Health risks of alcohol consumption in Aotearoa New Zealand: modelling to inform low-risk-drinking guidelines.
6 affiliations
- 1Department of Public Health, University of Otago (Wellington), Wellington, New Zealand.
- 2Canadian Centre on Substance Use and Addiction, Ottawa, Canada.
- 3Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada.
- 4School of Public Health and Social Policy, University of Victoria, Victoria, Canada.
- 5Rongowhakaata, Ngāti Porou, Ngāti Kahungunu ki Te Wairoa, Ruapani, Tūranganui-a-Kiwa, New Zealand.
- 6Ngāi Tahu Research Centre, University of Canterbury, Christchurch, New Zealand.
Abstract
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 (LRDGs) in Aotearoa.Methods
We used the New Zealand Alcohol Intervention Model-a multi-state life-table model parameterized with Aotearoa-specific alcohol and epidemiological data-to estimate the health risks associated with a 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 YLL used as a proxy for alcohol-related death, at lifetime-risk thresholds of 1-in-100 and 1-in-1000.Results
When the WHO RR library was used, males reached a 1-in-100 risk of alcohol-attributable death at 8.6 standard drinks (SDs, 10 g of ethanol) [95% uncertainty interval (UI) 3.1-12.0] per week, while females reach this threshold at 9.2 SDs (95% UI 3.7-12.4). The removal of 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, use of the GBD RR library led to more permissive results. Ethnicity-specific results showed that Māori breach the risk thresholds at lower levels of consumption than non-Māori.Conclusion
Our modelling demonstrates that the Aotearoa LRDGs are outdated and need updating to reflect contemporary understandings of the harms associated with alcohol use.
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BibTeX
@article{mizdrak2026health,
title = {{Health risks of alcohol consumption in Aotearoa New Zealand: modelling to inform low-risk-drinking guidelines.}},
author = {Anja Mizdrak and Adam Sherk and Kristen Maynard and Tim Chambers},
journal = {International journal of epidemiology},
year = {2026},
month = oct,
doi = {10.1093/ije/dyag191},
url = {https://europepmc.org/article/MED/42893797},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Health risks of alcohol consumption in Aotearoa New Zealand: modelling to inform low-risk-drinking guidelines.
AU - Anja Mizdrak
AU - Adam Sherk
AU - Kristen Maynard
AU - Tim Chambers
PY - 2026
DA - 2026/10/01
JO - International journal of epidemiology
DO - 10.1093/ije/dyag191
UR - https://europepmc.org/article/MED/42893797
AB - 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 (LRDGs) in Aotearoa.Methods We used the New Zealand Alcohol Intervention Model-a multi-state life-table model parameterized with Aotearoa-specific alcohol and epidemiological data-to estimate the health risks associated with a 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 YLL used as a proxy for alcohol-related death, at lifetime-risk thresholds of 1-in-100 and 1-in-1000.Results When the WHO RR library was used, males reached a 1-in-100 risk of alcohol-attributable death at 8.6 standard drinks (SDs, 10 g of ethanol) [95% uncertainty interval (UI) 3.1-12.0] per week, while females reach this threshold at 9.2 SDs (95% UI 3.7-12.4). The removal of 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, use of the GBD RR library led to more permissive results. Ethnicity-specific results showed that Māori breach the risk thresholds at lower levels of consumption than non-Māori.Conclusion Our modelling demonstrates that the Aotearoa LRDGs are outdated and need updating to reflect contemporary understandings of the harms associated with alcohol use.
SN - 0300-5771
SN - 1464-3685
ER -