Report
Canada’s Guidance on Alcohol and Health: Final Report
Publication date:
2023
CCSA proudly led the initiative to update Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs). The project, funded by Health Canada, began in July 2020. The two-and-a-half-year process culminated in the creation of Canada’s Guidance on Alcohol and Health, which replaces the LRDGs.
Canada’s Guidance on Alcohol and Health provides people living in Canada with the information they need to make well-informed and responsible decisions about their alcohol consumption.
Use the tabs below to find further details on Canada’s Guidance on Alcohol and Health, the process taken to create the guidance, and supporting documents used in its development. If you have specific questions about this project, please contact the project coordinator at llevett@ccsa.ca.
Secondary Body
Canada’s Guidance on Alcohol and Health
Canada’s Guidance on Alcohol and Health
Canada’s Guidance on Alcohol and Health provides evidence-based advice on alcohol to support people in making informed decisions about their health. The guidance is based on the latest research on alcohol-related risks and replaces Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs) issued in 2011.
The guidance is based on the principle of autonomy in harm reduction and the fundamental idea behind it that people living in Canada have a right to know that all alcohol use comes with risk.
Key points from the guidance include:
- There is a continuum of risk associated with weekly alcohol use where the risk of harm is:
- 0 drinks per week — Not drinking has benefits, such as better health, and better sleep.
- 2 standard drinks or less per week — You are likely to avoid alcohol-related consequences for yourself or others at this level.
- 3–6 standard drinks per week — Your risk of developing several types of cancer, including breast and colon cancer, increases at this level.
- 7 standard drinks or more per week — Your risk of heart disease or stroke increases significantly at this level.
- Each additional standard drink radically increases the risk of alcohol-related consequences.
- Consuming more than 2 standard drinks per occasion is associated with an increased risk of harms to self and others, including injuries and violence.
- When pregnant or trying to get pregnant, there is no known safe amount of alcohol use.
- When breastfeeding, not drinking alcohol is safest.
- No matter where you are on the continuum, for your health, less alcohol is better.
CCSA is creating knowledge mobilization products that will be tailored to meet the needs of our audience. Please check back with us in the coming months as we release these new resources.
Infographic
Canada’s Guidance on Alcohol and Health, Public Summary: Drinking Less Is Better (Infographic)
Publication date:
2023
Project Background
Canada’s Guidance on Alcohol and Health replaces Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs). Since the release of the LRDGs in 2011, new evidence has been uncovered on alcohol-related mortality and morbidity. Research has also evolved on how drinking alcohol contributes to social harms. Other countries, including Australia, Denmark, France, the Netherlands, the United Kingdom and the United States, recently updated their guidelines to reduce the health risks of alcohol consumption.
Canada’s Guidance on Alcohol and Health is the result of a collaborative process among CCSA, health and social scientists, knowledge mobilization specialists and representatives of various Canadian organizations, including Health Canada. The process has been consensual and based on co-operation. All parties participated with equal status and the expression of each parties’ points of views were encouraged.
Process Followed to Develop the Guidance on Alcohol and Health
In July 2020 with funding from Health Canada, CCSA began the project to update the LRDGs. The chart on Process and Documentation outlines the process that resulted in Canada’s Guidance on Alcohol and Health. Click the links in the chart to access the supporting documents produced as part of the process.
Public and Stakeholder Consultations
People in Canada should have access to the latest evidence-based advice on alcohol to support them in making informed decisions about its use. They should also have opportunities to have their voices heard and to share what matters to them when it comes to their health, well-being and alcohol consumption. Consulting throughout the guidance development process with the public, professionals and organizations concerned with alcohol, health and well-being was key to ensuring that Canada’s Guidance on Alcohol and Health meets the diverse needs of people and organizations in Canada and is accessible to all.
Public Consultation on the 2011 Low-Risk Alcohol Drinking Guidelines
CCSA held an online public consultation on the 2011 LRDGs between March 8 and April 18, 2021. This consultation was to understand the experiences of people in Canada with the LRDGs and their needs and expectations for updated guidelines. It was open to all people in Canada, including the general public, professionals and representatives from organizations with an interest in alcohol, health and well-being. A total of 4,846 people from every province and territory across Canada completed the online consultation questionnaire. The report, Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Summary of Findings from Public Consultation, outlines how the consultation was conducted and what we heard.
Consultations with Representatives of Health Organizations
CCSA held virtual focus groups with counsellors and treatment providers, people with lived or living experience of substance use and representatives from public health organizations, professional associations, mental health and addictions organizations, and organizations that treat chronic disease. The goal was to obtain their perspective on the familiarity and understanding of people living in Canada with the LRDGs and related issues. The focus groups also discussed messaging and communication strategies that could increase awareness of the LRDGs among target groups such as youth and women.
A total of 48 representatives participated in the focus groups. The results informed discussions about how to present the conclusions of the LRDG update. They are included in the report, Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Summary of Stakeholder Focus Groups.
Public Consultation on Guidance on Alcohol and Health
The report, Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Final Report for Public Consultation, includes the public summary, the technical summary and the technical report for the new Guidance on Alcohol and Health. It describes how the development of the guidance used a public-health perspective to provide the latest evidence-based advice on alcohol to support informed decisions about its consumption. The report was released for consultation between Aug. 29 and Sept. 23, 2022, to ensure the readability, clarity and validity of the final products. CCSA sought comments from people in Canada on all aspects of the final report through an online survey. We received almost a thousand submissions, which have been reflected in the final products for Canada’s Guidance on Alcohol and Health.
Frequently Asked Questions
Why was Canada’s Guidance on Alcohol and Health created?
The guidance replaces Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs). Both were developed to ensure that people have the information they need to make informed choices about their health and alcohol consumption.
Canada’s LRDGs were originally published by CCSA in 2011. Those guidelines were based on the best evidence available at that time. The new recommendations reflect the substantial advances in research and understanding of alcohol and health over the past decade.
How is the new guidance different from the 2011 LRDGs?
In 2011, people were provided with numerical limits for weekly and daily amounts of alcohol use. In comparison, the 2023 guidance recommends people consider reducing their alcohol use. To help them make an informed decision about possible alcohol use reduction, the 2023 guidance presents a continuum of risk according to which:
- 1–2 drinks a week represents a low risk of harms,
- 3–6 drinks a week represents a moderate risk of harms and
- 7 or more drinks a week represents an increasingly high risk of harms.
The guidance also recommends that if you drink more than 2 drinks a week, make sure you don’t exceed 2 drinks on any day.
The 2023 guidance recommends that people consider reducing their alcohol use because overwhelming evidence confirms that when it comes to drinking alcohol, less is better.
Is CCSA recommending that people limit their alcohol use to 2 drinks a week?
No. The guidance recommends that people consider reducing their alcohol use. The reason why some people may want to reduce alcohol use is that according to recent evidence:
- 1–2 drinks a week represents a low risk of harms,
- 3–6 drinks a week represents a moderate risk of harms and
- 7 or more drinks a week represents an increasingly high risk of harms.
Why no more than 2 drinks on any day?
Many consequences from alcohol, such as injuries and violence, begin to increase with any alcohol use. Consuming more than 2 standard drinks per occasion is associated with an increase in harms. That’s why, regardless of the number of drinks you have during a week, if you drink, make sure you don’t exceed 2 drinks on any occasion. It will reduce your risk of several harms to yourself and others.
Is CCSA recommending that people not drink alcohol?
No. The guidance recommends that people consider reducing their alcohol use. The guidance provides people with the information they need to make their own choices about their health. People are going to have different comfort levels with different levels of risk.
Why are recommendations now the same for females and males?
Our analyses show that at low and moderate levels of alcohol use, both sexes experience harms. The type of harm they experience is different, but both females and males experience harm.
However, studies clearly show that at a higher level of alcohol use, the health risks increase more steeply for females.
CCSA understands that not everyone identifies as female or male. Further research is needed to understand and describe the risks and health effects in a broader gender context. CCSA will continue to bring the public the most up-to-date understanding.
Can males drink more than females?
Physiologically, males may require more alcohol than females to experience intoxication and associated harms. However, from a gender perspective, studies show that men are more likely than women to take other risks. When combined with alcohol, men further increase their likelihood of experiencing and causing alcohol-related harms.
Overall, far more injuries, violence and deaths result from men’s drinking.
Therefore, the guidance has the same risk continuum for everyone.
Do some studies show that alcohol is good for you?
The evidence no longer supports the idea that alcohol is good for your health. The fact that there is no healthy amount of alcohol use is supported by the World Health Organization and the World Heart Federation.
What steps can I take to reduce my drinking?
- Count your standard drinks.
- Set a weekly drinking limit and stick with it.
- If you’re going to drink, make sure you don’t exceed 2 drinks on any day.
- Drink slowly.
- Drink lots of water.
- For every drink of alcohol, have one non-alcoholic drink.
- Choose alcohol-free or low-alcohol beverages.
- Eat before and while you’re drinking.
- Have alcohol-free weeks or do alcohol-free activities.
What if someone drinks more than a moderate amount? What does the guidance recommend?
Any reduction in alcohol use is beneficial. This applies even for those who are unable or unwilling to reduce their risk to low or moderate levels. In fact, those consuming high levels of alcohol have even more to gain by reducing their consumption by as much as they are able.
Even small changes at any age can have a positive effect.
If you’re planning to reduce your alcohol use but are having difficulty reducing how much you drink, contact your physician or healthcare provider. Help is available.
Does the type of alcohol I drink matter?
It is the alcohol in the drink that causes harm, not the specific type of drink. Any beverage that contains alcohol — beer, wine, cider, spirits — carries the risk of harms.
However, the amount of alcohol (the number of standard drinks) in any beverage can vary widely, depending on the particular beer, wine, cider or spirits.
Understanding how many standard drinks you’re drinking will help you to make informed decisions about the level of risk you’re comfortable with, no matter what type of alcohol you may drink. You can calculate alcohol for different drinks using a standard drink calculator.
What should I do if I’m worried that someone is drinking at a high-risk level?
Canada’s Guidance on Alcohol and Health is an opportunity to have conversations about drinking. Feel free to share our website and empower people you care about to make decisions that make sense for them. It’s important not to shame or stigmatize people. We know this doesn’t produce positive change. Rather, find out what aspects of their health are most important to them and offer support, encouragement and compassion to help them achieve the goals they set.
I want to do something with my organization or community around this guidance and work to make these recommendations more relevant and impactful.
Contact us! CCSA is always looking for community, government and business partners to raise awareness of the guidance. You can find more information on the CCSA alcohol web pages.
Supporting Documents
Supporting Documents
| Document name | Date published | Description |
|---|---|---|
| Canada’s Guidance on Alcohol and Health: Final Report | 2023 | Summarizes the evidence drawn from worldwide evidence reviews, mathematical modelling, and extensive consultations and discussions. The Guidance provides people in Canada with accurate and current information about the risk of harms associated with the consumption of alcohol. Results will also provide the evidence base for future alcohol policy and alcohol use disorder prevention resources. |
| Lifetime Risk of Alcohol-Attributable Death and Disability | 2023 | Examines the lifetime risk of death and disability for various levels of alcohol consumption. The report also examines separate alcohol guidelines for males and females, and offers recommendations for alcohol consumption as measured in grams per day. |
| Canada’s Guidance on Alcohol and Health, Public Summary: Drinking Less Is Better (Infographic) | 2023 | Summarizes the recommendations in Canada’s Guidance on Alcohol and Health in simple terms and illustrations. Offers concise, image-based explanations of the risks and harms from alcohol consumption on an increasing scale, as well as tips to reduce those risks |
| Lifetime Risk of Alcohol-Attributable Death and Disability | 2022 | Examines the lifetime risk of death and disability for various levels of alcohol consumption. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Overview of Reviews of the Association Between Alcohol Use and Aggression and Violence | 2022 | A review of the association between alcohol use and violence, including patterns of drinking, as it relates to perpetration of and victimization by aggression. |
| Effect of Alcohol Consumption on the Development of Depression, Anxiety and Suicidal Ideation: Update of a Systematic Review | 2022 | Assesses the link between alcohol consumption and the development of depression, anxiety and suicidal ideation. |
| Commissioned Report: Update on Canada’s Low-Risk Alcohol Drinking Guidelines: Summary of Stakeholder Focus Groups | 2022 | Summarizes findings of eight virtual focus groups conducted with CCSA stakeholders. Groups explored the familiarity and understanding of current LRDGs, knowledge mobilization and understanding of standard drink recommendations. |
| Sex, Gender and Alcohol: What Matters for Women in Low-Risk Drinking Guidelines? | 2022 | Reviews research on the effects of alcohol through a sex and gender lens. With a focus on women, it examines the sex-specific effects of alcohol on male and female bodies. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Final Report for Public Consultation | 2022 | Summarizes worldwide evidence reviews, mathematical modelling, consultations and discussions. It aims to provide people in Canada with accurate, up-to-date information about the risks and harms associated with the use of alcohol. Includes the public overview and technical report. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Evidence Review Technical Report | 2022 | Reviews and updates the evidence on the effects of alcohol use on physical health, mental health and social harms. The report is intended for those interested in understanding the process followed in developing new alcohol consumption guidelines. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Disclosure of Affiliations and Interests | 2021 | This declaration of interests is a list of affiliations, and financial and intellectual interests from the past three years for members of the Low-Risk Alcohol Drinking Guideline Executive Committee and the Scientific Expert Panels. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Summary Evidence on Understanding and Response to Alcohol Consumption Guidelines | 2021 | This is an update of the evidence review produced for the 2016 United Kingdom Chief Medical Officers alcohol guidelines group, to determine how people understand and respond to official public health guidance. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Summary of Findings from Public Consultation | 2021 | Summary of Findings from Public Consultation product description with, "A summary of Canadians’ experiences with the current LRDGs and their needs and expectations for updated guidelines, based on responses from 4,845 participants. |
| Update of Canada’s Low Risk Alcohol Drinking Guidelines: Terms of Reference | 2021 | Outlines the terms of reference for the initiative to update Canada’s Low-Risk Alcohol Guidelines. Includes information on the project scope, governance, scientific expert panels, and roles and responsibilities. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Source Guidelines | 2021 | Summarises the current Canadian Low-Risk Alcohol Drinking Guidelines, the United Kingdom Chief Medical Officers’ Low Risk Alcohol Drinking Guidelines and the Australian Guidelines to Reduce Health Risks from Drinking Alcohol. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Evaluation of Selected Guidelines | 2021 | Report presents evaluations of the current Canadian Low-Risk Alcohol Drinking Guidelines (2011), and guidelines from the United Kingdom (2016) and Australia (2020) using a standard instrument, the Appraisal of Guidelines for Research and Evaluation II. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Development of Research Questions | 2021 | Outlines the research questions to support the update of the Low-Risk Alcohol Drinking Guidelines and the process used to develop them. |
| Update of Canada’s Low-Risk Alcohol Drinking Guidelines: Process and Timelines | 2021 | Interactive diagram providing an overview of the process to update Canada’s Low-Risk Alcohol Drinking Guidelines and the progress of the project. This document is updated regularly. |