Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?
Open Access
- 21 October 2014
- journal article
- opinion
- Published by Springer Science and Business Media LLC in BMC Medicine
- Vol. 12 (1), 1-6
- https://doi.org/10.1186/s12916-014-0189-z
Abstract
Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking. The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol’s exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation. A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.Keywords
This publication has 28 references indexed in Scilit:
- Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approachInternational Journal of Cancer, 2012
- Surveying the range and magnitude of alcohol's harm to others in AustraliaAddiction, 2011
- Epidemiology-based risk assessment using the benchmark dose/margin of exposure approach: the example of ethanol and liver cirrhosisInternational Journal of Epidemiology, 2010
- The relation between different dimensions of alcohol consumption and burden of disease: an overviewAddiction, 2010
- Awareness of lifestyle risk factors for cancer and heart disease among adults in the UKPatient Education and Counseling, 2009
- Competing Risks in Mortality AnalysisAnnual Review of Public Health, 1991
- Alcohol Control and Public HealthAnnual Review of Public Health, 1984
- Acceptable RiskJournal of the Operational Research Society, 1983
- The Gentlemen's Club: International Control of Drugs and Alcohol.Contemporary Sociology: A Journal of Reviews, 1976
- Social Benefit versus Technological RiskScience, 1969