Health risk at varying levels of alcohol consumption: modelling to inform low-risk drinking guideline development in Aotearoa — The Association Specialists
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  3. Health risk at varying levels of alcohol consumption: modelling to inform low-risk drinking guideline development in Aotearoa

Health risk at varying levels of alcohol consumption: modelling to inform low-risk drinking guideline development in Aotearoa (23902)

Anja Mizdrak 1 , Adam Sherk 2 , Kristen Maynard 3 , Tim Chambers 4
  1. University of Otago (Wellington), Newtown, WELLINGTON, New Zealand
  2. Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
  3. Koru Ngākau, Aotearoa New Zealand
  4. Ngāi Tahu Research Centre, University of Canterbury, Christchurch, New Zealand

Background
The present study aimed to estimate the alcohol-attributable mortality in Aotearoa New Zealand (Aotearoa) at varying levels of alcohol consumption to help inform low-risk drinking guidelines (LRDG) in Aotearoa.
Methods
We used the New Zealand Alcohol Intervention Model (NZ-AIM), a multi-state life-table model parameterised with Aotearoa -specific alcohol and epidemiological data, to estimate health risks associated with daily alcohol intake of 0–100 g/day. We modelled a cohort of 12-year-olds for their life course, with exposure and disease rates fixed to 2018 levels. We used relative risk (RR) libraries developed by the World Health Organization (WHO) and Global Burden of Disease Study (GBD). The primary output was years of life lost (YLL), with 17.5 YLLs used as a proxy for alcohol-related death, at lifetime risk thresholds of 1-in-100 and 1-in-1,000.
Results
Using the WHO RR library, males reached a 1-in-100 risk of death at 8.6 standard drinks (SDs) (95%UI 3.1 - 12.0) per week, while females reach this threshold at 9.2 SDs (95%UI 3.7 – 12.4). Removing health conditions receiving a one-star evidence rating from the GBD substantially reduced the number of SDs to 2.7 (95%UI 2.1 – 4.6) for males and 3.5 (95%UI 2.9 – 4.4) for females. Across all analyses, using the GBD RR library lead to more permissive results. Ethnicity-specific results showed Māori breached risk thresholds at lower levels of consumption than non-Māori.
Conclusion
Our modelling demonstrates that the Aotearoa LRDG are outdated and need updating to reflect contemporary understandings of the harms associated with alcohol use.