Two glasses a week? Why Canada’s new alcohol guidelines have us rethinking our relationship with risk (2023)

It was dance night at the roller rink. The lights were low; the ’80s tunes cranked high. And Laura Mack was back on skates after a nearly 40-year absence.

Unlike in her youth, the 62-year-old’s wrists, knees and elbows were wrapped in protective padding, a helmet snug on her head. With a few lessons under her belt, she was ready for some fun.

It had been a difficult few years. Her husband, Andrew, died of complications from cardiovascular disease in January 2021. During his year-long decline, and hospitalizations that separated the couple, Mack, who previously enjoyed a drink of wine with Andrew at dinner, often found herself alone and grieving her husband’s impending loss with a couple of “quarantinis.” A couple too many, and enough to leave her questioning, and ultimately, giving up alcohol.

But roller skating? The fun seemed worth the risk. So on this night last fall, in a newly opened rink in Vancouver and eight months into sobriety, Mack busted a move. Then she busted her hip — to “smithereens.”

“(Roller skating) brought me joy until it didn’t,” said Mack who required surgery and two months of convalescing in bed. “And I can say exactly the same thing of alcohol — it brought me a lot of joy until it didn’t.”

In weighing the risks she has taken in her life, Mack may regret her fancy footwork “I have decided I’m selling the roller skates,” she said — but at one year sober she is buoyed by recent guidance from the Canadian Centre on Substance Use and Addiction (CCSA) which strongly stated: no amount of alcohol is good for your health, and anything beyond two glasses a week increases your risk for alcohol-related consequences, from injury to cancer.

Two glasses a week? Why Canada’s new alcohol guidelines have us rethinking our relationship with risk (1)

“I’m quite firmly and comfortably in the percentage of people who are celebrating these guidelines as an affirmation of the decision we’ve made of being alcohol-free,” said the Courtenay, B.C., resident who has found the guidelines to be the talk of her online sober support communities.

But for others, the report has been nothing but a killjoy.

For the past dozen years, Canada’s advice was to stick to no more than 10 drinks a week for women and 15 for men. Above that, you were putting your long-term health in jeopardy. Below was considered low-risk. While not exactly a free-for-all, the threshold, set in 2011, allowed people to have a glass a day and maybe a couple of extra beers on the weekend. Of the 23.7 million Canadians who drink alcohol, according to 2019 data, three-quarters reported doing so within those limits.

The updated recommendations, funded by Health Canada and based on new evidence, mathematical modelling and consultation, call for a radical reduction.

(Video) Canada's new guidelines on alcohol and health | About That

And while they may reflect a global shift in thinking among researchers, including the World Health Organization which earlier this month declared there is no safe amount of alcohol, the new guidelines landed like last call at a boisterous bar when the night seems still so young.

There was disbelief, displeasure, denial.

“Two drinks a week?! That’s just not feasible, not in this country!” said a man in a CHCH TV news video that has gone viral for his candour, channelling the Canadian beer-loving legacy of SCTV’s Bob and Doug McKenzie.

From call-in shows and social media discourse, and in news coverage and opinion pieces, people have criticized the CCSA’s conclusions, accused Canada of being out of line with other countries, and in some cases, rejected the advice outright.

“For me, it sounds ridiculous, it’s so shocking,” said Yashy Murphy, a Toronto mom of two and content creator for Parenting to Go, a multi-platform brand that “encourages urban parents to maintain the pre-kid lifestyle post-kid.” A martini glass is integrated into the site’s logo.

Murphy had already cut back a little on alcohol due to concerns about her family history and the amount of drinking she had done at industry events in a past career in the beverage business. She now makes mocktails for the odd change of pace, and for her kids. But she can’t see giving up hosting girlfriends for drinks or doing her annual 12 pubs of Christmas crawl.

“This news is not going to alter those occasions for me,” she said. “I still want to go have fun. I still want to go out, have a few cocktails.”

In response to the backlash, Catherine Paradis, the CCSA’s interim associate director, research, and co-chair of the report, insists the non-governmental organization “is not the red wine squad going around and issuing tickets to people who drink above a certain level.”

The new guidelines don’t dictate a way of life, she said. “We came out with information that people can decide to integrate into their way of life, if they’d like to.”

Canadians have a gap in their alcohol literacy, she added, with many believing you either had an alcohol disorder or no problems at all, failing to realize there could be consequences for even low-level consumption.

“So, we felt people had a right to know.”

But like a hangover, the report’s conclusions have people fretting about their past intake and re-evaluating their relationship with alcohol. In the cold hard light of day, we’re all confronting the same question: is a glass of wine still a risk worth taking?

“Research shows no amount or kind of alcohol is good for your health. Drinking alcohol, even a small amount, is damaging to everyone, regardless of age, sex, gender, ethnicity, tolerance for alcohol or lifestyle. That’s why if you drink, it’s better to drink less.”

(Video) Navigating Canada's new alcohol guidance | The Breakdown

That CCSA warning comes with what is described as a “continuum of risk” — a colour-coded chart the centre hopes people will use to weigh the consequences of their weekly alcohol consumption: two standard drinks a week is considered low risk; three to six is moderate; anything over seven is increasingly high.

“Alcohol is a carcinogen that can cause at least seven types of cancer,” the report starkly concludes.

“When you make a blanket, unnuanced statement that (alcohol) increases your risk of cancer, that is really going to frighten people,” said Dr. Meldon Kahan, an addiction physician at Women’s College Hospital. “It also doesn’t put it into context. There’s a lot of things that have been shown to increase the risk of breast cancer, for example: red meat in the diet, deficiency of vitamin D, obesity, and by far the most important, our family history.”

For those diagnosed with cancer, these guidelines will cause tremendous guilt, said Kahan. And those who are drinking more than two drinks a week and doing just fine, they are just not going to listen.

“People don’t react well to being lectured to and to what feels like an attempt to frighten them.”

Kahan and others have questioned the report and its panel of experts on everything from the way they conveyed individual risk to the number of studies the report reviewed. For someone trying to navigate the recommendations, the criticisms are enough to make a head spin.

Among them:

  • Drinkers have pointed enviously to thresholds in other countries. However, comparisons aren’t a simple one-to-one. For example, there is no international consensus on what constitutes a “standard” drink. In Canada, a standard drink contains 13.45 grams of pure alcohol, which translates to a 12-ounce bottle of beer or a five-ounce glass of wine. In the United Kingdom, the standard is eight grams; in Australia, it is 10. Those countries have higher weekly limits, but they are also less than they once were. The various standards reflect differences in “risk appetite,” an alcohol policy researcher recently told the Guardian: “The fundamental challenge of drinking guidelines is what threshold of risk is more appropriate. There isn’t a magic line in the sand that we all agree upon.”
  • Critics have also queried why recommendations were based on only 16 systematic reviews. Paradis explained that her team chose the highest-quality meta-analyses from among the thousands of available studies. Her team applied rigorous, international standards, grading each review, removing duplication, and for modelling purposes, had to choose only one systematic review per disease.
  • People have grappled with the statistics. Did the stated risk of an alcohol-attributable death from having two drinks a week — 17.5 years of life lost in 1,000 lifetimes — mean everyone would lose just six days in the end, some queried with a shrug? Or would one unlucky person in 1,000 die 17.5 years sooner? (It’s the latter.)
  • And for those clinging to the common notion that a glass of red wine a day is good for one’s health, the new guidelines seemed particularly perplexing because the findings noted that low levels of alcohol neither increased nor decreased the risk of heart disease. However, alcohol still poses a risk for stroke to liver disease, said Paradis, who added — half-jokingly — that you can’t say to your wine, please just go to my heart and not touch my other organs. “You don’t get to pick and choose your disease.”

But the new guidelines are aimed at putting some control in an individual’s hands — even if the simple colour-coded “continuum of risk” belies the complexity and seeming confusion of what’s behind them.

“More information is always better. And I’m a firm believer in evidence-based medicine,” said associate professor Jessica Mudry, director of the Healthcare User Experience Lab at Toronto Metropolitan University.

“But the second we quantify the consumption of anything … you create a framework for people to moralize others and to moralize themselves,” even if that one night out is a lifeline for someone craving social contact.

“On a cellular level, is alcohol a toxin? Absolutely. Will it kill you? Yes. So will sugar. So will meat. Life is pretty toxic.”

(Video) Two drinks per week?! New alcohol consumption recommendation in Canada

But, Mudry added, “is (alcohol) also an excuse for human connection? Yes. Is human connection vital to happiness and well-being and longevity? Yes.”

Paradis acknowledges the social importance alcohol holds for people and understands how they might now feel like their lifestyle choices are under scrutiny. “They thought that this was fun and harmless, and they’re not happy to know that it could hurt them.”

Most people tend to think their risk is lower than it really is, said Taryn Grieder, a psychology professor at the University of Toronto, who acknowledges the skydiving she loves to do might seem riskier than drinking to some. “We have this idea that we’re almost indestructible, especially males, and the younger a person is.”

She holds up the students in her classes as an example. When recently discussing the new guidelines, the students brushed off any thoughts of giving up or doing less partying.

“The older and wiser we get, the more risk-averse we become,” Grieder said. “We’ve learned through our experiences and through other people’s unfortunate ones that we aren’t immune to harms.”

But having lived through the pandemic, people from all walks may be more accepting of risk as the price for enjoying life again. “We know what it’s like to be cooped up in our houses and not to socialize or go out to bars and have our friends over for a night,” said Grieder.

And perhaps it doesn’t help that these new recommendations have landed just as society is suffering from message fatigue.

“The pandemic has substantially affected the way we digest public health recommendations,” said James MacKillop, the Peter Boris Chair in Addictions Research at McMaster University. COVID-19 regulations moved at “the speed of evidence,” often changing in ways that confused people, leaving them feeling like the guidance was unreliable, he said. “And I think that it may be that people are less willing to accept public health guidelines unquestioningly.”

For people who thought they were safely imbibing within the old drink limits set in 2011, they would be rightly surprised to discover they are suddenly categorized as a moderate- or high-risk drinker, said MacKillop. Meanwhile, patients with alcohol-related concerns will find their intake well beyond the colour-coded chart. “It is not clear how a clinician would use the guidelines to treat patients,” said MacKillop.

Dr. Kahan agrees. “I think physicians will be reluctant to tell a 30-year-old woman who is drinking four or five drinks per week that she should cut down to two drinks otherwise she could get breast cancer.”

The way Paradis sees it, any reduction in alcohol use is beneficial. If someone is at 35 drinks a week, she said, but gives up their Tuesday drinking, moving down to 32 beers, “that’s brilliant.”

She accepts that people may need more of a nudge than the new guidelines or the discussion around them can provide. They’ll need a supportive environment. That’s why part of the CCSA recommendations include a call for warning labels on bottles, echoing the successful deterrents on cigarette packaging. The organization also states it is aiming to “change Canada’s drinking culture and curb the normalization of harmful alcohol use in society.” At a time when there’s never been more choice for alcohol-free beers, wines and spirits but Ontario is also expanding access to liquor, that’s a challenging message to absorb.

“I think people are afraid,” said Mack, whose son is two months into his own drug-free journey. “Alcohol is such a crutch for so many people. And in a reasonable amount, it’s thoroughly enjoyable. People don’t want to lose that.

But for the leadership development facilitator and executive coach, the pros of her decision, are clear.

“I sleep better. I’m less anxious. I’m less reactive. I’m supporting my son in his sobriety. I’m more present for my clients. All of those things. Plus I’m reducing my cancer risk.”

(Video) A new measure of unhealthy drinking

Janet Hurley is a Toronto Star journalist and senior writer covering culture, education and societal trends. She is based in Toronto. Reach her via email:



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What is the purpose of Canada's low-risk alcohol drinking guidelines? ›

Canada's Low-Risk Alcohol Drinking Guidelines can help you make informed decisions about drinking. The guidelines recommend setting limits to help you reduce the acute (short-term) and chronic (long-term) health risks of alcohol use.

What is the purpose of Canada's low-risk alcohol drinking guidelines quizlet? ›

Canada's Low-risk Alcohol Drinking Guidelines were developed to help Canadians moderate alcohol consumption and decrease alcohol-related harm, such as drinking and driving, and provide tips for safe drinking and not drinking while pregnant.

Do the benefits of alcohol outweigh the risks? ›

Moderate drinking sits at the point at which the health benefits of alcohol clearly outweigh the risks. The latest consensus places this point at no more than 1-2 drinks a day for men, and no more than 1 drink a day for women.

What are the overall recommendations regarding alcohol intake and our health who gives these recommendations? ›

The Dietary Guidelines for Americansexternal icon recommends that adults who choose to drink do so in moderation – 1 drink or less on a day for women or 2 drinks or less on a day for men.

What are Canada's new low risk drinking guidelines? ›

CTV National News: New alcohol consumption

Canada's new recommendations to limit alcohol consumption from two drinks a day to two drinks a week.

Why Canada shouldn't lower the drinking age? ›

MLDA 21 exerts valuable social pressure on potential underage drinkers and those who may serve them. The MLDA should stay at 21 because people tend to be more mature and responsible at 21 than 18. Lowering the drinking age will invite more use of illicit drugs among 18-21 year olds.

What are low risk guidelines for alcohol? ›

To reduce the risk of alcohol-related harms, the 2020-2025 Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.

What are the risks of alcohol? ›

High blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum. Weakening of the immune system, increasing the chances of getting sick. Learning and memory problems, including dementia and poor school performance.

What are the health risks of alcohol? ›

Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including: Cardiomyopathy – Stretching and drooping of heart muscle. Arrhythmias – Irregular heart beat. Stroke.
  • Steatosis, or fatty liver.
  • Alcoholic hepatitis.
  • Fibrosis.
  • Cirrhosis.

What is the most important risk factor for alcoholism? ›

Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder. Starting at an early age. People who begin drinking — especially binge drinking — at an early age are at a higher risk of alcohol use disorder.

Why does alcohol increase risk taking? ›

Drinking alcohol is associated with greater risk-taking behaviours because alcohol can make young people feel less self-conscious or concerned about negative consequences.

What is the healthiest alcohol to drink? ›

However, if you are going to drink, having red wine in moderation is a healthier choice than other alcoholic drinks. This is due to its high levels of antioxidants called polyphenols, which have been linked to better heart and gut health.

What do the guidelines say in relation to alcohol? ›

Alcohol guidelines

To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.

What are at least 2 effective strategies communities can take to reduce the effects of alcohol? ›

  • Increase Alcohol Taxes. Alcohol taxes increase the price of alcohol at the federal, state, or local level on beer, wine, or distilled spirits. ...
  • Regulate Alcohol Outlet Density. ...
  • Commercial Host “Dram Shop” Liability Laws. ...
  • Maintain or Limit Days or Hours of Sale. ...
  • Enhance Enforcement of Laws Prohibiting Sales to Minors.

What does the government recommend about alcohol? ›

men and women are advised not to drink more than 14 units a week on a regular basis. spread your drinking over 3 or more days if you regularly drink as much as 14 units a week. if you want to cut down, try to have several drink-free days each week.

What are the low-risk weekly alcohol guidelines? ›

The recommended weekly low-risk alcohol guidelines are less than:
  • 11 standard drinks for women.
  • 17 standard drinks for men.

How many drinks a week are safe Canada considers a much lower limit? ›

To reduce long-term risks, the first guideline recommends that women should not exceed more than 10 drinks a week, with no more than two drinks a day most days. Men should not exceed more than 15 drinks a week, with no more than three drinks a day most days. Everyone should plan non-drinking days every week.

What are the recommended drink limits in order to reduce long-term health risks Canada? ›

Recommendations. To reduce long-term health risks, Canada's Low-Risk Alcohol Drinking Guidelines recommend: No more than 10 drinks a week for women, with no more than 2 drinks a day most days. No more than 15 drinks a week for men, with no more than 3 drinks a day most days.

What country has the lowest drinking age? ›

The youngest legal drinking age in the world is 15, with both Mali and the Central African Republic allowing folks to drink at that time. Seven countries do not have a government-mandated drinking age, while 11 countries ban the consumption of booze entirely.

Which countries have no drinking age? ›

This is actually a bit of a trick question, as several European countries including: Armenia, Belgium, Bulgaria, Czech Republic, Denmark, France, Moldova, Netherlands, Norway, Poland, and Russia have no formal laws on what age people are allowed to consume alcoholic beverages.

What is the drinking age in Germany? ›

Countries like Denmark, Germany, and Belgium have set a minimum age of 16 years for this purpose. People of 16 years can easily buy beverages containing 1.2% of distilled alcohol whereas people of 18 years are allowed to buy spirits containing more than 1.2% of distilled alcohol.

How can you avoid risks of being an alcoholic List 5 ways and explain each? ›

The following tips can help keep your drinking low risk and manage high risk situations.
  1. Avoid drinking situations. ...
  2. Count your drinks. ...
  3. Slow down your drinking. ...
  4. Take less alcohol with you. ...
  5. Make every second drink a non-alcoholic drink. ...
  6. Eat before or while you are drinking. ...
  7. Avoid top-ups. ...
  8. Drink water with a meal.
Jul 20, 2020

What is the name of the guideline to manage and reduce the risk of intoxication? ›

The GL4002 'Prevention of intoxication on licensed premises March 2015' guidelines are issued by the Secretary, NSW Department of Industry, under section 73(5A) of the Liquor Act 2007 and are available from Liquor & Gaming NSW at

What are the low risk drinking guidelines for seniors? ›

The National Institute on Alcohol and Alcoholism advises that people older than age 65 who are healthy and who do not take any medicines, have no more than seven drinks a week. The American Diabetes Association guidelines indicate one drink or less a day for women, or two drinks or less a day for men is acceptable.

How much alcohol is too much per week? ›

Heavy Alcohol Use:

NIAAA defines heavy drinking as follows: For men, consuming more than 4 drinks on any day or more than 14 drinks per week. For women, consuming more than 3 drinks on any day or more than 7 drinks per week.

What are 10 negative effects of alcohol? ›

They include:
  • high blood pressure.
  • stroke.
  • pancreatitis.
  • liver disease.
  • liver cancer.
  • mouth cancer.
  • head and neck cancer.
  • breast cancer.

What happens if you drink alcohol everyday for a month? ›

Daily alcohol use can cause fibrosis or scarring of the liver tissue. It can also cause alcoholic hepatitis, which is an inflammation of the liver. With long-term alcohol abuse, these conditions occur together and can eventually lead to liver failure.

How much alcohol is safe to drink daily? ›

He explains that the standard drink size is 330 ml for beer, 30 ml for hard alcohol (whiskey, gin etc) and 150 ml for wine (red or white). Dr Sequeira says that the body can metabolise one drink per hour, and not more than three standard drinks per day.

What are the lifetime risk guidelines for alcohol? ›

Consequences of drinking too much over a lifetime

The national guidelines state that for healthy men and women, drinking no more than ten standard drinks a week reduces the lifetime risk of harm from alcohol-related disease or injury.

What are 3 factors that influence alcohol? ›

Genetics, body weight, gender, age, what type of beverage, food in your stomach, medications in your system, and your state of health, influence how people respond to alcohol.

What are 3 factors that influence alcohol effects? ›

How alcohol affects you can depend on a range of factors, including your:
  • sex.
  • mental and physical health.
  • medical conditions.
  • use of other drugs and medications.
Aug 2, 2022

Does alcohol increase the risk of violence? ›

Alcohol plays a large role in criminal activities and violence. Excessive drinking has the ability to lower inhibitions, impair a person's judgement and increase the risk of aggressive behaviors. Because of this, alcohol-related violence and crime rates are on the rise throughout the country.

What is the low-risk guidelines for alcohol consumption? ›

Low-risk drinking advice
  • men and women are advised not to drink more than 14 units a week on a regular basis.
  • spread your drinking over 3 or more days if you regularly drink as much as 14 units a week.
  • if you want to cut down, try to have several drink-free days each week.

What is Canada's low-risk drinking guidelines recommended weekly limit of drinks for men? ›

To reduce long-term risks, the first guideline recommends that women should not exceed more than 10 drinks a week, with no more than two drinks a day most days. Men should not exceed more than 15 drinks a week, with no more than three drinks a day most days.

What is the purpose of the alcohol Act? ›

The object of the Act is safe and responsible sale, supply, and consumption of alcohol and the minimisation of harm caused by its excessive or inappropriate use.

What are the recommendations for low-risk alcohol drinking? ›

To reduce the risk of alcohol-related harms, the 2020-2025 Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.

What are the 5 risk factors for alcoholism? ›

Both internal and external factors contribute to the development of alcoholism. Internal factors include genetics, psychological conditions, personality, personal choice, and drinking history. External factors include family, environment, religion, social and cultural norms, age, education, and job status.

How many units of alcohol is safe in a week? ›

It's recommended to drink no more than 14 units of alcohol a week, spread across 3 days or more. That's around 6 medium (175ml) glasses of wine, or 6 pints of 4% beer. There's no completely safe level of drinking, but sticking within these guidelines lowers your risk of harming your health.

What are the low-risk drinking limits on a single day and per week for men? ›

Guidelines from National Institute on Alcohol Abuse and Alcoholism define low-risk drinking in the following way: Healthy men under 65: No more than 4 drinks in one day and no more than 14 drinks per week.

How many drinks a week is normal for men? ›

The NIAAA weekly volume guideline is not to exceed 14 drinks per week for men and 7 drinks per week for women. (Daily guideline is no more than 4 drinks in any day for men, and 3 drinks in any day for women.) Refer to the U.S. low-risk drinking guidelines.

What are the new Canadian alcohol guidelines? ›

Long-term health risk by drinking no more than 10 standard drinks a week for women, with no more than two drinks a day most days, or 15 standard drinks a week for men, with no more than two drinks a day most days.

Why did the US want to ban alcohol? ›

National prohibition of alcohol (1920–33) — the “noble experiment” — was undertaken to reduce crime and corruption, solve social problems, reduce the tax burden created by prisons and poorhouses, and improve health and hygiene in America.

Why is the US ban on alcohol repealed? ›

Prohibition, failing fully to enforce sobriety and costing billions, rapidly lost popular support in the early 1930s. In 1933, the 21st Amendment to the Constitution was passed and ratified, ending national Prohibition.

What are reasons why the government may want to tax alcohol specifically? ›

Governments can use the taxation of alcohol beverages to generate revenue and encourage consumers to select domestic products over imported products; increasing alcohol prices through taxation may also be intended to reduce consumer demand and, therefore, consumption, harmful drinking, and alcohol-related harm.

How much is too much alcohol per week? ›

NIAAA defines heavy drinking as follows: For men, consuming more than 4 drinks on any day or more than 14 drinks per week. For women, consuming more than 3 drinks on any day or more than 7 drinks per week.

How many alcohol free days are also recommended for low risk alcohol drinking? ›

Low-risk drinking advice

To reduce long-term health risks, have at least two alcohol-free days each week and drink no more than: Two standard drinks a day for women.


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