Research in Sweden and the United Kingdom Shows a Gap Between Official Drinking Recommendations and Drinkers’ Experiences

A study showed that individuals create their own definitions of risky drinking based on personal experiences, not on recommended quantities.

A new study published in the journal BMC Public Health investigated how adults attempting to reduce their alcohol consumption perceive “risky drinking” and interpret official health guidelines. The research, conducted with 308 participants from Sweden and the UK, revealed a significant disconnect between medical recommendations and how people actually think about alcohol risks.

Methodology and Key Findings

Researchers analyzed written responses from participants seeking online help to moderate consumption. When asked about their definition of “dangerous drinking,” the identified patterns were subjective, based on drinkers’ experiences and consequences of use, rather than abstract categories from official guidelines:

Definitions based on consequences, not quantities:

• Losing control over how much is drunk;
• Using alcohol to cope with depression, anxiety, or loneliness;
• Memory blackouts;
• Harm to work, family, or relationships;
• Obsessive thoughts about the next drink.

Notably, few mentioned specific alcohol quantities, and when they did, the numbers cited significantly exceeded official recommendations.

Reactions to Official Guidelines

After describing their personal perceptions, participants were presented with their countries’ guidelines (maximum 10 standard drinks/week in Sweden; 14 units/week in the UK). Reactions fell into three main categories:

• Skepticism (majority): “Limits are too low; most people I know drink more than 10 drinks per week.”
• Denial: “I’ve been drinking above the recommended amount for 40 years and I’m not an alcoholic.”
• Ambivalence: “I know I drink too much and want to cut down, but it’s hard.”

Differences Between Countries

The study identified important cultural distinctions:

• British participants highlighted specific drink types (straight spirits, shots) as risk markers;
• Swedish participants emphasized cognitive aspects such as intrusive thoughts about alcohol and loss of inhibitory control.

These differences may reflect distinct policies—Sweden maintains a state monopoly on sales and stricter advertising restrictions.

Why These Results Matter

The research has direct public health implications:

• Ineffective communication: Numerical guidelines do not resonate with how people process risk daily;
• Prevention barriers: Those who do not recognize their pattern as risky are unlikely to seek change;
• Need for a new approach: Campaigns should address experiential and emotional aspects, not just quantities.

Practical Recommendations

The authors suggest health professionals should:

• Discuss contexts and motivations for drinking, not just volumes;
• Relate guidelines to concrete, recognizable experiences;
• Address indicators such as drinking alone, self-medication, or loss of control;
• Recognize and work with ambivalence about change.

Study Limitations

The study focused on people already motivated to reduce drinking, which may not represent the general population. Participants had an average age of 59 and mostly university education. Responses were relatively short (average 7-8 words), limiting deeper analysis.

Conclusion

The study demonstrates a gap between how health authorities communicate risk and how individuals perceive it. To increase effectiveness, guidelines and prevention campaigns need to incorporate the experiential language people naturally use to assess their own risk, focusing on consequences, control, and context—not just abstract numbers of drinks or units.

References:

1. Crawford J, et al. Personal perceptions of risky drinking and alcohol guidelines – a qualitative analysis. BMC Public Health. 2025;25:3049. DOI: 10.1186/s12889-025-24296-6