title: Different guidelines for different countries? On the scientific basis of low-risk drinking guidelines and their implications.
abstract: The scientific evidence for low-risk drinking guidelines was examined in a narrative review focusing on three points: definition of exposure, the best way to select outcomes and risk relations and how to determine thresholds. With respect to exposure, at least two dimensions should be incorporated: average volume of alcohol consumption and patterns of irregular heavy drinking occasions. Mortality should be selected as the most severe outcome, and a disaggregated approach should be adopted incorporating the regional demographic and cause of death structure. Finally, our plea is for establishing a general threshold for acceptable risk on a societal level rather than ad hoc specific committees setting norms for specific risks. Acceptable thresholds will be different if the risk is to oneself or to others.
authors.affiliation: Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada. jtrehm@aol.com
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.forename: Jayadeep
authors.initials: J
authors.lastname: Patra
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality*; D019973:Alcohol-Related Disorders / Q000517:prevention & control*; D017408:Guidelines as Topic; D006801:Humans; D017063:Outcome Assessment, Health Care; D012306:Risk; D009626:Terminology as Topic