What is a healthy relationship with alcohol?

That was a question I was asked to respond at the 8th European Alcohol Policy Conference that took place in Edinburgh, Scotland last month. As an abstainer, I have a straightforward answer to that, and I did mention it in my presentation as well. The healthiest would be to stay clear from alcohol, and I think that should also be a key position and premise of any society that thrives on having a healthy environment for its citizens. So that people would be free of any pressure to use addictive substances. As it was echoed at the conference as well, in our societies people too often have to explain why they don´t drink while drinking and sometimes even in excess is considered normal. In that kind of context, it is difficult to speak about a healthy relationship with alcohol.

I have noticed in my own country that even public health experts, in their interviews, seemed to have a pressure to point out that they see a need for stronger alcohol policies for instance, „but they are not personally abstainers.“ As that would be too radical or somehow discredit them in the eyes of the society.

So, as one fundamental prerequisite for having a healthy relationship with alcohol, would be a state where someone´s abstinence from alcohol would be normal, not worthy of any special attention or discussion. See as something obvious.

In addition to everyone’s freedom to live an alcohol-free life, there should also be a state level recommendation, based on medical and evidence-based position, to avoid alcohol to prevent many problems and health issues.

Over one hundred years the message „better to avoid alcohol“ has come from the temperance movement and as such it has been viewed as too radical and ignored by many. But in modern days we are witnessing a serious change. The sources of that same message are now scientists and cancer researchers. The message is strong and clear. From the point of cancer risk, it is better to avoid alcohol. There is no riskfree amount when it comes to cancer. That message was emphasized by the World Cancer Research Fund in a report published earlier this year. „For cancer prevention, it´s best not to drink alcohol.“ The same recommendation is in the European Code Against Cancer.

A systematic analysis of alcohol use and burden for the Global Burden of Disease Study 2016, published on August in The Lancet concluded in following: „Our results show that the safest level of drinking is none.“

Let me repeat, this is not a moralistic or ethical position, as the message of temperance movement is labelled too many times. This is a conclusion that scientists have come to, based on their work and evidence.

Coming back to the initial question, I would add three more preconditions that would make the concept of a healthy relationship with alcohol a possibility.

First, if a person would be aware of all the risks associated with alcohol use. Evidently, it is everyone’s choice if they consume alcohol or not. But we cannot talk about a healthy relationship with it if people are unaware of the different risks that substance has. Alcohol consumption is a causal factor in more than 200 disease and injury conditions, including seven forms of cancer. At the same time according to a recent survey in the UK, only one in 10 people know that alcohol causes cancer. That can not be acceptable. Also in the UK, a study was published at the end of November according to which „79% of mothers had drunk any alcohol at all when they were pregnant.“ This data confirms again that public awareness of alcohol´s teratogenic effect is minimal. These are only a couple of important examples. When people are unaware of alcohol-related risks, we cannot speak about a healthy relationship with that substance.

As a second precondition, I would stress that people shouldn´t start consuming alcohol as teenagers pressured by their peers, alcohol marketing, pop-culture or even their parents. If alcohol is invading into teenagers, still developing body and life, it is a violent and a criminal invasion. Also based on our legislation. Any health risk that alcohol causes, it multiplies when we speak of children. When a relationship with alcohol starts like that, we cannot talk about a healthy relationship with it.

And as a third precondition, I would stress a need for a myth-free relationship with alcohol. In other words, an honest relationship which doesn´t deny any existing problems or doesn´t imagine a positive effect that doesn´t exist.

December is one of the months when people tend to increase their drinking. Christmas holiday, a vacation from work means celebrations that are filled with more alcohol. It could be a time of reflections as well. Hopefully, our countrymen consider their drinking habits and take an honest look at the health of that relationship.

Lauri Beekmann
Executive director, NordAN