Dr. Strang explains newly proposed guidelines of alcohol consumption

Nova Scotia's chief medical officer of health says people should know the risks associated with alcohol consumption after a national advisory organization proposed new guidelines earlier this week.

In a report published Monday, the Canadian Centre on Substance Use and Addiction said any level of alcohol consumption had a net negative impact on health for almost every disease that was reviewed, including several types of cancer, heart disease and liver cirrhosis.

The health risks become "increasingly high" when someone has six or more drinks per week. And for women who have three or more drinks per week, the risk of health issues increases more steeply compared to men, research shows. 

Previous guidelines suggested low-risk consumption limits of 15 drinks per week for men and 10 for women.

Dr. Robert Strang is on the executive committee that revises Canada's Low Risk Alcohol Drinking Guidelines. He has also sat on the National Alcohol Strategy Advisory Committee since 2009.

He spoke with host Jeff Douglas about the proposed guidelines on Friday.

Their conversation has been edited for length and clarity.

These new guidelines are a significant drop, which has been jarring for a lot of folks.

It certainly is a change, but I think that, as the report outlines, this is really what the latest science is saying and the whole intent of this report is, what do we know about a whole range of health risks from alcohol consumption and what do we need to then do to make sure Canadians have this information and can use that and support them in the choices they make?

But ultimately, how does this information then start to inform various policy decisions around how we create environments that will support people in those choices?

How do these new guidelines intersect with what we know of our habits around alcohol in Nova Scotia?

[The centre] actually, to me, raised the opportunity to really strengthen our work around both engaging Nova Scotians, but also in terms of the policy discussions. We have a long history and are well-known to have high rates of over consumption of alcohol in Nova Scotia.

This study basically just really strengthens that that type of consumption of alcohol has tremendous impacts on our collective health, has tremendous cost to our health care, criminal justice and education systems, so to me it's an opportunity to have a conversation around, "Are we OK with that?"

How do we make this change and improve health, decreasing impacts of all those systems and then how do we go about doing that? Both educating and supporting individuals, but also what are the policy discussions that will help support people who consume alcohol in a much safer way.

Do we have any data here in Nova Scotia that quantifies the burden alcohol consumption has been to our health-care system?

There's been some work done on that in various provinces but the data I have right in front of me from the report talks about national data. The collective cost of alcohol at a national level on health care is $5.4 billion, annually.

The use of alcohol is a major driver of poor health and a major driver of cost utilization, whether it's from acute effects — the increased risk of violence and injury — or some of the long-term effects — cancer, heart disease, et cetera, and the impacts are also on mental health need to be talked about.

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It has a huge cost driver, not just in health care but in our criminal justice system, on our community services, education systems and that $5.4 billion is really just a national level just on the health-care system alone.

Where would you like to see the policy conversations go, surrounding alcohol as a factor in our society?

To me, the policy conversations have to start with things like product labelling. We've had it long-standing with tobacco products. When we legalized cannabis there was a major focus on both product labelling and point of purchase, point of use. 

To me, for years, it's stood out that we have nothing like that for alcohol and the recommendations in the report are clear on that. We need to have product labelling. If we're saying low risk drinking is two or less standard drinks a week, well, having how many standard drinks is in a bottle of wine is important.

But also health warnings, the risk of cancer and other things like we have on both cannabis and tobacco products and some other nutrition information. That should be the first thing we're talking about and usually that labelling stuff happens with tobacco and cannabis at a federal level. That's really their jurisdiction. That should be the first policy discussion that feeds out of this in terms of how do we give people more information on the products as they're actually using them.

Several years ago, there was a pilot project in Yukon to put warning labels on alcohol as you're describing. My understanding is that pilot never took off because of lobbying by liquor producers. In the national alcohol strategy, what kind of buy in does the industry have?

The alcohol industry used to have a seat directly at that advisory community table and they no longer do.

The national alcohol strategy is actually led by the Canadian Centre on Substance Abuse. They're supported by Health Canada and so there was a decision made and the restructuring decision was ultimately supported by Health Canada because since I've been there that having industry at the table as she doesn't work because they're taking information they learn sitting at at a health table and using that in many ways in closed rooms going around processes, lobbying and having their tremendous influence on elected officials.

So they basically stalled and the project you talked about I'm aware of. That's a great example. They actually used their influence to stop that important research around the impact of labelling, and the study was able to happen in a limited way and the limited time of results showed a significant impact.

The alcohol industry is not going to be happy about this, but this is a consumer product so my position would be that Canadians, Nova Scotians, deserve to have accurate information about the risks of a product. We're not telling them they can't use it, but you should have accurate information about it to help you make your choices about how you use that product.