A fresh bout of media attention on the revised alcohol guidelines hit the headlines last week as survey figures released by CAMRA suggest much of the public 'disagree with official health guidelines on alcohol consumption'.
This may not be news to many in the field who know of the public's sensitivity to what many perceive as 'lecturing', or the tendency of those drinking above the guidelines to disagree based on 'normative misperception' or other reasons.
The specific survey questions do not appear to have been reported, but the CAMRA commissioned YouGov poll said '51 per cent disagreed with the Chief Medical Officers' decision that alcohol guidelines should be the same for men and women'.
Sixty-one per cent though 'agreed that moderate alcohol consumption could be part of a healthy lifestyle', though this does not necessarily contradict the guidelines. Whilst there may be 'no safe level' owing to a very small level of cancer risk starting at any level of drinking, few would argue that moderate alcohol consumption isn't compatible with a generally 'healthy lifestyle'.
CAMRA's claims that 'moderate drinking can have a protective effect against various health problems including cardiovascular disease, cognitive decline and certain forms of cancer' however will not find much agreement from health groups; earlier this year a large review concluded there were no health benefits from moderate drinking.
Risk - reward?
Indeed the revised guidelines stirred up a renewed discussion within the public health field about the actual level, their purpose and how they should be communicated. The CMO herself acknowledged that the guidelines alone 'may not reduce consumption directly', but there are obvious reasons why an official health guideline should exist for a widely consumed but potentially harmful drug.
The debate though has revolved around 'communication of risk', and how and whether a very small level of cancer risk at 'moderate' levels should be relayed to a majority of drinkers who are unlikely to experience any ill health effects.
On his alcohol epidemiology blog, John Holmes highlighted a number of issues with the 'no safe level message'; for one it 'fails to distinguish between the presence of risk and the scale of risk', as well as the fact that it is essentially interpreted as an abstinence message. Holmes however cautions against any association with moderate drinking and health benefits, even if it were to be proven; 'people need little encouragement to drink and abstainers have a wide range of alternative options available for improving their cardiovascular health.'
Where next?
The latests media attention adds weight to one of our expert reactions to the guidelines earlier this year; Chris Hackley, a Professor of Marketing, argued that the guidelines had become a 'dramatic media performance of policy, rather than an actual policy', distracting attention from other issues of greater importance to the field. Indeed a pub group commissioned survey telling us unsurprising public opinions may not warrant much attention, but it may remind health advocates of the need to tread carefully in promoting 'safer' drinking messages.
CAMRA also called for the Department of Health to 'launch a new public consultation into whether alcohol guidelines are fit for purpose and evidence based'. However an official consultation on the guidelines and how they should be communicated followed, the results of which are yet to be released.
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