Unite for a Framework Convention for Alcohol Control
Research comment
Summary
In the 2012 UN Political Declaration, when describing the main contributors to the four most prominent non-communicable diseases, the term harmful use is only used to describe alcohol use. Such a term implies that alcohol use can be safe and beneficial.
This assumption could be partly driven by the findings of conventional epidemiology studies indicating moderate alcohol users have a lower risk of cardiovascular disease than abstainers. Such conclusions have been the topic of debate for several decades because moderate alcohol users might have other characteristics that are cardioprotective, rather than alcohol itself (ie, confounding).
Recommendations from some researchers and health-care professionals, together with the alcohol industry’s aggressive and uncontrolled promotion to drink for cardiovascular health, have added to the increasing epidemic of alcohol use.
In a prospective cohort study in The Lancet, Iona Millwood and colleagues showed that, at least for stroke, the apparently protective effects of moderate alcohol consumption were largely non-causal using mendelian randomisation, which is the optimal non-experimental design to minimise confounding.
Conventional epidemiology results on the cardioprotective effect of alcohol, albeit confounded, will likely appear repeatedly, generate confusion, and might be exploited by the alcohol industry to enable market expansion.
Braillon proposed the term moderate alcohol use should be replaced with low risk of drinking, where appropriate, to show that there is a health risk associated with drinking at any level. We further advocate that the term harmful use should no longer be used.
The WHO voluntary global non-communicable diseases target for 2025 of a 10% reduction in harmful alcohol use (which is ill-defined) is unachievable with current approaches. Alcohol control is complex and stronger policies are required. The alcohol industry is thriving and should be regulated in a similar way to the tobacco industry.
The authors advocate and call for,
- A Framework Convention for Alcohol Control
- A stage of alcohol epidemic model (SAEM)
We need to learn from tobacco control and unite to advocate for a FCAC,” wrote the authors, as per Science Direct.