Produced by the LRADG Public Health Working Group October 2013 Low-Risk Drinking: An Informational Presentation on Canada’s Low-Risk Alcohol Drinking Guidelines (LRADGs)

Presentation Outline 1.Introduction to the LRADG Public Health Working Group 2.Introduction and Brief History of the LRADGs 3.Communications Best Practices 4.Resources to Support LRADGs 2

Introduction to the LRADG Public Health Working Group © iStockphoto.com/Nikada 3

4 Coordinate awareness and knowledge exchange strategies with Ontario public health units (PHUs) and key provincial organizations Support PHUs to meet Accountability Agreement targets for and through the performance management indicator: % of the population (19+) that exceed the Low-Risk Alcohol Drinking Guidelines. Co-chaired by Laura Pisko, Ministry of Health and Long-Term Care (MOHLTC) and Dr. Hazel Lynn, Grey Bruce Health Unit Background: Low-Risk Alcohol Drinking Guidelines Public Health Working Group

Organization Ministry of Health and Long-Term Care Liquor Control Board of Ontario Centre for Addiction and Mental Health Ontario Public Health Association Association of Local Public Health Agencies Public Health Units Public Health Ontario Content Experts (invited as guests as needed) 5 Objective: to clarify roles and responsibilities of partners, and produce a knowledge exchange and dissemination plan for Background: Low-Risk Alcohol Drinking Guidelines Public Health Working Group

Background: Canada’s Low-Risk Alcohol Drinking Guidelines 1 Developed by the Canadian Centre on Substance Abuse and endorsed by all Canadian Health Ministers in November 2011 Provide consistent messaging to adults (19+) to promote informed alcohol choices and responsible use Contain key messages for specific groups i.e., youth, pregnant women, specific circumstances, etc. 6

Background: Multi-sectoral Stakeholders 1 Alcohol and Gaming Commission of Ontario Smart Serve LCBO/Parent Action on Drugs Health and Safety Associations Ministry of Finance Ministry of Transportation Ontario College of Family Physicians 7

Introduction and Brief History of Canada’s Low-Risk Alcohol Drinking Guidelines (LRADGs) 1 Source: CCSA, 2013

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What is a Standard Drink? 1 10

Canada’s Low-Risk Alcohol Drinking Guidelines 1 Guideline 1: Daily and weekly limits Guideline 2: Special occasions Women: No more than 3 drinks Men : No more than 4 drinks 11 WomenMen weekly limit of 10 drinks no more than 2 per day plan weekly non-drinking days weekly limit of 15 drinks no more than 3 per day plan weekly non-drinking days

Canada’s Low-Risk Alcohol Drinking Guidelines 1 12 Guideline 3: When zero’s the limit Driving, using machinery or tools Taking medication or other drugs Doing dangerous physical activity Living with mental or physical health problems Alcohol dependent Pregnant or planning to be Responsible for the safety of others Making important decisions

Canada’s Low-Risk Alcohol Drinking Guidelines 1 13 Guideline 4: Zero is safest If you are pregnant or planning to become pregnant, or are about to breastfeed Guideline 5: Delaying drinking If teens choose to drink, they should never drink more than 1-2 drinks at a time and never more than 1-2 times a week. Guidelines should never be exceeded as alcohol can harm the way the body and brain develop.

Canada’s Low-Risk Alcohol Drinking Guidelines Burden 2 Harmful use of alcohol is a leading risk factor for premature death and disabilities, including chronic conditions, such as cirrhosis of the liver along with acute events such as road crashes, injury, and violence Alcohol is carcinogenic: there is no safe lower limit to the risk of cancer associated with alcohol consumption 14 ©iStockphoto.com/Darija Cikac

Canada’s Low-Risk Alcohol Drinking Guidelines Burden 3 Regular moderate-to-heavy alcohol consumption has also been causally associated with type-2 diabetes, adverse cardiovascular outcomes, and cardiovascular disease 17.8 per cent of drinkers report engaging in hazardous or harmful drinking Ontarians avoiding the unhealthy use of alcohol have been shown to increase life expectancy by up to three years 15 © iStockphoto.com/kcline

Ontarians (aged 19+) exceeding Canada’s LRADGs 4 16 Source of information: Canadian Community Health Survey

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Local and regional data 6 Formula uses data from the bi-annual self-reported Canadian Community Health Survey (CCHS) Measures the proportion of population (19 years of age and older) who reported consuming alcohol at levels that exceed Canada’s Low-Risk Alcohol Drinking Guidelines (Guidelines 1 and 2) Contact your local public health epidemiologist for the most current data 18

HomeHome > Data & Analytics > Snapshots 7Data & AnalyticsSnapshots 9 19

Communications Best Practices © iStockphoto.com/fabervisum 20

Communications Best Practices 8 Computer or web-based interventions have been shown to be effective in reducing drinking behaviour, particularly among: Youth High-risk drinkers General population Students within university and college settings Media interventions have little effect on reducing alcohol consumption among women, youth and the general population Media interventions have been shown to be effective in increasing alcohol-related knowledge and awareness among women 21

Communications Best Practices 8 Social norm campaigns have been shown to be effective in modifying normative perceptions, Social norm campaigns have mixed evidence on their effectiveness for behavioural consequences among students within college and university settings. Public health practitioners can help to address the gap in research evidence by evaluating relevant interventions in this population. 22 © iStockphoto.com/fabervisum

Resources to Promote Canada’s LRADGs 1 LRADG Brochure Healthcare providers LRADG Guidelines LRADG Poster LRADG PowerPoint presentation Communicating alcohol-related risk LRADG Frequently asked questions 23

Resources to Promote LRADGs: Screening, Brief Intervention and Referral (SBIR) 1 A new alcohol web resource based on the Low-Risk Alcohol Drinking Guidelines: Developed by CCSA and expert advisory committee Offers a simple, three-step process to family physicians and healthcare professionals for detecting and addressing problematic alcohol consumption 24

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Need more information? Please contact your local public health unit for more information on low-risk alcohol drinking and available resources 26 © iStockphoto.com/fergregory

References 1.Canadian Centre on Substance Abuse. Canada’s Low-Risk Alcohol Drinking Guidelines [homepage on the internet]. 2012; [cited 2013 Aug 28]. Available from: guidelines/Pages/default.aspx guidelines/Pages/default.aspx 2.Cancer Care Ontario, Ontario Agency for Health Protection and Promotion (Public Health Ontario). Taking action to prevent chronic disease: recommendations for a healthier Ontario. Toronto: Queen’s Printer for Ontario; Manuel DG, Perez R, Bennett C, Rosella L, Taljaard M, Roberts M, Sanderson R, Meltem T, Tanuseputro P, Manson H. Seven more years: The impact of smoking, alcohol, diet, physical activity and stress on health and life expectancy in Ontario. An ICES/PHO Report. Toronto: Institute for Clinical Evaluative Sciences and Public Health Ontario; Statistics Canada. Canadian Community Health Survey Ministry of Health and Long-Term Care. Indicator #13: % of population (19+) exceeding Low-Risk Alcohol Drinking Guidelines, by Public Health Unit Ministry of Health and Long-Term Care, Public Health Division. Technical Document: Public Health Accountability Agreement Indicators Version 3. January 17, Public Health Ontario. Snapshots [homepage on the internet]. 2013; [cited 2013 Oct 11]. Available from: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Effectiveness of approaches to communicate alcohol-related health messaging: review and implications for Ontario’s public health practitioners. Toronto, ON: Queen’s Printer for Ontario;