By Lauren Smith

Updated: 22 May 2023 & medically reviewed by Dr. Kimberly Langdon

Citing the risk of cancer and heart disease, the Canadian Centre on Substance Use and Addiction (CCSA) has recommended that Canadians limit themselves to just two alcoholic drinks per week, and said no amount of drinking is risk-free.

Beer being served in a Canadian bar

Recommendations reflect latest research into drinking risks

The recommendations have spurred debate in a country where the majority of adults regularly consume alcohol. In 2021, two-thirds (66%) of Canadians 15 and over reported drinking at least once in the previous month.[1]

The guidelines also mark a sharp change from the CCSA’s previous guidelines, issued in 2011, which stated that men could consume 15 drinks per week and women ten drinks with low risk to their health.[2]

But the panel that drafted the new guidance said they are based on the latest research into alcohol’s health hazards, which found elevated risks of breast and colon cancers, strokes, and heart disease, as well as accidents and violence.

The panel specifically pointed to a 2019 study from the UK that compared the cancer risks of alcohol and tobacco. The study found that one standard drink delivers an equivalent cancer risk of one cigarette for men and two for women.[3]

While they acknowledged the comparison is flawed because cigarettes are more addictive, they still said the findings were relevant.[4]

“We wanted to simply present the evidence to the Canadian public, so they could reflect on their drinking and make informed decisions,” said Peter Butt, professor of family medicine at the University of Saskatchewan and member of the panel. “It’s fundamentally based on the right to know.”[5]

“This isn’t about prohibition.”

Under the new guidelines, consuming two drinks per week is classed as a low risk to health. Three to six drinks per week is considered a moderate risk for both men and women, and consuming seven or more drinks is high risk. The only no-risk behavior is avoiding alcohol entirely. 

However, Butt said the guidelines aren’t “about prohibition,” but rather encouraging people to monitor and reduce their alcohol consumption.

The guidelines also state that no amount of alcohol is safe while pregnant or trying to get pregnant. Abstinence is also the safest option while breastfeeding, but one standard drink occasionally doesn’t significantly elevate risks.

The CCSA also called for mandatory labeling of alcoholic beverages to inform people of these new guidelines and the possible health risks of drinking.

In Canada, a standard drink contains 13.6 grams of pure ethanol, roughly the amount in a 12-ounce bottle of 5% beer or cider, a 5-ounce glass of 12% wine, or a 1.50-ounce shot of 40% hard liquor.[6]

Skepticism from some experts

However, other experts criticized the revised guidelines. Dan Malleck, a professor of health sciences at Brock University and a historian of alcohol and drug policy, described them as “irresponsible,” as they risk creating “anxiety and stress” among Canadians who enjoy alcohol in moderation.

“The research they’re using also ignores the enjoyment and pleasure and stress relief and collegiality associated with alcohol. None of those things are in the calculation whatsoever,” he added.

Malleck also argued that the evidence used by the authors showed no evidence of a “radical” risk of cancer from moderate drinking, except in people with liver diseases and pre-existing oral cancers. 

Butt said the panel calculated risk using internationally accepted mortality risk standards. The two-drink limit was associated with a one in 1,000 chance of premature death, while six drinks per week led to a one in 100 chance of premature death.

Related: Types of alcohol

Canada’s new guidelines are substantially lower than those in other countries

Canada’s new guidelines on drinking are substantially more stringent than those endorsed by other countries. In the United States, health officials recommend drinking be limited to two drinks per day for men and one for women, with a standard drink being around 14 ounces of ethanol (similar to Canada’s standard drinks).[7]

In the UK, the National Health Service recommends drinking no more than 14 units of alcohol per week, spread over three days or more. A unit is 10ml or 8g of ethanol and 14 units per week translates to six pints of average-strength beer or 10 small glasses of wine.[8]