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Citation
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Shield KD, Paradis C, Butt PR, Naimi T, Sherk A, Asbridge M, Myran DT, Stockwell T, Wells S, Poole N, Heatley J, Hobin E, Thompson K, Young MM. Addiction 2024; 119(1): 26-27. |
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Abstract
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We would like to thank Mr Angus and Drs Livingston, Holmes and Greenfield for their commentaries on our debate article [1-4]. These commentaries focus upon (i) the definition, operationalization and communication of health consequences from alcohol use and (ii) the need to communicate how per occasion drinking impacts health.
The Canadian Guidance on Alcohol and Health (CGAH) uses years of life lost (YLL) as the main measure of health loss. However, as noted by the commentators, while YLL are more comprehensive of health loss when compared to death, there is a need for evidence on how the use of YLL affects people's perceptions of alcohol's impact upon health [5].
As noted by the commentators, further research and consultation is needed on the acceptability of alcohol-related risks, and to determine what constitutes low-, moderate- and high-risk. For example, is it appropriate to use Starr's analysis, as we did, or should we determine different risk zone thresholds for different activities? How, then, do we help people compare risk-taking behaviours if variable criteria are used under different circumstances? We acknowledge that the effect of the CGAH risk zone approach (as opposed to a single threshold approach) on a person's perceptions of alcohol's impact upon health are unknown, as there is no evidence on this topic [6]. The CGAH risk zones correspond to Starr's analysis of people's willingness to accept risks from voluntary behaviours [7]. Rather than defining an acceptable risk level, we used the widely accepted 1:1000 and 1:100 life-time-attributable death thresholds as bench-marks to communicate risk. One benefit of using risk zones is that they promote autonomy by avoiding the endorsement of any particular risk threshold as acceptable. Their use also may increase the relevance of guidelines to those for...
Language: en |