This table applies equally to men and women.
The data in their Hazard Ratio vs All cause Mortality the curve is essentially flat up to about 12.5 units which implies that alcohol has minimal effect up to that level. Between 12.5 and 25 Units per week the graph shows an upward trend that equates to about 0.5 Years Lost to Life at 25 units per week. The Years Lost to Life then increase rapidly as consumption rises beyond 25 units a week.
Although this paper cannot be directly correlated to the downward change in UK alcohol limits to a maximum of 14 units per week, the two seem to be saying the same thing : keep to less than 12.5 to 14 units and the risk is low, but be aware that the risk rises rapidly for consumption beyond about 12.5 -14 units per week. Note that they defined drinking more than 100g/12.5 Units of alcohol in one session as “binge drinking” for the purpose of this study, whereas I have seen other sources define “binge drinking” as low as 6 Units in one session. The latter definition essentially classifies 3 small glasses of wine as binge drinking in which case I need to confess to many offences!
A few months later, on 24th August 2018, another large study was published in the Lancet which also confirmed that there was no safe limit for alcohol. That gave rise to the following BBC article :
“No alcohol safe to drink, global study confirms”
This was a huge study covering 195 countries and looked at a wide range of health “outcomes” arising from alcohol consumption, not just mortality rates. Although I don’t think that this paper states anything more serious than the previous paper, the reporting headlines appeared a little more sensational.
It was stated that in a population of 100,000 non-drinkers it would be expected that 914 would develop an alcohol “type” of problem such as cancer or suffer an injury, such as falling over, so the background risk rate of such health outcomes in non-drinkers is 0.914%. If the 100,000 non drinkers consumed 1 “standard drink” per day (1 “standard drink” = 10g pure alcohol = 1.25 Units) then an additional four people would be affected. Really? That means that a consumption of 8.75 Units per week would result in only 4 more people in 100,000 suffering one of these alcohol “type” outcomes. That represents a change in risk from 0.914% to 0.918% which, although not zero, is nevertheless insignificant compared with the background risks of just being alive experienced by drinkers and non drinkers alike! So that while the headline that there is no safe lower limit is absolutely true, it is also very misleading because the increased risk at 1 standard drink per day is insignificant.
If 100,000 non drinkers consumed 2 standard drinks per day (17.5 Units per week) then there would be an additional 63 people affected by the defined health outcomes, so the risk factor would increase from 914 in 100,000 for non drinkers to 977 in 100,000 for those drinkers consuming 17.5 units per week, which in absolute terms is only an increase of risk from 0.914% to 0.977%. Although 63 people is a significant number of people it is still 15 times smaller than the number of non drinkers who would still be affected by background risk factors. Basically the background factors still appear to dwarf the affects of alcohol at 17.5 units per week.
Because this study does not use exactly the same methodology or data sets as the earlier one in April, it is not possible to do an accurate like for like comparison, but it seems to me that both studies show similar findings. They show that while there here is no zero risk threshold for alcohol consumption, the risks at the UK’s limit of 14 Units per week seems to be pretty small compared to the background risks of cardiovascular disease and cancers that we are also exposed to through genetics, environment, diet, and exercise (or lack off).
I started reading this article with a sense of dread that alcohol would have to go but when I looked at the numbers presented they just did not add up to the scary headlines. Once again the BBC obtained a quote from Prof David Spiegelhalter, Winton Professor for the Public Understanding of Risk at the University of Cambridge, to try to quantify the risks in terms of everyday reality, and I have to say that I concur with the professor : "Given the pleasure presumably associated with moderate drinking, claiming there is no 'safe' level does not seem an argument for abstention. There is no safe level of driving, but the government does not recommend that people avoid driving. Come to think of it, there is no safe level of living, but nobody would recommend abstention."
Professor Spiegelhalter’s role is to help communicate the idea of risk to the public in simple terms. He came up with the concept of a unit of risk called a Microlife which represents a reduction in life of 30 minutes. For example, smoking two cigarettes represents a risk of 1 Microlife for a 30 year old man. Put another way, smoking two years will likely reduce the life of a 30 year old man by 30 minutes. That certainly focuses the mind much more than quoting a % hazard ratio. Professor Spiegelhalter has a great blog which explores the subject of risk and microlives :