This is reblogged from the excellent Alcohol IBA blog about setting achievable goals and the dose effect:
Mentioning either ‘units’ or the ‘guidelines’ alone can trigger a sceptical response from a drinker. I’m sure you’ve heard someone protest that “units are confusing” or that they “don’t believe the guidelines”. How should we respond to such statements or beliefs?
Firstly we should accept that people may have ambivalent attitudes about their drinking and may appear dubious or dismissive of health advice we may offer. They may also be right; units can be confusing and hard to keep track of, and we can’t take a ‘one size fits all’ health guideline too literally.
However the principle behind understanding units and applying these to the guideline is important. Consuming any drug – including alcohol – can be considered in terms of the ‘dose effect’ (or the dose-response relationship). Essentially, the greater the dose consumed, the greater the chance of unwanted (as well as perhaps wanted) effects. The recommended guidelines therefore set out the approximate ‘dose’ (in units) which alcohol can be consumed with a low risk of negative effects.
A crucial consideration here is that there is no clear ‘threshold effect’, or no point at which the dose the longer matters. Put simply, the more you drink, the greater the risks . This is important because even if someone says ‘forget the guidelines, I’m never going to stick to them’, they still may be open to considering the fact that 5 pints is still less risky than 6.
There is evidence that some people who drink to get drunk only consider their ‘limits’ in terms of behaviour and whether they are ‘in control’. As such, health guidelines may not feel relevant for them. But emphasising that reducing health or behavioural risks still applies in terms of how much they drink. One message that has been found to be possibly more appealing is to try and ‘drink 2 less’, rather than perhaps ‘only drink 2’! And perhaps more importantly, it may feel much more achievable.
Now the purist, all or nothing part of me, disapproves of this because for me it wasn’t the answer but actually this was part of my journey too. We have to meet people where they are and if this works for them then who I am to disagree? Plus if you are drinking over a bottle of wine a night and drinking 2 less means you are able to reduce the amount you are drinking enough to not require medical support with stopping then this makes it less daunting and more doable which has to be a good thing. So having used the 7t’s —take time to think the thing through, or as Prim would say responding rather than reacting, I see it quite differently. What do you think?