Why does society accept a higher risk for alcohol than for other voluntary or involuntary risks?

BMC Medicine

Robin Room³  Dirk W Lachenmeier¹  Jürgen Rehm² 

[1] Chemisches und Veterinäruntersuchungsamt Karlsruhe, Karlsruhe, Germany;Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany;Centre for Social Research on Alcohol & Drugs, Stockholm University, Stockholm, Sweden

关键词: Voluntary versus involuntary risk;    Risk;    Patterns of drinking;    Mortality;    Alcohol;    Acceptable risk;   

Others  :  1118433
DOI  :  10.1186/s12916-014-0189-z

 received in 2014-08-19, accepted in 2014-09-18,  发布年份 2014

【 摘 要 】

Background

Societies tend to accept much higher risks for voluntary behaviours, those based on individual decisions (for example, to smoke, to consume alcohol, or to ski), than for involuntary exposure such as exposure to risks in soil, drinking water or air. In high-income societies, an acceptable risk to those voluntarily engaging in a risky behaviour seems to be about one death in 1,000 on a lifetime basis. However, drinking more than 20 g pure alcohol per day over an adult lifetime exceeds a threshold of one in 100 deaths, based on a calculation from World Health Organization data of the odds in six European countries of dying from alcohol-attributable causes at different levels of drinking.

Discussion

The voluntary mortality risk of alcohol consumption exceeds the risks of other lifestyle risk factors. In addition, evidence shows that the involuntary risks resulting from customary alcohol consumption far exceed the acceptable threshold for other involuntary risks (such as those established by the World Health Organization or national environmental agencies), and would be judged as not acceptable. Alcohol’s exceptional status reflects vagaries of history, which have so far resulted in alcohol being exempted from key food legislation (no labelling of ingredients and nutritional information) and from international conventions governing all other psychoactive substances (both legal and illegal). This is along with special treatment of alcohol in the public health field, in part reflecting overestimation of its beneficial effect on ischaemic disease when consumed in moderation.

Summary

A much higher mortality risk from alcohol than from other risk factors is currently accepted by high income countries.

【 授权许可】

   
2014 Rehm et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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