Ann Dowsett Johnston  Special to the Toronto Star

Canadas first national low-risk alcohol drinking guidelines have been given the green light by provincial ministers at a meeting in Halifax.

More than two years in the shaping, the guidelines approved on Friday have received the blessing of the Canadian Public Health Association, the Canadian Medical Association, the liquor industry and more.

According to the new guidelines, women should consume no more than two drinks most days, up to 10 a week, and men should consume no more than three drinks most days, up to 15 a week.

All should plan for non-drinking days, ensuring that they arent developing a habit.

Beyond the weekly limits, the guidelines also make reference to special occasion drinking: "Reduce your risk of injury by drinking no more than three drinks (for women) or four drinks (for men) on any single occasion.

"That we have all agreed on what the guidelines should look like government, the alcohol industry and public health is unique to Canada, says Michel Perron, CEO of the Canadian Centre on Substance Abuse (CCSA), which oversaw the shaping of the guidelines. "You will not find another country that has this level of congruence.

The guidelines are long overdue. Like most G8 countries, Canada has witnessed an uptick in risky drinking. Canadians consume 8.2 litres of pure alcohol on an annual basis more than 50 per cent above the world average. "Its not that we drink, says Rob Strang, chief medical officer of Nova Scotia, "but how we drink.

And how we drink causes a lot of alcohol-related harm. "If a country has a $14-billion a year problem, says Perron, "and much of it stems from the use of a legal product, the first step is to explain how the product can be used, and how to decrease that avoidable cost. Much of that cost is preventable.

What is significant about the guidelines is that they were the first priority of the National Alcohol Strategy, an intelligent and comprehensive blueprint which has yet to be fully endorsed by the federal government. The strategy was shaped in 2007 by an expert working group convened by the CCSA, Health Canada and what was then known as the Alberta Alcohol and Drug Abuse Commission.

This group, together with representatives from public health agencies, alcohol manufacturers, treatment agencies and alcohol control boards, produced "Reducing Alcohol-Related Harm in Canada: Towards a Culture of Moderation. This was a milestone effort, presenting 41 recommendations.

These new guidelines wont change the drinking culture overnight, but they will establish an important benchmark for Canadians. "Up until now, the fun factor has been different, depending on which province you lived in, says Perron, referring to the fact that Canada has had four different sets of guidelines.

What is most remarkable is that the guidelines have industrys approval. At several junctures, it looked like industry might walk from the table. "It nearly went off the rails many times, says one insider. They stayed.

"They certainly dont want to be caught out like the tobacco people were, says Peter Butt, who chaired the expert review committee.

Clinically, these guidelines are important for the medical community, key to screening and brief intervention a tool known to be effective for helping problem drinkers.

The next step? Broad circulation and promotion of the new guidelines.

Ideally, the liquor monopolies will play a major role. "One of the advantages we have in Canada is the monopolies, says Perron. "Social responsibility is the primary justification through which the LCBO can maintain their monopolistic advantage. And social responsibility is not something you do its how you do things.

After that: standard drink labelling on all alcoholic beverages, articulating how many standard drinks are in each container. "Without them, its like having a 100-kilometre speed limit and no speedometer on your car, says Perron. "How do you gauge consumption if you dont know how much you are drinking.

Strang agrees: "Industry loves to say theyre all about responsible drinking, but how does their marketing and labelling portray responsibility?

This could be a sticky point with the alcohol industry. Says Andrew Murie, CEO of MADD Canada: "I am not sure that the beverage industry is going to come singing Kumbaya on this one. But like tobacco, its a product where you need to warn the public.

These guidelines represent a healthy limit. But drinking to optimize health? Thats another matter. "One drink a dayand thats a fairly unusual consumption pattern, says Tim Stockwell, executive director of the Centre for Addictions Research of B.C. Still, he points out, a daily drink is where "the risk of cancer starts.

If Stockwell had his way, Canada would move to warning labels: "If you can do this for tanning salons, why not alcohol? What other product do we protect when there is scientific evidence that use causes cancer? In this country, billions of dollars are made by governments on alcohol, and it causes the deaths of 10,000 or more each year. Consumers have a right to know. Of course, the alcohol producers might have trouble with this.

November 25, 2011