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We ask the experts to settle

common questions we've all wondered about.

QUESTION

Recent studies have found a link between alcohol consumption and a higher risk for certain cancers. Is alcohol the new smoking?

ANSWER

"Cocktails anyone?" the promotions ask. During this season of celebrations, it is easy to think about alcoholic beverages solely in the context of their glossy and enticing holiday-oriented promotions.

And while it's true that there are health benefits for some older adults who have a few drinks a week, our culture's overwhelming emphasis on the positive side of drinking can lead to an imbalanced and dangerously misleading perception of alcohol.

The downsides include the still-too-common risks of drinking and driving, domestic violence, fights and public disruption, as well as the lesser-known risks for prevalent chronic diseases such as cancer. Research conducted under the auspices of the World Health Organization has identified more than 70 types of trauma and chronic disease where alcohol is a contributing cause.

In developed countries including Canada, alcohol is considered the third-highest factor in contributing to death, disease and disability (of 26 examined), just below tobacco and high blood pressure, and above high cholesterol, obesity, physical inactivity and illicit drugs. A study based on 2002 health and law-enforcement statistics produced a conservative estimate of $14.6-billion in costs attributed to alcohol in Canada (not including social problems), compared to $17-billion for tobacco.

Since that time, both the overall consumption of alcohol and the incidence of high-risk drinking have continued to increase in Canada, and both have been shown to contribute to damage. There are a number of cancers where alcohol is a contributing cause, such as cancers of the digestive and gastrointestinal tracts. The WHO-affiliated International Agency for Research on Cancer recently highlighted alcohol as a contributing cause for colorectal and breast cancers.

For breast cancer the IARC found that "even for regular consumption of 18 grams of alcohol per day, increase in relative risk is statistically significant." Eighteen grams is less than one-and-a-half glasses of table wine, mixed drinks or beer. The health benefits for older adults can largely be achieved by drinking 13.6 grams, such as a glass of table wine or can of regular-strength beer, every other day.

It is possible to reduce overall consumption as well as high-risk drinking, defined as five or more drinks per occasion. For example, France and Italy - once among the heaviest alcohol-consuming countries in Western Europe - have reduced their overall rate of alcohol consumption by about two-thirds over 30 years.

However, in Britain Prime Minister Gordon Brown recently called a crisis meeting to deal with serious alcohol issues. Britain is struggling to contain high rates of trauma, public disruption and chronic disease resulting from easy access to alcohol, long hours of sale and heavy promotion.

The advice to "celebrate responsibility" will only produce the desired results if reinforced by responsible public policies such as more effective controls on alcohol promotion, prices that keep pace with the cost of living, and no further increases in hours of sale or density of alcohol outlets.

Until then, the negative aspects of alcohol will substantially outweigh the protective effects on cardiovascular disease and Type 2 diabetes associated with moderate consumption - such as less than two drinks a day.

Drs. Juergen Rehm and Norman Giesbrecht are senior scientists at the Centre for Addiction and Mental Health in Toronto.