NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL GUIDELINES FOR CONSUMPTION OF ALCOHOL

This section contains a summary of the 2001 and 2009 National Health and Medical Research Council (NHMRC) guidelines for consumption of alcohol. For more detailed information on the 2001 guidelines, see the Australian Alcohol Guidelines: Health Risks and Benefits and for the 2009 guidelines, see the Australian Guidelines to Reduce Health Risks from Drinking Alcohol and Frequently Asked Questions.


2001 NHMRC GUIDELINES

The 2001 NHMRC guidelines [3] for reducing health risks associated with alcohol consumption comprised three guidelines for the population as a whole, and nine guidelines for particular groups of people. Guideline 1 provided recommendations to minimise short and long-term health risks for both men and women, while Guidelines 2 and 3 gave recommendations for people undertaking activities that involve risk or a degree of skill, and for people who were responsible for private and public drinking environments. Guidelines 4 to 12 provided advice for particular groups of people; for example, older people or people with specific health problems.

As the focus of this article is on short and long-term health risks, only Guideline 1 is described here. This guideline consisted of six recommendations for men and women.

Guideline 1: to minimise risks in the short and longer term, and gain any longer-term benefits

Minimising risk in the longer term (Guidelines 1.1 and 1.4)

The 2001 guidelines gave separate recommendations for men and women. To minimise the risk of ill-health in the longer-term, it was recommended that men should not drink more than 4 standard drinks a day on average, while women should not drink more than 2 standard drinks a day on average.

In addition, risky and high risk levels of consumption in the longer term were described in the guidelines (see Table 1).

Minimising risk in the short term (Guidelines 1.2 and 1.5)

To reduce the risk of injury or illness in the short term, it was recommended that men should not drink more than 6 standard drinks and women should not drink more than 4 standard drinks in any one day.

Similar to the longer term guidelines, risky and high risk levels of consumption in the short term were described in the guidelines (see Table 1).

Alcohol-free days (Guidelines 1.3 and 1.6)

Men and women were also advised to have one or two alcohol-free days per week in order to reduce health risks, including the likelihood of alcohol dependence. These guidelines are not considered in this article.

	Low risk	Risky	High risk
Minimising risk in the longer term
Males	up to 4 standard drinks	5–6 standard drinks	7 or more standard drinks
Females	up to 2 standard drinks	3–4 standard drinks	5 or more standard drinks
Minimising risk in the short term
Males	up to 6 standard drinks	7–10 standard drinks	11 or more standard drinks
Females	up to 4 standard drinks	5–6 standard drinks	7 or more standard drinks

2009 NHMRC GUIDELINES

In 2009, the NHMRC published new guidelines for reducing health risks associated with alcohol consumption. The number of guidelines was reduced to two universal guidelines for healthy adults, one guideline for children and young people, and one guideline for pregnant or breastfeeding women.

These guidelines emphasise that the lifetime risk of disease and injury increases with each drink consumed above the recommended level, rather than specifying levels of 'low risk', 'risky' or 'high risk' consumption as in the 2001 guidelines. The 2009 guidelines were instead based on the estimated cumulative risk of disease and injury that may result from many drinking occasions, as well as the risk of injury arising directly from a single drinking occasion.

As the 2009 guidelines do not represent a 'safe' level of drinking, the measures used in this article (in relation to them) describe proportions of people who 'exceeded' or 'did not exceed' the 2009 guidelines. The terms 'low', 'risky' and 'high risk' are used in relation to the 2001 guidelines.

The 2009 guidelines are described below.

Guideline 1: reducing the risk of alcohol-related harm over a lifetime

This guideline advises that the lifetime risk of harm from drinking alcohol increases with the amount consumed. For healthy men and women, 'drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury' [4].

Guideline 2: reducing the risk of injury on a single occasion of drinking

This guideline advises that on a single occasion of drinking the risk of alcohol-related injury increases with the amount consumed. For healthy men and women, 'drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion' [4]. A single occasion of drinking refers to a person consuming a sequence of drinks without their blood alcohol concentration reaching zero in between.

Guidelines 3 and 4

Guideline 3 relates to consumption of alcohol by children and young people under 18 years of age, while Guideline 4 relates to consumption of alcohol by women who are pregnant, planning a pregnancy or breastfeeding. These guidelines are not considered in this article.

	Does not exceed guideline	Exceeds guideline
Guideline 1 - Lifetime risk	up to and including 2 standard drinks	more than 2 standard drinks
Guideline 2 - Single occasion risk	up to and including 4 standard drinks	more than 4 standard drinks
(a) For both males and females.