How many cigarettes are there in your bottle of wine?


You probably know that drinking too much alcohol, too often, can damage your liver. You also must know that being drunk carries the risk of physical injury to yourself and those around you. But did you know that alcohol causes cancer?


Alcohol is a known carcinogen. That is, alcohol is a substance that promotes the formation of cancer. However, understanding the risks of alcohol consumption, particularly when it comes to cancer, can be hard to understand and even more difficult to apply to your own drinking, especially with all the conflicting information and social media noise - surely one glass of red at night is okay, if not good for you, right?!?


We all know and can understand the risks of smoking with regards to cancer and there is a new study that I heard about on the ABC Health Report that translates the risks of cancer from drinking into number of cigarettes smoked. 



Drum roll please!











One bottle of wine contains five cigarettes for men and ten cigarettes for women!!!


Or more precisely, consuming one bottle of wine increases the lifetime risk of cancer the same amount as smoking five cigarettes in men and ten cigarettes in women.


Alcohol is known to cause cancer of the mouth, throat, oesophagus (the muscular tube that carries food from the mouth to the stomach), bowel cancer, rectal cancer, liver cancer and, you might be surprised, breast cancer. Other cancers that have been linked to alcohol, in that higher doses of alcohol are associated with higher risks of that cancer, include melanoma and cancers of the gallbladder, prostate, pancreas and lung. And as an aside for those ‘social smokers’ out there, smoking can substantially increase the cancer risk associated with drinking alcohol, especially for cancers of the mouth, throat and oesophagus. That is, smoking causes cancer and other diseases but it also exacerbates the risk of cancers caused by drinking alcohol.


Alcohol and breast cancer?


The risk of cancer increases with increased alcohol consumption, and unfortunately affects women more due to the fact alcohol causes breast cancer. This is well established. A study in the UK has demonstrated that for each extra drink a woman consumes per day there are 15 more cancers per 1000 women, 11 of these are breast cancer. In Australian, one in five breast cancers can be linked to alcohol consumption (data from the cancer council). One bottle per week increases your relative risk* of breast cancer by 10%.


* note: relative risk refers to the increased risk compared to the base line risk of that disease; this 10% increase in breast cancer with 1 bottle of wine per week is the increased risk calculated as a proportion of the average risk of breast cancer which translates into an absolute (or total) risk increase of about 1.25% as the rate of breast cancer in Australia is 1 in 8).


But hang-on what about those studies that say one glass of red is healthy for you?


Unfortunately, those studies have been superseded by new data and new studies. One factor to account for the better outcomes in people who had a small amount of alcohol daily, is that ‘sick-abstainers’, that is, people who did not drink because they were unwell or had stopped drinking because it was harming them, were often included as non-drinkers, skewing the data. The latest study, printed in the Lancet in April this year, really puts the nail in the coffin for health benefits of drinking alcohol. In this global study including data from over half a million people, they found that while there were some protective effects for heart disease and diabetes in women, these very slight benefits were completely outweighed by the risk of harm from alcohol including cancer, injury and other diseases. Basically, there are NO safe levels of alcohol and there are NO health benefits from drinking alcohol.


Dr Holly, you are a killjoy and you can prise the glass of wine out of my cold dead hand!


It is important to note that the study about the number of cigarettes in a bottle of wine is not saying that drinking alcohol in moderation is the same as being an average smoker. The average smoker smokes about 80-100 cigarettes per week, far greater than the risk associated with moderate alcohol consumption. Further, the study looked at cancer risk alone, not the other risks of smoking such as heart disease. The point of the study was to create a way for the public to understand the lifetime cancer risks of alcohol to be able to make informed choices about their alcohol consumption.


Alcohol does cause cancer and it is important to be aware of that. But putting it into perspective, drinking a bottle of wine per week for your life carries about the same risk of driving a car for 50 years. The guidelines of 2 standard alcoholic drinks per day, works out to be about 1% risk of death from alcohol. Death from alcohol occurs due to physical injuries as a result of intoxication, cancer, liver disease, and high blood pressure and heart disease.


I am not suggesting everyone should quit drinking. I like a quote from a Guardian article by Professor David Speigelhalter in the UK:


"Given the pleasure presumably associated with moderate drinking, claiming there is no ‘safe’ level does not seem an argument for abstention. There is no safe levels of driving, but government do not recommend that people avoid driving. Come to think of it, there is no safe of level living but nobody would recommend abstention".

It is important to know that there is NO safe levels of alcohol and NO overall health benefits from drinking alcohol. Knowing this and that a bottle of wine is like smoking five or ten cigarettes may make you take pause and consider your levels of drinking and perhaps make healthier and safer choices for your life.


Resources:


ABC Health Report: April 8th, 2019

Transcript available @ https://www.abc.net.au/radionational/programs/healthreport/how-many-cigarettes-are-in-a-bottle-of-wine/10980712#transcript


The Health report can be heard on ABC radio at 5:30 pm on ABC Radio National (repeated Tuesdays at 5:30 am and Wednesdays at 11 am). 



“How many cigarettes are there in a bottle of wine?” study 
Available @ https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6576-9


UK study on alcohol and breast cancer

Available @ https://academic.oup.com/jnci/article/101/5/296/913713


Cancer cancer data

https://www.cancer.org.au/news/media-releases/media-releases-2011/one-in-five-breast-cancers-linked-to-alcohol.html


Lancet global study on alcohol consumption in over half a million people

Available @ https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30134-X/fulltext


Guardian article

https://www.theguardian.com/society/2018/aug/23/no-healthy-level-of-alcohol-consumption-says-major-study

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