Alcohol Guidelines - Science and Technology Committee Contents

Conclusions and recommendations

International comparisons

1.  The UK's alcohol guidelines are about average, compared with those of other developed nations. However, national guidelines can reflect social objectives and cultural differences as well as scientific evidence, and therefore we do not consider that international comparisons should be relied on as an indicator of how appropriate the UK's alcohol guidelines are. (Paragraph 13)

The evidence base

2.  There is a lack of consensus amongst experts over the health benefits of alcohol, but it is not clear from the current evidence base how the benefits of drinking alcohol at low quantities compare to those of lifelong abstention. In addition, it seems likely that the same purported health benefits could be gained through a healthy lifestyle. Therefore we are sceptical about using the alleged health benefits of alcohol as a basis for daily alcohol guidelines for the general adult population, particularly as these benefits would apply only to men over 40 years and post-menopausal women and the guidelines are aimed at all adults. (Paragraph 25)

3.  As the Government provides guidelines for specific population groups such as children and pregnant women already, we consider that there could be merit in producing guidelines for older people, balancing evidence of beneficial effects of alcohol with evidence of increased risks. (Paragraph 28)

4.  We are content that there is sufficient physiological and epidemiological evidence on health risks to support the retention of lower drinking guidelines for women in general. (Paragraph 31)

5.  The UK's Chief Medical Officers (CMOs) reviewed the guidelines for drinking during pregnancy in 2006 and produced updated guidelines that encouraged abstinence but also provided advice for women who chose to drink. We are satisfied that the CMOs have recently reviewed the evidence base and consider that the current guidance adequately balances the scientific uncertainty with a precautionary approach. However, we note that the Scottish CMO has adopted different advice. Consistency of advice across the UK would be desirable. (Paragraph 33)

6.  We have heard sufficient concerns from experts to suggest that a thorough review of the evidence on alcohol and health risks is due. The Department of Health and the devolved health departments should establish a nationwide working group to review the evidence base and use the findings of the review to provide advice on whether the guidelines should be changed. In the meantime, we consider that there does not appear to be sufficient evidence to justify increasing the current drinking guidelines. (Paragraph 37)

Public understanding and communication

7.  Public awareness of alcohol units appears to be high, but there are problems with public understanding of how many units are in alcoholic beverages. We see no reason why the established concept of alcohol units should be changed. We consider that efforts should be focused on helping people to translate the concept of alcohol units and sensible drinking guidelines into practice. (Paragraph 44)

8.  We are concerned that the Government views the guidelines as a tool to influence drinking behaviour when there is very little evidence that the guidelines have been effective at this. The Government should treat the guidelines as a source of information for the public. (Paragraph 48)

9.  It is unclear to us how the term "regular", as applied to all adults who drink, relates to the advice to take a 48 hour break after heavy drinking episodes. We suggest that, if daily guidelines are retained, the Government consider simplifying the guidelines so that, as is the case in Scotland, all individuals are advised to take at least two alcohol-free days a week. This would enforce the message that drinking every day should be avoided, and would helpfully quantify what "regular" drinking means to the public. (Paragraph 52)

10.  On balance, we consider that introducing guidance for individual drinking episodes could be helpful to inform the public and we invite the Department of Health to consider the suggestion as part of a review of the evidence base, taking into account social science evidence, including evidence from other countries on the impact that similar guidelines have had on drinking patterns. Guidance for individual drinking episodes should only be introduced if guidance is provided in a weekly context again, as having two daily drinking limits would be confusing to the public. (Paragraph 53)

11.  There is clearly a risk that drinks companies could face a conflict of interest as promoting a sensible drinking message could affect profits. However we have heard no evidence to suggest that the alcohol labelling pledges within the Public Health Responsibility Deal could be achieved without the cooperation of drinks companies. Nor have we heard sufficient evidence to suggest that, given the Government exercises proper scrutiny and oversight, a conflict of interest would jeopardise the progress of the alcohol pledges. (Paragraph 61)

12.  We are concerned that there will not be an independent assessment of the programme until the target date of December 2013. We recommend that the Government immediately set an interim labelling target for December 2012. It should then conduct a preliminary assessment of the progress of the alcohol pledges in the Public Health Responsibility Deal in December 2012. If through the voluntary involvement of the drinks industry, the intermediate target has not been met by December 2012, the Government should review the initiative, including the possible need to mandate compliance with labelling requirements. (Paragraph 62)


13.  At a time when the Government is putting efforts into encouraging people to drink within guidelines, we consider that a review of the evidence would increase public confidence in the guidelines. (Paragraph 63)

14.  The review of the evidence base should be conducted by an expert group, including amongst its members civil servants and external scientific and medical experts from a wide range of disciplines, including representatives from the devolved administrations. The group should review:

a)  The evidence base for health effects of alcohol including risks and benefits;

b)  Behavioural and social science evidence on the effectiveness of alcohol guidelines on (i) informing the public and (ii) changing behaviour;

c)  How useful it would be to introduce guidance on individual drinking episodes;

d)  What terminology works well in public communication of risks and guidelines; and

e)  Whether further research is needed, particularly for the alcohol-related risks to specific demographic groups (for example, older people).

The group should provide a recommendation to Government on whether the current alcohol guidelines are evidence-based, and if they are not, what the guidelines should be changed to. (Paragraph 64)

15.  We consider that the Government, industry and charities should emphasise in public communications:

a)  The specific risks associated with drinking patterns, that is, (i) the acute risks associated with individual episodes of heavy drinking and (ii) the chronic risks associated with regular drinking;

b)  That there are situations where it is not appropriate to drink at all, for example while operating machinery; and

c)  That people should have some drink free days every week. (Paragraph 66)

16.  Having explored the complexity around the risks faced by different groups of people, for example women, pregnant women, older people and young people, we consider that while simplicity of advice is preferable for public communication, complexity should not be avoided if it improves public understanding and confidence in the guidelines. For example, the guidelines for children and young people are more complex than for adults but are also clear, concise and leave no room for misinterpretation, and we consider that guidelines for adults could be similarly expressed. (Paragraph 67)

17.  We recommend that there should be an online resource where individuals could obtain more individualised advice where factors such as weight, age, ethnicity and family history of alcohol problems could be taken into consideration. This resource should include links to sources of further information and support, and recommendations on whether to seek further expert medical advice. We consider that this resource could help dispel people's notions that generic alcohol guidance does not apply to them. Charities such as Drinkaware and other organisations should develop methods of increasing access to this type of individualised advice for those who have limited or no access to online resources. (Paragraph 68)

18.  The cooperation of the drinks industry is essential if the Government wants to achieve the Public Health Responsibility Deal's alcohol pledges. However, the Government should remain mindful that sensible drinking messages may conflict with the business objectives of drinks companies, and should therefore exercise scrutiny and oversight to ensure that any conflicts of interest are mitigated and managed. (Paragraph 69)

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Prepared 9 January 2012