Clear criteria based on absolute risk: Reforming the basis of guidelines on low-risk drinking
Article first published online: 14 DEC 2011
© 2011 Australasian Professional Society on Alcohol and other Drugs
Drug and Alcohol Review
Special Issue: Low Risk Drinking Guidelines. Guest Editors: Tim Stockwell and Robin Room
Volume 31, Issue 2, pages 135–140, March 2012
How to Cite
ROOM, R. and REHM, J. (2012), Clear criteria based on absolute risk: Reforming the basis of guidelines on low-risk drinking. Drug and Alcohol Review, 31: 135–140. doi: 10.1111/j.1465-3362.2011.00398.x
- Issue published online: 5 MAR 2012
- Article first published online: 14 DEC 2011
- Received 25 July 2011; accepted for publication 24 October 2011.
- low-risk drinking guideline;
- alcohol guideline;
- risk of drinking;
- absolute versus relative risk;
- gender and drinking risk
Issues.The paper discusses the approach behind the Australian Guidelines to Reduce Health Risks from Drinking of 2009. The Guidelines involved a new approach to the central conundrum of low-risk drinking guidelines: how to set a guideline threshold on smooth risk curves.
Approach.The context of the 2009 Guidelines is discussed in terms of previous Australian guidelines and of risk analyses and threshold setting for other risks to health and well-being, such as environmental and food toxins. The Guidelines were accordingly based on new lifetime risk modelling of absolute risk, with specification of the risk attached to the guideline thresholds of 1 in 100 lifetime mortality risk. The Guidelines thus specify no more than two Australian standard drinks a day, and no more than four drinks on any occasion.
Implications and Conclusions.The approach described brings alcohol guidelines within a general analytical frame of guidelines and standards for hazards to health. At the level of 1 in 100 lifetime risk, there is little justification for different guidelines for men and women. On grounds of differential risk, separate guidelines for young adults might be considered, but could not be based on lifetime risk.[Room R, Rehm J. Clear criteria based on absolute risk: Reforming the basis of guidelines on low-risk drinking. Drug Alcohol Rev 2012;31:135–140]