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Different guidelines for different countries? On the scientific basis of low-risk drinking guidelines and their implications

Authors

  • JÜRGEN REHM,

    Corresponding author
    1. Centre for Addiction and Mental Health (CAMH), Toronto, Canada
    2. Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Canada
    3. Department of Psychiatry, University of Toronto, Toronto, Canada
    4. Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
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  • JAYADEEP PATRA

    1. Centre for Addiction and Mental Health (CAMH), Toronto, Canada
    2. Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Canada
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Jürgen Rehm PhD, Professor, Jayadeep Patra PhD, Scientist. Dr Jürgen Rehm, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1. Tel: +1 416 535 8501 ext. 6173; Fax: +1 416 260 4156; E-mail: jtrehm@aol.com

Abstract

The scientific evidence for low-risk drinking guidelines was examined in a narrative review focusing on three points: definition of exposure, the best way to select outcomes and risk relations and how to determine thresholds. With respect to exposure, at least two dimensions should be incorporated: average volume of alcohol consumption and patterns of irregular heavy drinking occasions. Mortality should be selected as the most severe outcome, and a disaggregated approach should be adopted incorporating the regional demographic and cause of death structure. Finally, our plea is for establishing a general threshold for acceptable risk on a societal level rather than ad hoc specific committees setting norms for specific risks. Acceptable thresholds will be different if the risk is to oneself or to others.[Rehm J, Patra J. Different guidelines for different countries? On the scientific basis of low-risk drinking guidelines and their implications. Drug Alcohol Rev 2012;31:156–161]

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