Improving the epidemiology of low‐risk drinking guidelines is not enough

New perspectives on how to formulate alcohol drinking guidelines: Response to commentaries

“…We would like to thank Mr Angus and Drs Livingston, Holmes and Greenfield for their commentaries on our debate article [1][2][3][4]. These commentaries focus upon (i) the definition, operationalization and communication of health consequences from alcohol use and (ii) the need to communicate how per occasion drinking impacts health.…”

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There is a need for research on how the use of years of life lost and risk zones affect risk perception, and how risk acceptability differs between individuals. Furthermore, there is a need for guidance documents to better delineate how single-occasion drinking increases harms.We would like to thank Mr Angus and Drs Livingston, Holmes and Greenfield for their commentaries on our debate article [1][2][3][4]. These commentaries focus upon (i) the definition, operationalization and communication of health consequences from alcohol use and (ii) the need to communicate how per occasion drinking impacts health.

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Risky drinking or risky governance?

“…The inherent limits of low-risk thresholds are quite obvious and should be acknowledged – certainly so when used in a healthcare setting. Here, we are not only thinking about the fact that guideline panels make quite arbitrary cut-offs on smooth risk curves ( Room & Rehm, 2012 ), or that the 1‰ or 1% risk levels are far from given ( Livingston, 2023 ). We, as others, also believe that any guideline should allow people to make decisions based on their own risk tolerance ( Livingston, 2023 ).…”

“…Here, we are not only thinking about the fact that guideline panels make quite arbitrary cut-offs on smooth risk curves ( Room & Rehm, 2012 ), or that the 1‰ or 1% risk levels are far from given ( Livingston, 2023 ). We, as others, also believe that any guideline should allow people to make decisions based on their own risk tolerance ( Livingston, 2023 ). This issue is important for healthcare staff to understand in order to avoid blanket recommendations that patients might find non-credible or even misplaced.…”