Researchers consider how to 'denormalize' drinking culture ahead of new alcohol guide

A person walks past shelves of bottles of alcohol on display at an LCBO in Ottawa, Thursday March 19, 2020. THE CANADIAN PRESS/Adrian Wyld

Lee-Anne Richardson is celebrating the three-year anniversary of a support group she founded for people who've decided to ditch alcohol or cut back as part of what she considers a movement toward healthier living, especially by younger generations.

Richardson, 38, said she spent much of her 20s binge-drinking. She blames alcohol for destroying many of her relationships and says her self-esteem plummeted as she tried to control how much she consumed.

The turning point came after another night out with friends at a bar in March 2014 when Richardson realized she either had to quit drinking or "something very, very bad is going to happen."

After attending Alcoholics Anonymous meetings, Richardson realized she needed to replace the social connections she'd made during her "drinking career" with more positive ones while also supporting others through their own journey to sobriety or less alcohol.

In January 2020, she launched a group called Sober City and soon heard from people who were drinking more in isolation during pandemic lockdowns due to boredom and/or anxiety.

Richardson was surprised to learn how much alcohol is considered a "low risk" based on Canada's current low-risk drinking guidelines -- up to two drinks a day, or 10 a week for women and three daily drinks, or 15 per week, for men.

"That's a fair amount. This is a poison that we're talking about," she said of the links to heart disease and cancer associated with alcohol.

The guidelines, set in 2011, are expected to be updated next week by the Canadian Centre on Substance Use and Addiction. Proposed changes released last summer suggest Canada's recommendations will dramatically decrease.

In its proposal, the centre said research suggests health-related risk from alcohol is negligible to low when consuming two drinks per week; moderate for three-to-six drinks per week; and increasingly high beyond that.

Overall, it recommends no more than two drinks a week.

The update is expected Tuesday after two years of research, a review of nearly 6,000 peer-reviewed studies and about 1,000 survey submissions from the public. Part of the project was funded by Health Canada.

The research includes the impact of alcohol in areas such as women's health and the association between alcohol use, aggression and violence, the CCSA said. It's aiming to launch an online advertising campaign by February to raise awareness.

Richardson believes a potential dramatic shift in the guideline is in line with what she's heard from people in their 20s and 30s about the importance of their mental health and that excessive drinking is "not really that cool."

"They know that drinking makes mental health and anxiety worse. They're seeing it," said Richardson, a data analyst for a shipbuilding company.

However, Catherine Paradis, interim co-chair of the CCSA's updated guidance project, said the recommendation for Canadians to consider reducing their alcohol intake is "not an easy ask" for those who enjoy drinking regularly, so policy changes will need to be made to highlight the risks.

"A particularly effective one could be the mandatory labelling of all alcoholic beverages with the number of standard drinks, Canada's guidance on alcohol, and health warnings," Paradis said, adding that would involve the federal and/or provincial governments.

"People will need support from governments. We will need to shape our whole drinking environment differently so there will need to be policies that promote public health," she said.

Alcohol is known to affect various organs, putting people at increased risk for cirrhosis, pancreatitis, gastrointestinal bleeding, multiple cancers as well as injury from falls and motor vehicle crashes.

Erin Hobin, a senior scientist at Ontario Public Health and a member of the scientific advisory committee responsible for reviewing the evidence on the updated guidance, said there is relatively low public awareness about the health impacts of alcohol other than increased risk of birth defects for those who drink during pregnancy.

Hobin was a lead investigator on a 2020 study published in the Journal of Studies on Alcohol and Drugs. It suggested 24.5 per cent of 836 liquor store patrons surveyed at three liquor stores in Yukon and Northwest Territories in 2017 were aware of alcohol-related cancer risks. The study was led by the Canadian Institute for Substance Use Research at the University of Victoria.

The idea behind the updated guidance is to provide Canadians with the latest evidence-based information about the health risks involved, Hobin said.

"Alcohol is present at weddings and anniversaries and birthday parties; on Friday night to relax after a long week of work. So how do we start to shift the Canadian culture around alcohol to denormalize alcohol? Perhaps (warning) labels may play a role in starting this," she said.

Hobin was also an investigator in a federally funded study launched in the fall of 2017 that had researchers placing three types of rotating warning labels on wine, spirits, beer and two-litre bottles of coolers at a government liquor store in Whitehorse, with a comparison site in Yellowknife.

One of the labels, which featured a bright yellow background and a red border, warned that alcohol can cause cancer, including of the breast and colon; another listed Canada's low-risk recommended guidelines for men and women; and a third included information on standard drinks.

However, the Yukon Liquor Corp. paused the study four weeks into the eight-month label phase of the research. The minister responsible for the liquor corporation cited concerns over defamation and whether Yukon had the authority to affix the warnings.

The study was continued between March and July 2018, on the condition that the label about health risks not be used, Hobin said, adding the labels in Yukon's largest liquor store prompted some people to cut back on their drinking.

The findings were published as part of the same 2020 study on public awareness about the health risks of alcohol. They suggest per capita sales of labelled products dropped by 6.6 per cent compared with products at the control site where alcohol was not labelled.

"The importance of enhanced alcohol labels is now recognized by the World Health Organization and it positions labels as a key first step in a comprehensive alcohol strategy," Hobin said.

This report by The Canadian Press was first published Jan. 12, 2023.

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