence and advise whether the guidelines should be changed. In the meantime, the evidence suggests that (i) in the context of the current daily guidelines, the public should be advised to take at least two alcohol-free days a week; and (ii) the sensible drinking limits should not be increased.
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