Alcoholic beverages being served at a bar.
Alcoholic beverages being served at a bar. Credit: Stanislav Ivanitskiy / Unsplash Credit: Stanislav Ivanitskiy / Unsplash

It started with a report from the Canadian Centre on Substance Use and Addiction on alcohol consumption and, then, its release of Canada’s Guidance on Alcohol and Health. To the point: the Centre recommended that no amount of alcohol is safe, more than two drinks is risky, and that risk escalates with every additional drink. What followed was not the calm discussion that is needed. 

Many experts supported the report and its overall thrust that, when it comes to alcohol, the lower, the better. A typical reaction was the one from the much interviewed cardiologist, Dr. Christopher Lobos: “Alcohol is not good for your heart.” Another expert pointed out that not only does this substance endanger physical but also mental health. One study concluded that heavy and frequent alcohol use increased the risk of death by suicide by 94 per cent especially for women, military personnel, and youth. The Council of Chief Medical Officers of Health of Canada released a statement in support of the Centre. Individuals recounted their personal tale of the turmoil that alcohol has caused in their lives.

But there was lots of blunt pushback. One critic charged that the report “…was suggesting that somehow we can avoid death.” (He did later acknowledge that “…people would be very ill advised if they think that there’s ‘nothing’ wrong with alcohol”). A prominent addiction physician, in her characterization of the report, opined: “People don’t react well to being lectured and …an attempt to frighten them.” An academic, describing herself as aligned with evidence-based medicine, nevertheless  warned ”the second we quantify the consumption of anything..[we] create a framework…to moralize others.”

The editors of the Globe and Mail also weighed in and were less than enthusiastic about the Centre’s efforts. The editorial critiqued the report on a number of fronts. But what really drew its fire was the report’s recommendation that warning labels be put on alcohol products. The editors were fine with standard drink information. But warning labels were seen as part of efforts to “stampede moderate drinkers toward teetotalling.” 

Readers of the report can judge for themselves if the Centre was suggesting we can avoid death or was bent on frightening, moralizing, or stampeding people. In any case the thrust of the report does not stand alone. None of the critics mentioned that in January, the same month as the Centre’s report and the Guidance appeared, staff members of WHO published a statement in the Lancet Journal of Public Health that, if anything, was more direct than the report. That document assessed many studies on the health effects of alcohol.  It concluded: “…no safe amount of alcohol consumption for cancers and health can be established.”   

The timing for the Centre’s report is not the best. The worst of Covid appears to be over. People want to be out enjoying bars and restaurants (though a sizeable portion may have been drinking more during the pestilence.) The hospitality industry, after teetering on the edge because of the darkness of the plague, is now seeing daylight. It may be aghast at the suggestion that a main component of its business model should essentially disappear. The alcohol industry is trying to ignore the report and the Guidance (maybe in the hope that they will just fade away). 

At any rate, as one commentator observed, “we may not care” that a report is telling us we drink too much no matter how accurate is its analysis. This brings us to the nub of the matter. It could be that the Centre’s recommendation of two glasses a week is too low for most drinkers to grapple with, at least for the near future. But we could come to care. What the report’s recommendation may do is to trigger conversations about risk levels and alcohol and its effects on individuals’ health. There are glimmers of this happening. 

Talk of the dangers of alcohol and growing awareness of its risks are critical in moving the dial. As with tobacco, there are several regulatory interventions (including mandating warning labels and standard drink information) that are available to suppress harmful consumption. But, also as with tobacco, shifting attitudes that embrace serious risk as a fact will be necessary to shape behaviour that leads to less (much less?) consumption of booze. It took decades to alter attitudes towards and behaviour regarding smoking. Big changes in terms of alcohol use may come. But probably not anytime soon. In the meantime let’s have “sober” conversations about the strength and weaknesses of the report and the Guidance.

W. A. Bogart

W. A. Bogart is distinguished university professor and a retired professor of law at the University of Windsor. He is the author/editor of eight books including Off the Street: Legalizing Drugs.