Alcohol isn’t good for us, but is drinking in moderation still OK?

We tend to associate these health risks with heavy drinking but one statistic, which less than 50 per cent of Australians know, is that even at low levels, alcohol is linked with seven different types of cancer: mouth, throat, oesophagus, stomach, liver, breast and bowel. In fact, most alcohol-related harm occurs among low-to-moderate risk drinkers, simply because they are more numerous in the population.

It has all made me wonder how we will view alcohol in another five or 10 years time. Are we likely to look back on drinking the way we do on smoking? Something that was once widespread and socially acceptable (it was even recommended as a “cure” for asthma) that many of us now see as a bit gross?

In the future, will those of us who do enjoy a glass in moderation seem in the wrong? Will it become a shameful act, where we are relegated to sneaking one in the dunny? If that is the case, what does that say about us and our relationship to alcohol?

An appetite for risk

There are certainly parallels between alcohol and smoking, says Professor Simone Pettigrew, program director of Health Promotion and Behaviour Change the George Institute of Global Health.

“Tobacco is a group one carcinogen and so is alcohol,” she says, adding that tobacco is an “evil bastard” causing 19 different cancers.

“It kills one in two regular users. We’re probably not ever going to get to that same mortality statistic with alcohol.”

And as Emmanuel Kuntsche, director of the Centre for Alcohol Policy Research at La Trobe University, points out, unlike alcohol, tobacco is addictive in small doses and causes great harm. “Low quantities of alcohol – one a day – have very small risks.”

Our attitudes to consuming alcohol are, in part, about risk perception and at what point that risk of harm becomes unacceptable.

In Australia, national drinking guidelines, which recommend no more than 10 standard drinks a week or four in one session, were based around a one in 100 risk of an alcohol-related illness if you stick to them.

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“The notion that humans will accept no risk in the activities that they undertake is not realistic,” Giorgi says. “We accept risk in everything we do in our lives from the second we wake up through to the moment we go to sleep, when we cross the road, when we jump in our car, through to more risky behaviours that we might undertake. And that’s why these guidelines are established to say, we understand that as humans, we accept a level of risk.”

As our knowledge grows, the risk we are willing to accept may change along with our relationship with the activity.

A toxic relationship

Today, our relationship with alcohol remains largely toxic. Kuntsche likes to imagine that in 20 years time, we’ll look back at the way, in many situations, we automatically grab a drink or three and think “Oh, how weird was that?”

A small percentage of the population are physically addicted to alcohol, but many are psychologically addicted, Pettigrew adds. “It’s part of a much bigger story about modern living and how we manage our time and our stress. Alcohol is the crutch of choice for many people. We need other ways for people to deal with stress.”

This can be challenging when alcohol companies spend billions on ensuring booze is embedded in the cultural fabric of our lives from celebrations, to funerals, to life’s most benign moments and the industry preys on the most vulnerable people, says Giorgi. “Every phone is a bottle shop and our billboard for alcohol companies, there is no way to escape this.”

She would like us to save our chagrin and judgement for the industry, instead of each other and whether any of us choose to drink or not, and for the government to rein in their influence: “Governments need to prioritise the health and wellbeing of the community ahead of commercial invested interests.”

Giorgi adds that, as individuals, we can all help to support those who choose not to drink by socialising in settings that don’t revolve around alcohol as well as ensuring alcohol-free options are available on occasions like dinners. Abstinence is the only path for some and a path of freedom and good health others.

For those of us who consume in moderation, Kuntsche says there is no need to demonise alcohol or ban it.

We are unlikely to ever look at alcohol in the same way as tobacco, however Pettigrew says the choice to drink ought to be an informed decision, not one where we lie to ourselves and raise a glass to our health. “If people are deluding themselves when they are having that drink, it’s an issue. If they are making that choice, knowing what the risks are, that’s fine. It’s a free world.”

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