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Topics: Ethical Living | Opinion

The public response to Canada’s new alcohol guidelines misses the point

We need to accept that booze is harmful and fight for helpful policies around it


As you’ve almost certainly heard by now, Canada has a new set of “low-risk drinking guidelines” for alcohol consumption. These latest recommendations are the result of a multi-year Health Canada-funded study by the Canadian Centre on Substance Use and Addiction, and replace the country’s old guidelines from 2011.

Much has changed on the alcohol science front in a decade, particularly regarding the causal relationship of drinking with cancer risk. As a result, the new guidelines have drastically reduced the threshold of low-risk drinking from 15 “standard drinks” a week for men and 10 for women down to only two per week for all genders. Between three and six drinks a week is now defined as carrying “moderate risk,” while seven and over is “increasingly high risk.” Even this continuum frames risk in a far different way than many other societal harms, evaluating lifetime risk of death from an alcohol-related cause as 1 in 100 or 1,000, compared to risk of cancer cases (not deaths) from air pollution as between 1 in 10,000 to 1,000,000.

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Unsurprisingly, these findings have attracted considerable national and international attention, much of it hostile. A widely shared Twitter thread by Brock University medical historian Dan Malleck, for instance, disparaged the study as ideologically biased, massively overstating risks, and representing a “misuse of data to push a neo-temperance agenda.” Social media posts and media interviews have often resorted to anecdotes and dismissals, such as a student telling CBC News that “my grandparents are definitely drinking more than two drinks a week, and they’re fine. Everything causes cancer nowadays.”

The new guidelines are shocking, especially for those of us whose social lives, leisure activities, and coping strategies largely revolve around the many use-values offered by drinking. Public health science can also be exceedingly confusing given esoteric measurements like grams of alcohol or “standard drinks” and the dynamic nature of risk (involving age, gender, socioeconomic status, medical history, genetics, and much more). So it’s understandable that the instinct is often to disregard the science altogether, particularly in the context of the ongoing public health catastrophes of COVID-19 and toxic drug poisonings.

But such an instinct is frankly not how significant public health impacts should be debated and regulated. This is even more true given the reality that the vast majority of alcohol consumed in Canada is produced by massively powerful multinational companies. For instance, Molson Coors and Anheuser-Busch InBev’s Labatt dominate half of the country’s market share for beer, while the beloved class of “craft beer” accounts for less than 10 percent of total volume (and this nebulous category includes heavyweights such as the TSX-listed Big Rock and Molson-owned Creemore Springs). Major profits are on the line for these corporations and the new guidelines pose a direct threat to their continued expansion. Although governments also generate significant revenues from alcohol sales, these returns are outweighed by the social costs of alcohol, including an estimated $4.2 billion in healthcare spending per year. It’s within this context that industry lobby groups have responded in a predictably coordinated fashion with appeals to the strategically ambiguous discourses of “responsible” or “moderate” drinking. 

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A progressive response to the new guidelines cannot include anti-science denialism, even if concern is well-intentioned; like with tobacco and fossil fuels, the industry is banking on the continued blurring of facts and downloading of responsibility for spiking deaths onto individual “problem drinkers.” It’s instead necessary for us to seriously grapple with the material impacts of alcohol in society — acknowledging, for instance, that the substance is indeed carcinogenic and that cancer risk linearly increases with intake — and fighting for policy that is just and equal. 

Like with COVID-19, policy options are not a strict binary between prohibition (“lockdown”) or privatized production and sale for profit (“freedom”). Rather, it’s about implementing public health measures that reduce harm: for COVID-19, it’s policies like a mask mandate, paid sick leave, and proper ventilation, while for alcohol, it’s things like mandatory health disclosures, advertising restrictions, harm reduction-oriented healthcare, and providing free or cheap alternatives to alcohol (such as other psychoactive drugs and high-quality public spaces or amenities). Such structural transformations would properly account for alcohol’s impacts and facilitate the development of lower-risk relations with the much-loved substance.


James Wilt is the author of Drinking Up the Revolution: How to Smash Big Alcohol and Reclaim Working-Class Joy.

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  • says:

    A different view is presented in "The Case for Alcohol’s Health Benefits
    Canada’s new drinking guidelines don’t consider the social benefit. Should they?"
    by Kiffer George Card, an assistant professor in health sciences at Simon Fraser University. His article, which appears in "The Tyee," originally appeared in the "Conversation."

  • says:

    Questioning the way a policy-lobby group (the CCSA) packages its data isn't "science-denialism". Because substance use, particularly alcohol, is so deeply rooted in the human experience and connected to so many social problems, it's understandable that some well-intentioned 'harm reduction' approaches are influenced by moralising agendas that can do anything but reduce harms (in this case, temperance).

    Dr Paradis herself has repeatedly said that the CCSA used the same methodology as their counterparts in other countries, including Australia. Yet in Australia the recommended "low risk" guidelines were 7 drinks per week (10 if you don't account for differences in standard units). The repeat insinuation that more than 2 drinks a week would lead to early death for most or even a significant minority of people comes across as fear-mongering because it's so far outside most people's lived experience and it doesn't seem to be backed up by their own data (or that of other similar abstinence leaning studies, e.g. a 2018 Lancet article).

    If you read the CCSA's report you'll see these increased risk factors without any context. The most widely lampooned example was "3 drinks per week increases the risk of tuberculosis by 100%". TB, in Canada, in the 21st century? Forget the fact that the TB infection rate is 0.0002% in this country and you can't even get TB unless you come into contact with someone who actually has it. You can't just provide statistics like those without context as though it's reliable health information. A poll from Abacus Data showed that 73% of Canadians won't change their drinking in line with the new recommended guidelines and 52% viewed it as 'fear-mongering'. If people start tuning out health advice, yeah I'd call that a harm.

    Alcohol isn't just this input unit that people consume thinking it's healthy. It's an age-old, likely prehistoric, recreational activity attached to culture.