Outdated alcohol guidelines understate health risks, ministry documents reveal
Photo:
RNZ
New Zealand's official low-risk drinking guidelines are outdated and "understate the health risks" of alcohol, according to Health New Zealand (HNZ) documents.
Efforts to update the guidelines were halted after
alcohol lobbyists complained
to a Ministry of Health general manager Ross Bell.
Bell, who works within the ministry's Public Health Agency, says he intervened to clear up confusion about whether HNZ or the Ministry of Health (MOH) should manage the guidelines.
He said the MOH would manage them now but that work was on hold while it considered its priorities.
Documents released to RNZ under the Official Information Act show why HNZ considered updating the safe drinking guidelines was crucial and that it saw "scrutiny from the alcohol industry" as a risk factor in the process.
New Zealand's drinking guidelines say that to stay low-risk, men should have no more than 15 drinks per week and women ten.
The maximum number of drinks recommended per week to stay low-risk (for men and women) is set at two in Canada, ten in Australia and 14 in the UK.
Canada, Australia and the UK all significantly reduced their safe drinking guidelines in recent years as evidence emerged about the health risks of alcohol, which is linked to seven types of cancer.
Photo:
RNZ
A November 2024 memo from HNZ alcohol harm prevention manager Tom Devine said New Zealand's guidelines, written in 2011, were now out of date.
"The evidence around alcohol and its risks to health has evolved since then and other countries like ours, such as the United Kingdom (in 2016), Australia (in 2020), and Canada (in 2023), have updated their Alcohol & Health Advice, resulting in much lower recommended drinking limits," Devine wrote. "The current advice is complex (and) out of step with other jurisdictions."
He said the current guidelines also did not meet the needs of pregnant and breast-feeding women and young people. "A review and update are necessary to ensure the advice is clear, inclusive and based on the most up-to-date evidence."
Another HNZ document, written in January 2024, said "The current advice does not reflect the latest scientific evidence meaning that it understates the health risks from alcohol."
The documents show HNZ commissioned Massey University to work on the first phase of a review in February 2024 - at a cost of about $130,000 - but later that year Ross Bell from the Ministry of Health intervened.
Emails obtained by RNZ show a lobbyist with the Brewer's Association emailed Bell in October 2024 asking why a HNZ website was reporting that the drinking guidelines were under review.
He emailed again a month later complaining that references to the review were still on the alcohol.org.nz website, run by HNZ, and also took issue with the fact the site linked to Canadian drinking guidelines.
Bell emailed HNZ in December 2024: "All work on this project will now pause. You will update relevant Health NZ websites to remove references to the review and also to other jurisdictions' guidelines (including the Canadian one)."
Bell has declined requests for an interview with RNZ, but in a previous statement said material was removed from the website to avoid confusion, as the drinking guidelines were now led by the Ministry of Health not Health New Zealand, which runs the alcohol.org.nz website.
He said that was an internal decision by MOH and that a review of the drinking guidelines was now on hold while the ministry considered its priorities.
But the documents released to RNZ show HNZ believe it is crucial to update the guidance.
A memo from HNZ alcohol harm prevention manager Tom Devine said health professionals relied on accurate guidelines, which were "foundational" for screening, interventions and referral for treatment.
"This is where health professionals ask patients about their alcohol consumption using the advice as a baseline to assess risk, which informs the need for brief interventions or referral for counselling or treatment."
Devine's memo said one of the risks in reviewing the guidelines was "scrutiny from the alcohol industry" and his mitigation strategy included "a strategic communications plan to articulate the evidence base and reasoning".
Associate Professor Andy Towers, the co-director of the Mental Health & Addiction Programme at Massey University, worked on the initial stages of the review for HNZ.
He said the current guidelines understated the risk.
"There's more and more evidence now, especially with longitudinal health data, to show that even low levels of alcohol use over a long time can result in some significant alcohol related harms."
He said sticking with the 2011 guidelines could lull drinkers into a false sense of security.
"For us to set low risk advice thresholds that are quite high, much higher than other countries, means that we will continue to have serious alcohol related harms occurring across the country, in communities, and that will flow through into hospitals."
Cancer Society evidence and insights lead Emma Shields said a review of the drinking guidelines was needed to bring them into line with the latest evidence and international guidance.
She said alcohol caused seven different types of cancer including breast, bowel and oesophageal. "When it comes to cancer risk, there is no 'safe' level of alcohol use, and even small amounts of alcohol increase the risk of cancer."
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