OBJECTIVE Many countries propose low-risk drinking guidelines (LRDGs) to mitigate alcohol-related harms. North American LRDGs are high by international standards. We applied the International Model of Alcohol Harms and Policies (InterMAHP) to quantify the alcohol-caused harms experienced by those drinking within and above these guidelines. We customized a recent Global Burden of Disease (GBD) analysis to inform guidelines in high-income countries. METHOD Record-level death and hospital stay data for Canada were accessed. Alcohol exposure data were from the Canadian Substance Use Exposure Database. InterMAHP was used to estimate alcohol-attributable deaths and hospital stays experienced by people drinking within LRDGs, people drinking above LRDGs, and former drinkers. GBD relative risk functions were acquired and weighted by the distribution of Canadian mortality. RESULTS More men (18%) than women (7%) drank above weekly guidelines. Adherence to guidelines did not eliminate alcohol-caused harm: those drinking within guidelines nonetheless experienced 140 more deaths and 3,663 more hospital stays than if they had chosen to abstain from alcohol. A weighted relative risk analysis found that, for both women and men, the risk was lowest at a consumption level of 10 g per day. For all levels of consumption, men were found to experience a higher weighted relative risk than women. CONCLUSIONS Drinkers following weekly LRDGs are not insulated from harm. Greater than 50% of alcohol-caused cancer deaths are experienced by those drinking within weekly limits. Findings suggest that guidelines of around one drink per day may be appropriate for high-income countries.

中文翻译：

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低风险指南中的饮酒是否可以预防危害？使用国际酒精危害和政策模式对高收入国家的影响

目标许多国家提出了低风险饮酒指南（LRDG），以减轻与酒精有关的危害。按国际标准，北美的LRDG较高。我们应用了国际酒精危害和政策模型（InterMAHP）来量化那些在这些准则之内和之上的饮酒者所遭受的酒精造成的危害。我们定制了最近的全球疾病负担（GBD）分析，以为高收入国家提供指南。方法访问加拿大的记录级死亡和住院时间数据。酒精暴露数据来自加拿大物质使用暴露数据库。InterMAHP用于估计在LRDG内饮酒的人，在LRDG上饮酒的人以及以前的饮酒者的酒精引起的死亡和住院时间。获取GBD相对风险函数并通过加拿大死亡率的分布加权。结果高于每周指南的男性（18％）多于女性（7％）。遵守准则并不能消除酒精造成的危害：与准则中选择戒酒的人相比，在准则中饮酒的人仍然有140多例死亡和3,663例住院时间。加权相对风险分析发现，对于男性和女性，每天摄入10 g的风险最低。对于所有消费水平，发现男性的加权相对危险度都比女性高。结论每周LRDG饮用者不能免受伤害。每周饮酒的人中有超过50％的酒精引起的癌症死亡。