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Alcohol drinking guidelines – how much is too much?

Wednesday 28 February, 2018

New research shows need for drinking guideline mass education

New research has found that alcohol harm reduction advertisements that provide education about low-risk drinking guidelines could be a key strategy to helping people reduce their alcohol consumption.

The research led by Cancer Council Victoria found that adding the National Health and Medical Research Council (NHMRC) drinking guidelines to advertisements that highlight the risks of drinking alcohol can improve their effectiveness, increasing knowledge of low-risk drinking levels and intention to reduce consumption over the next week.

Yet, according to Cancer Council Victoria CEO Todd Harper, these guidelines are not well known by the public and rarely advertised, presenting an opportunity for greater education about the risks associated with alcohol consumption.

“People deserve to know how much alcohol they can drink while keeping their risk of health impacts, like cancer, low, so they can make informed choices about their drinking,” Mr Harper said.

“While guidelines for low risk drinking exist in Australia, community knowledge of the guidelines is poor; too many Australians are either unaware of the recommendations, or they overestimate the amount of alcohol that’s safe to consume without significantly increasing risk of long or short term harm.”

The 2016 National Drug Strategy Household Survey found that 32 per cent of males and nine per cent of females thought they could drink three or more drinks every day without putting their health at risk [i] , when in reality the guidelines state that more than two standard drinks a day can increase the risk of cancer and other long-term health problems.

“As a result, people are unknowingly drinking at levels which can damage their health, and increasing their risk of eight types of cancer,” Mr Harper said.  

“The community’s low awareness of the harm alcohol can cause is incredibly worrying when we know it’s a leading contributor to Australia’s burden of disease. Alcohol causes more than 3200 cases of cancer every year, including cancers of the breast, bowel, mouth, throat and liver [ii]

“Currently 17 per cent of people drink at levels that put themselves at risk of long-term harm over their lifetime [iii].”

The new research, published in Addiction today, tested if an individual’s knowledge and drinking intentions could be improved by communicating the NHMRC low risk drinking guidelines.

The guidelines, which are currently under review by NHMRC, state that people should drink no more than two standard drinks a day and never more than four standard drinks on a single occasion to reduce their risk of injury and long-term health problems.

As part of the experimental study, the guidelines were added to a sample of alcohol harm reduction television advertisements (figure 1) made by government and public health agencies.  

The researchers compared ads with and without the guidelines.

Lead researcher Professor Melanie Wakefield said they found that while the ads without the guidelines made an impact, long-term harm ads with the guidelines were even more effective.

“Drinkers who viewed a long-term harm advertisement that also showed the drinking guidelines were significantly more likely to provide a correct estimate of drinking levels associated with long-term harm, compared to the participants who viewed the other advertisements,” Professor Wakefield said.  

Cancer Council Victoria has called on the Federal Government to invest in an alcohol public education campaign to better publicise the long term harms of drinking and low-risk drinking guidelines as part of the National Alcohol Strategy 2018-2026 public consultation.

Mr Harper said that the new research provided more weight as to how an investment in alcohol harm reduction mass media campaigns can help the community.

“These findings show there is value in investing in alcohol harm reduction mass media campaigns that explain how alcohol can harm your health, and include education about how much is considered low-risk, allowing people to make informed, healthy choices,” he said.

The draft National Alcohol Strategy, overseen by the Ministerial Drug and Alcohol Forum, recognised public health campaigns promoting the risks and harms associated with alcohol consumption as an opportunity to reduce harm.

Online submissions closed earlier this month and are now being considered. 

Alcohol drinking guidelines – how much is too much?

Figure 1: Example end-frame edited onto the end of the television advertisements. The end frame was accompanied by the voiceover, “If you choose to drink, health experts recommend no more than two standard drinks on any day to reduce your risk of developing serious diseases.” 

About the research

  • The research involved 3718 Australian drinkers aged 18–64 years.
  • Participants were exposed to four ads. Afterwards, they estimated what they thought low-risk drinking levels were, and indicated their intentions to avoid or reduce alcohol consumption in the next week.
  • Those who viewed the short and long term harm advertisements with the low-risk drinking guidelines were more likely to correctly estimate the level of low risk drinking specified by the guidelines, than those who viewed ads without the guidelines.
  • Those who viewed both the long and short term harm advertisements (with and without the guidelines) reported a higher intention to avoid or reduce their alcohol consumption in the next week.
  • The ads featuring the long-term guideline prompted an even greater intention to drink less.
  • The research was conducted by the Centre for Behavioural Research in Cancer, Cancer Council Victoria and was funded by an NHMRC project grant.

[i] Australian Institute of Health and Welfare 2017. National Drug Strategy Household Survey 2016: detailed findings. Drug Statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW.

[ii] “Cancers in Australia in 2010 attributable to the consumption of alcohol,” Aust N Z J Public Health 2015.  Available from

[iii] idib