The recent Health Research Board study, Drinking in Denial, is the second study in the last 12 months to look at factors associated with the public’s self-perception of their own drinking and to conclude that lack of awareness of the low-risk drinking guidelines is a problem. Clearly action is needed if we’re to improve understanding of the guidelines to break the cycle of misuse and harm, but also clarity:
“Denial” suggests deliberate disregard and therefore knowledge of what low risk drinking is, but as the data in the study shows, there is little awareness of the low risk drinking guidelines amongst the drinking population. The HRB data concludes this lack of knowledge is a factor in people’s misconception of their harmful drinking, something which has been borne out consistently by the Drinkware Barometer (2018, 2019, 2020).
But if we want to reduce alcohol misuse, it’s important to note that whilst the HRB study shows that many do not recognise their harmful drinking, the Drinkaware Index (2019) critically showed that hazardous drinkers are open to positively changing their behaviour:
- 39% recognised that they would have health problems if they continued to drink in the current manner
- 44% said they had already started to cut down on their drinking
- 26% said they were changing their drinking habits now
Furthermore the metrics of Drinkaware’s proactive and sustained public awareness campaigns on the official HSE public health messaging on standard drinks and low-risk guidelines, show that people are actively seeking this out information and advice:
- The standard drinks and guidelines webpages on drinkaware.ie are among the most viewed, with a combined 430,000 pageviews since 2016.
- Our online drinks calculator has been used by over 660,000 people who sought to understand exactly how much they are drinking and whether it’s within the low-risk limits.
Of note in the Index also is that it quantified for the first time how, as a society, we are aware and accepting of our harmful drinking culture (74% of adults believe that drinking to excess is ‘just a part of Irish culture’). This suggests disassociation of one’s own behaviour, as opposed to outright denial.
We need to break the deep-rooted association of drinking with celebrating, commiserating and coping, and elevate people’s understanding of risk and harm. Because as the HRB study, the Drinkaware Index and successive Drinkaware annual Barometers have shown, people are clearly unaware of what ‘low risk’ is and therefore potentially and unintentionally, drink in a harmful manner.
As noted in the HRB study and other research, messaging and awareness alone will not shift the dial on harmful drinking. Knowledge is an important first part of the journey, but people also need practical capacity-building supports.
The HRB also highlights the prevalence of often-cognisant misuse amongst young Irish men. This mirrors one of the key findings in the Drinkaware Index which prompted the Change the Trend campaign aimed at men under 35, which Drinkaware has been running since last year. Men continuously over index in alcohol related harms and more needs to be done to redress this.
The Public Health Alcohol Act is landmark legislation that can be leveraged to address alcohol misuse, but as this research flags, we also need to fast track awareness of what constitutes low-risk drinking. As per the evidence and best practice, a collective approach to public health messaging that will amplify the reach and the resonance with the public, is what’s required.
But before there is a national campaign, Drinkaware is calling for an urgent collective rethink on how we talk about harmful drinking. This must involve all who work to reduce alcohol misuse and harm, i.e. government, healthcare, researchers, charities including Drinkaware. Do we need low-risk daily limits? What guidelines will resonate with the public? Is the current language – moderate drinking, responsible drinking, binge drinking – ambiguous to the point of being counterproductive.
We suggest therefore that an open and public consultation on the Low Risk Weekly Guidelines be considered. To play our part, we have already garnered public views on the guidelines in our Alcohol & Covid Barometer (2020) and as continuously and publicly stated, are offering to share our data, our learnings and our work.
We welcome further discussions on this, and are calling on the new government and all health stakeholders and communities to work together to promote and embed improved levels health literacy regarding alcohol consumption, to ultimately deliver what is a common goal of an Ireland where alcohol is not misused.