The large scale ‘Alcohol Harm Across the Drinking Spectrum’ research, conducted by the Behavioural Insights Team (BIT) on behalf of Alcohol Change UK, examined the drinking habits of more than 4,000 UK adults and the wide range of harms associated with different levels of alcohol consumption.
While it found that harms are more prevalent and severe among those drinking at hazardous and harmful levels, the study identified statistically significant associations between ‘low risk’ drinking – up to 14 units per week, about six pints or eight medium glasses of wine a week – and higher rates of cardiovascular disease (5% vs 1%) and cancer (4% vs 1%). In addition, ‘low risk’ drinkers reported experiencing reduced sleep quality, worse daily functioning and poorer dental health, compared to those who have never consumed alcohol.
The report also highlights disparities in alcohol-related harms, with men and people from lower socioeconomic groups experiencing increased health problems related to their alcohol consumption.
With over 30 million people in the UK drinking at these levels, Alcohol Change UK is highlighting the wide range of harms that people experience between not drinking and alcohol dependency, which it argues could be prevented with health warnings on products and greater protections from how alcohol is marketed to us in our daily lives.
Dr Richard Piper, CEO of Alcohol Change UK, said:
“For decades, we’ve fallen prey to a binary but false idea that ‘drinking problems’ only affect a minority of people with alcohol dependence. But as this research makes clear, alcohol is taking a toll on our health and wellbeing right across the drinking spectrum, even at ‘low risk’ levels.”
While this study highlights statistically significant associations between ‘low risk’ alcohol consumption and harm, previous evidence1 from Alcohol Change UK suggests that the environment surrounding alcohol is misleading drinkers, exacerbating the messy middle of harm:
- 55% of ‘low risk’ drinkers in the UK report being comfortable with the amount of alcohol they drink and plan to keep drinking the same amount in 2025, compared to 34% and 35% of increasing/high risk drinkers who said the same* - despite there being room for reducing our risk at any level
- Low risk drinkers are the least likely to be taking any steps to moderate their consumption – 51% say ‘I haven’t done anything to manage my drinking’ vs 18% and 34% of increasing/high risk drinkers who said the same**
Piper added: “When it comes to alcohol, ‘low risk’ doesn’t mean 'risk free’. But without clearer information, many of us believe that drinking less than 14 units a week is safe. The Chief Medical Officers’ guidelines give us a valuable tool to make our own decisions, but not the full picture. There is a difference between consuming 1 and 14 units per week, between a small glass of wine and a bottle and a half a week, between half a pint and six pints a week, within that ‘low risk’ category.
"Alcohol is also everywhere we look, advertised on bus stops and tube stations, in prime-time TV shows and on social media, constantly encouraging us to drink more and suggesting alcohol is essential to our daily lives. But that’s just not true."
“While the drinking risk guidelines are useful, our wider environment is working against us and fuelling this messy middle of harm. Product labelling is still, shockingly, regulated by the alcohol industry itself, so it’s in their interests to hide the truths about alcohol health risks. Alcohol is also everywhere we look, advertised on bus stops and tube stations, in prime-time TV shows and on social media, constantly encouraging us to drink more and suggesting alcohol is essential to our daily lives. But that’s just not true.
“Anyone who has cut back, or is cutting back, on their drinking, is doing so despite an alcohol-centric environment; an environment that is not natural, not inevitable and has worsened in recent years. We need to change this environment so we all are genuinely free to make our own choices without the constant push to consume alcohol. Government action is needed to properly regulate out-of-control alcohol marketing, to better communicate health risks, and to stop alcohol from being constantly placed centre stage in our daily lives. This would have a positive impact on our quality of life and long-term health.”
What does this mean for our health services?
Beyond the impacts of alcohol on individuals’ health and wellbeing, ‘Alcohol Harm Across the Drinking Spectrum’ found that all respondents who consume alcohol, including 'low risk' drinkers, report accessing health services more often than those who have never drunk alcohol.
On average, so-called ‘low risk’ drinkers (up to 14 units a week) report 33% more visits to health services in the last year than those who have never drunk alcohol (average of eight visits vs six for never drinkers.)
Of those who visited the hospital in the past year, a higher proportion of ‘low risk’ drinkers reported attending for injuries or accidents (26% vs 17%), acute illness or infection (20% vs 17%), and mental health treatment (8% vs 5%) compared to non-drinkers. Demand on health services, particularly those identified by this research, would likely reduce or shift from urgent, emergency support in hospitals to more local and community-based health services if more people were supported to reduce their alcohol consumption.
Dr Craig Johnson, Principal Advisor at BIT who led the research said, “Our research with Alcohol Change UK reveals significant associations between alcohol consumption and various health outcomes across the drinking spectrum. Even at levels generally considered 'low risk', we found concerning associations with reduced sleep quality, poorer dental health, lower daily functioning and higher prevalence of cardiovascular disease and cancer compared to non-drinkers. These relationships strengthen at higher consumption levels, affecting not just individuals but also health systems and the wider economy.
“The impact varies notably among demographic groups, with stronger associations between ‘low risk’ drinking and health problems among men and those with lower socioeconomic status. This study was exploratory and further research, especially longitudinally into the associations between consumption and health outcomes, would help to deepen our understanding.”
Specialist in alcohol and behaviour change, Dr James Morris, added: “This study highlights links between alcohol use and harm, and for some, even at low levels of consumption. It reflects the ‘dose-response relationship’ whereby more alcohol means more harm, counter to common ideas of alcohol problems only affecting ‘heavier’ drinkers.
"People who cut down, even a little, often report being surprised by the health and wellbeing improvements they feel. We must therefore ensure that people who drink alcohol aren’t made to feel their only option is to quit altogether – reducing alcohol use at any level can bring benefits."
“Alcohol can, of course, bring social or other benefits and drinking choices should be recognised as not only health-based decisions. Yet, the accuracy with which people make these decisions is often skewed, in part due to the normalisation of alcohol use in our society. People who cut down, even a little, often report being surprised by the health and wellbeing improvements they feel. We must therefore ensure that people who drink alcohol aren’t made to feel their only option is to quit altogether – reducing alcohol use at any level can bring benefits.
“As such, this work raises important questions about the extent to which ‘low risk’ drinkers specifically experience harm, and how they should be best informed about these risks. As health professionals, we need to avoid scaring people about alcohol as this usually fails to achieve change. Instead, our goal should be that every one of us can make well-informed decisions about alcohol use and risk. Currently, this is too difficult in a society where ‘drinking problems’ are thought only to apply to a small minority, rather than our own individual risks. Changing the environment will ensure that the risks versus the benefits of drinking at different levels are better understood.”
Prevention across the spectrum
In line with these findings, Alcohol Change UK is calling on the Government to turn prevention rhetoric into reality by properly regulating alcohol labelling and marketing, measures that would improve information about the health risks of alcohol and protect us from constant efforts to get us to drink more.
These asks are part of a wider package of harm-prevention policies the charity is putting forward to the Government, directly focused on addressing the environmental factors which fuel the messy middle of alcohol harm in the UK:
- Legislate for statutory alcohol labelling, enforced by the Chief Medical Officer, via the Office of Health Improvement and Disparities (OHID). It is crucial that regulation and enforcement is carried out by a body that is independent of the alcohol industry. Labels should provide consumers with proper information about the ingredients, nutritional values, unit levels, and the risks of alcohol consumption.
- Bring in tighter restrictions on alcohol marketing and advertising, to protect us from efforts to get us to drink more.
