Is drinking alcohol the new smoking?

DURHAM — The season of holiday parties is well underway and most people by now are well aware of the dangers of drinking and driving. But if you’re planning on consuming alcohol, and you won’t be driving, you still might want to think twice before you accept a second or third drink — if you care about your health.

Research has now solidly established alcohol as a known carcinogen, linked to more than 70 chronic conditions and a contributing factor in cancer of the breast, mouth, liver, larynx, colon and more.

“Three drinks or more is the new smoking,” says Dr. Jurgen Rehm, a senior scientist at the Toronto-based Centre for Addiction and Mental Health. “Never have more than two drinks at any one sitting.”

Dr. Rehm is currently working in collaboration with the World Health Organization to develop a “global alcohol strategy” in 2010, that will encourage all countries to monitor alcohol and its related harm, with an eye to reducing its negative impacts. “It’s a very important step,” he says.

While alcohol as a known carcinogen is not news to the medical or scientific communities, Dr. Rehm acknowledges public awareness on the matter is still “relatively low”, despite more media attention during the past several years. A 2007 media report authored by Dr. Rehm and colleague Dr. Norman Giesbrecht noted the risk of breast cancer is “significantly increased” with regular consumption of just 18 grams of alcohol daily, slightly more than the standard serving of a bottle of beer, one glass of wine or shot of liquor.

Dr. Giesbrecht puts it in perspective: “Public awareness with alcohol is where the public was with smoking 30 or 40 years ago.” He is currently engaged in alcohol research looking at how community-based initiatives can be effective.

The long-term trend will see alcohol consumption come down, Dr. Rehm predicts; he says a WHO report has found alcohol consumption globally has more negative effect on society than smoking.

It might be difficult for some to wrap their heads around the health risks of a legal drug sold by the government. Alcoholic beverages are ingrained in our society, and the two scientists are quick to point out they’re not suggesting prohibition as a solution. Most adults in Ontario, an estimated 78 to 80 per cent, drink alcohol.

It is the most prevalent drug being abused, according to the Pinewood Centre in Durham Region, where 1,800 adults and 350 youths pass through the doors of the treatment centre’s community offices annually in Ajax, Oshawa, Port Perry and Bowmanville.

But most Ontario drinkers are not in alcoholic territory; Paul McGary, director of Pinewood, says the treatment industry uses a standard formula that suggests at any given time, 10 per cent of a population has an active substance abuse issue. Of that 10 per cent, only a fraction — another 10 per cent — will seek help. In Durham Region, that translates into a rough estimate of 25,000 adults with substance abuse issues, with alcohol being the drug of choice for the majority.

But even people who allow themselves three or four drinks at any given time are harming themselves, even though they would not consider themselves alcoholic, says Dr. Rehm.

“More than three drinks a day is a problem,” he says. “Individuals are more lenient with themselves. The limits get pushed and pushed.”

The notion of a glass of red wine being beneficial to the heart is not a one-size-fits-all fact, he says. An individual’s risk factors for heart disease and breast cancer must be taken into account. Someone with a family history of heart disease and no history of breast cancer might do well with a glass; someone with a genetic risk of breast cancer might want to think twice.

“We cannot make it less complicated,” notes Dr. Rehm. “It depends on your personal risk profile.”

He says “not many Canadians” actually keep their consumption level to one glass a day.

“You’re both helping your heart and increasing the risk of breast cancer.”

Binge drinking, defined as five drinks or more in a sitting, is definitely something the scientist advises should “never” be done. Binge drinking even once a month has a detrimental effect on heart health.

“We can advise everybody to stay away from three or four drinks,” says Dr. Rehm, adding one drink is in the “grey zone. We never advise anybody who’s abstaining to start drinking for health reasons. It makes no sense.”

November 24, 2009
By Judi Bobbitt

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