Women and alcohol: To your health?

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Publication Date: 
Wed, 2012-06-06

Alcohol is a carcinogen, and the risks of drinking far outweigh the protective factors. For some time, there has been a clear causal link between alcohol and a wide variety of cancers, including two of the most frequently diagnosed: breast and colorectal. According to a recent study in the British Medical Journal, alcohol consumption is directly responsible for one in 10 cancer cases for men, and one in 33 for women. Rehm underscores the fact that very few Canadians are aware that a daily drink increases the risk of breast cancer. Quadruple your intake, quadruple your risk.

When it comes to weekly risky drinking—broadly defined as five drinks or more on at least one occasion in the past week—rates rose significantly between 2003 and 2010 for the following age groups: underage girls, women 25 to 34, those 45 to 54 and 54 to 64. During that same time frame, the rates of risky drinking dropped significantly for young adult males aged 18/19 to 24.

And according to Gerald Thomas, senior researcher and policy analyst for the Canadian Centre on Substance Abuse (CCSA), if the measure were adjusted appropriately for the female gender—namely four drinks at one sitting, rather than five—the increase in risky drinking would likely run 35 to 45 per cent higher across all age groups. Says Thomas, “No-one knows if this upward trend among younger drinkers will translate into a larger number of women with alcohol problems later in life.”

Most alarming? These numbers are based on self-reported figures—figures that are way out of synch with what is sold in liquor stores across Canada. Researchers like Thomas know that Canadians under-report what is consumed by roughly 70 per cent.

If you account for what is bought in Canada, we currently drink 8.2 litres of pure alcohol per person over the age of 15, on average, on an annual basis. Our consumption is more than 50 per cent above the world average, and there is a growing convergence between consumption rates for men and women.

In fact, alcohol consumption is on the rise in much of the world, and in many countries, female drinkers are driving that growth.  “Women who are now in their 40s and 50s have a very high risk in terms of heavy drinking, and weekly drinking,” says Katherine Keyes, a post-doctoral fellow at Columbia University in New York and co-author of a recent study in Alcoholism: Clinical & Experimental Research. Having reviewed 31 international studies of birth-cohort and gender differences in alcohol consumption and mortality, she and her fellow authors concluded that younger groups, especially female, were increasingly at risk for developing alcohol-related disorders. “Those born between 1978 and 1983 are the weekend warriors, drinking to black out. In that age group, there is a reduction in male drinking, and a sharp increase for women.”

Most importantly, the study points to the critical role of societal elements in creating a drinking culture. “Traditionally, individual biological factors have been the major focus when it comes to understanding alcohol risk,” says Keyes. “However, this ignores the impact of policy and environment.” The one protective factor for women? Low-status occupations. “Those in high-status occupations, working in male-dominated environments, have an increased risk of alcohol use disorders.”

“This is a global trend: the richer a country, the fewer abstainers, the more women drink, and the smaller the gap between men and women,” says CAMH’s Rehm. “The new reality is that binge drinking has been increasing, especially among young adults, in modern high-economy countries—and women are largely responsible for this trend.”

Says Keyes: “We’re not saying go back to the kitchen and put down the sherry. But when we see these steep increases, you wonder if we are going to see a larger burden of disease for women.”

Drug of choice

Male and female: Canadians choose alcohol as their drug of choice, and it’s lucrative—if you look at one side of the ledger. In 2010, alcohol sales totalled $19.9 billion. However, the direct alcohol-related costs for healthcare and enforcement exceed the direct revenue from alcohol in most jurisdictions. “More than 80 per cent of our population over 15 drinks,” says Rehm, “which causes a lot of death. An average alcohol-related death is under 55— and that means it’s a combination of cancers, heart disease and injuries. By drinking, people are setting themselves up for morbidity and mortality issues.”

When it comes to alcohol, we live in a culture of denial. With alcoholics representing roughly two per cent of the population and more than 80 per cent of us drinking, it’s the widespread normalization of heavier consumption that translates to a national health burden. The top 20 per cent of the heaviest drinkers consume 73 per cent of the alcohol in Canada.

Episodic binge drinking by a large population of nondependent drinkers has a huge impact on the health and safety of the community. That larger group is well represented in the numbers missing work, getting injured or being hospitalized. When compared to those who drink moderately, risky drinkers are more than 12 times as likely to report significant harms, ranging from violence to car accidents. Says the pragmatic Rehm, who is not a prohibitionist by any stretch of the imagination: “A lot of hospital waiting lists would not exist if we eliminated alcohol in our society.”

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