It should always be Dry January, according to new guidelines on alcohol consumption released in Canada, concluding no amount of alcohol is safe and having any more than two drinks a week is risky.
The report by the Canadian Centre on Substance Use and Addiction (CCSA) marks a big shift from its previous guidelines in 2011, which recommended no more than 15 drinks for men and 10 drinks for women per week to reduce long-term health risks.
They're also dramatically different to current Australian guidelines, which say healthy men and women should drink no more than 10 standard drinks a week.
The CCSA has also called for health warning labels that include cancer risks to be placed on alcohol containers, and there have been similar calls for the same to happen in Australia.
So how much alcohol is safe? Why do guidelines vary? And should there be health labels on alcohol bottles? Let's take a closer look.
What did the Canadian report find?
The CCSA report was two years in the making and involved a panel of about two dozen experts examining nearly 6,000 peer-reviewed studies.
The University of Saskatchewan's Peter Butt, who co-chaired the project to develop the guidance, told the ABC lots of new evidence had emerged since the last guidelines were released more than a decade ago.
Crucially, the new guidelines have found there is no safe level of alcohol consumption, and that any more than two drinks a week poses a risk to health.
"Risk increases with the amount consumed, and by our definition of 'low risk' — which is an international one with regards to people engaging in voluntary activity — what we found is one to two of our standard drinks per week would be considered low, three to six of our standard drinks per week would be considered moderate, and seven plus would be considered increasingly high in terms of the risk zones," Dr Butt said.
What risks are we talking about?
The new recommendations lay out a spectrum of risks, finding danger increases with every additional drink.
Three to six drinks a week increases the risk of developing certain cancers, like colorectal and breast cancer, while more than seven drinks a week also increases your risk of heart disease and stroke.
Dr Butt said the risk jumped "exponentially" beyond that.
"Once you get into the seven plus range, then you are at an increasingly high level of risk," he said.
"And this is where people are strongly advised to position their drinking with regards to these risk zones and decrease, less is better when it comes to alcohol consumption," he said.
But he said it's not all doom and gloom.
"Just as the risk increases as you increase consumption, the good news is, if you decrease by one drink per day or per week, you're decreasing your risk and, thereby, improving your health and wellbeing."
The report cited the most recent available data that shows the use of alcohol causes nearly 7,000 cancer deaths each year in Canada, with most cases being breast or colon cancer, followed by cancers of the rectum, mouth and throat, liver, oesophagus and larynx.
Health Canada has said it looked forward to receiving the updated guidance from the CCSA, and to reviewing any recommendations.
What else was in the Canadian guidelines?
The CCSA report also found mandatory labelling of all alcoholic beverages with health warnings would be effective in increasing awareness of the link between cancer and alcohol.
The calls received immediate pushback from parts of the Canadian alcohol industry, which argued they were already informing consumers of the risks associated with alcohol.
There have been similar calls for alcohol labelling in Australia, with the Cancer Council saying it would be a powerful way of raising awareness.
Tobacco plain packaging with their accompanied graphic pictures are is often cited in this debate, with proponents arguing three years after full implementation an estimated 100,000 fewer Australians smoked.
Unsurprisingly, the alcohol industry in Australia has opposed any cancer warning labels, saying there is "no scientific justification" for them.
What do Australia's guidelines say?
Australia's guidelines were revised in 2020, and say to reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.
The guidelines say the less you drink, the lower your risk of harm from alcohol.
When making their recommendations, the guidelines committee chose the threshold for low risk as being a one-in-100 risk of dying from alcohol-related disease or injury.
Why do guidelines vary between countries?
The amount of alcohol considered "low risk" has long depended on where you live.
It's been a huge source of frustration for health experts, with Stanford Medicine researchers also finding the amount of alcohol in each country's "standard drink" ranged from 8 to 20 grams.
When you then consider the grams each drink contains will vary based on volume, you're left trying to come up with a Beautiful Mind-style algorithm to calculate how many drinks you should have before you have even taken a sip.
And even when standard drinks have the same definition, guidelines can still vary dramatically.
For example, like Australia, Ireland defines a standard drink as 10 grams of alcohol. But unlike Australia, its guidelines state the weekly low-risk alcohol guidelines are fewer than 11 standard drinks for women and 17 standard drinks for men.
Many countries also provide different definitions of low-risk drinking, or the amount of alcohol that can be consumed each day or week without experiencing adverse health effects.
Stanford researchers argue the variability in guidelines reflects the need for more study about responsible alcohol consumption, and also the difference in cultural attitudes among countries.
So do guidelines matter?
Researchers say it is unclear whether guidelines adopted as public policy prompt people to change their behaviour as a result.
But the Department of Health argues guidelines do matter when it comes to reducing the burden of disease.
"It is important to ensure that consumers have access to accurate and clear information about what they consume and its impacts, in order to make informed decisions," a spokesperson told the ABC.
"Alcohol is identified as a priority substance in the National Drug Strategy, with the consumption of alcohol contributing toward a range of adverse health outcomes, and significantly increasing Australia's burden of disease."
