We need a new way of thinking about drinking: Time to replace the ‘standard drink’ with advice people can actually use

When you are out for a drink with colleagues after work, do you order 20 grams of ethanol, or a Negroni? 10 grams of ethanol, or a Pilsner? 16 grams of ethanol, or a glass of Malbec? Unless you are a chemist, it is probably the latter. And yet, most drinking guidelines presume the former. Regulations in some countries have treated consumers like human calculators, expecting them to navigate a world of “units” and “standard drinks” that exist nowhere outside of a laboratory. Recently announced U.S. Dietary Guidelines made a notable shift away from this approach. They dropped daily drink recommendations, effectively abandoning the concept of the “standard drink”. This move allows for a simpler message: adults who choose to drink should do so moderately. As global policymakers consider how to best support moderation, a key question to grapple with is whether guidelines are fit for purpose in the real world. The myth of the standard drink The “standard drink” has always been a fiction that assumes a level of precision and consistency that may be found in a lab but not at a dinner party. Glass sizes vary. Alcohol strengths vary. Wine is often topped up mid-glass. Hard liquor is free-poured at home and in many bars. Most of the world’s top-selling cocktails, like a Negroni, Martini, or Old Fashioned, are often 20%–30% Alcohol by Volume (ABV) or more. Why are consumers being taught that “a drink is a drink” when there are stark differences in how much alcohol different drinks can contain? This challenge is compounded because a “standard drink” varies across borders. A unit of alcohol in Vienna is double the size of one in Madrid. If policymakers and scientists cannot settle on a common definition, it is unrealistic to expect consumers to translate these abstractions into everyday behaviour. And, around the world, alcohol is embedded in different cultures in a variety of different ways, which cann