Alcohol is an accepted part of many cultures as a means of relaxation and celebration and can have a positive impact on social and community life. The alcohol industry provides employment through production, retail and the night-time economy. However, as a widely available intoxicant and potentially addictive substance, it lends itself to misuse and has associated health risks.

This section will focus on alcohol consumption at increasing risk level, including binge drinking (see definitions sections). High risk and dependent drinking are covered in the Mental health and substance misuse JSNA chapter.

Current guidance from the government’s Chief Medical Officer (CMO) on safe and risky levels of alcohol consumption are summarised in Box 1.  These revised guidelines suggest that there is no safe level of alcohol consumption.

Box 1: Current CMO guidelines on alcohol consumption 12

In January 2016, the CMO published revised guidelines in relation to alcohol risk.

The new guidelines state that:

  • lower-risk drinking is now defined as less than 14 units a week for both men and women, spread over at least 3 days a week
  • there is no safe level of consumption.
  • a good way to cut down on alcohol is to have several drink-free days each week.

The CMO is presently consulting on risk levels, but the previous definition implies that the revised ‘increasing risk’ level would be 15–35 units per week for men and women.

It is worth noting that people tend to under-report the amount of alcohol they consume, so measures reliant on self-reporting (as described in this section) are likely to underestimate population levels of drinking.  Heavy drinking and non-routine drinking patterns, in particular, may be associated with greater under-reporting, and so estimates of drinking above recommended levels are likely to be disproportionately under-estimated. 3

With these caveats in mind, trends since 2005 show that there has been an overall decline in drinking frequency in the UK, which has been most marked for men and women up to age 44. 4

Increasing risk and binge drinking is a public health issue for a variety of reasons. A recent report identified alcohol to be the third leading risk factor for death and disability after smoking and obesity. 5 6 Alcohol has been identified as a causal factor in more than 60 medical conditions, including:  7

  • mouth, throat, stomach, liver and breast cancers
  • pancreatitis
  • heart disease & stroke
  • liver disease.

Alcohol misuse is also strongly linked to mental health problems, including depression and serious mental illness (for more detail see ‘Mental health and substance misuse’ JSNA chapter). The national confidential inquiry into suicide and homicide by people with mental illness found that there was a history of alcohol misuse in almost half (45%) of suicides in this group during the period 2002 to 2011. 8

There are specific risks for young people in terms of alcohol consumption. Alcohol consumption during any stage of childhood can be harmful for child development, and heavy drinking in young people carries risks in relation to liver, bone, growth and endocrine development. A Alcohol use during the teenage years, and especially before age 14, is related to a wide range of health and social problems, including alcohol-related injuries, involvement in crime, and suicidal thoughts and attempts (or suicide ‘ideation’). Drinking at an early age is also associated with having more sexual partners, unwanted pregnancy, using drugs, not being in education, employment or training, and other risky behaviours. 9 10

Alcohol misuse also places particular pressure on health services. For example, in 2013/14, there were over a million hospital admissions for alcohol-related ill-health in the UK, an increase of 64% since 2005. [12] In addition, an estimated 35% of accident and emergency (A&E) attendances are alcohol-related (rising to 70% at weekend peak-times), and 22-35% of GP visits are alcohol-related. 11

Drinking alcohol during pregnancy can also have a medical impact on the unborn child. The effects include a greater risk of miscarriage, low birthweight and premature birth. Drinking heavily throughout pregnancy can cause foetal alcohol syndrome (FAS), which is associated with poor foetal growth, facial abnormalities and learning and behavioural difficulties. 12

Finally, alcohol is a significant factor in violent crime, with almost half (47%) of victims perceiving their attacker to be under the influence of alcohol. More violent crimes are recorded between 9pm and 3am on Fridays and Saturdays than at other times in the week. 13  Please see ‘Society and environment’ JSNA chapter for further discussion of the health impacts of crime.


  1. The glands of the endocrine system and the hormones they release are instrumental in regulating mood, growth and development, tissue function, and metabolism, as well as sexual function and reproductive processes


  1. Drinkaware, “Drinkaware Alcohol Guidelines,” 2016. [Online]. Available: [Accessed 17 October 2016].
  2. Department of Health , “UK Chief Medical Officers’ Alcohol Guidelines Review Summary of the proposed new guidelines,” 2016. [Online]. Available: [Accessed 15 August 2016].
  3. M. Livingston and S. Callinan , “Underreporting in alcohol surveys: whose drinking is underestimated?,” J Stud Alcohol Drugs, vol. 76, no. 1, pp. 158-64, 2015.
  4. Office for National Statistics, “Adult Drinking Habits in Great Britain: 2014,” 2016. [Online]. Available:
  5. Public Health England, “Health Matters: Harmful Drinking and Alcohol Dependence,” 2016. [Online]. Available: [Accessed 15 August 2016].
  6. WHO, “WHO Global Alcohol Report,” [Online]. Available: [Accessed 18 October 2016].
  7. Public Health England, “Health Matters: Harmful Drinking and Alcohol Dependence,” 2016. [Online]. Available: [Accessed 15 August 2016].
  8. University of Manchester , “National confidential inquiry into suicide and homicide by people with mental illness,” 2015. [Online]. Available: [Accessed 15 August 2016].
  9. CMO Department of Health , “Guidance on the consumption of alcohol by children and young people,” 2009. [Online]. Available: [Accessed 15 August 2016].
  10. R. Green and A. Ross, “Young people’s alcohol consumption and its relationship to other,” 2010. [Online]. Available: [Accessed 18 October 2016].
  11. Currie et al, “Alcohol-specific activity in hospitals in England,” Nuffield Trust, 2015. [Online]. Available: [Accessed 15 August 2016].
  12. NHS, “Alcohol in Pregnancy – NHS Choices,” [Online]. Available: [Accessed 18 October 2016].
  13. Office for National Statistics, “Crime Statistics, Focus on Violent Crime and Sexual Offences: Year ending March 2015,” February 2016. [Online]. [Accessed 31 March 2016].