Standard drink

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United States standard drinks of beer, malt liquor, wine, and spirits compared. Each contains about 14 grams or 17.7 ml of ethanol. NIH standard drink comparison.jpg
United States standard drinks of beer, malt liquor, wine, and spirits compared. Each contains about 14 grams or 17.7 ml of ethanol.

A standard drink or (in the UK) unit of alcohol is a measure of alcohol consumption representing a fixed amount of pure alcohol. The notion is used in relation to recommendations about alcohol consumption and its relative risks to health. It helps to educate alcohol users. [1] A hypothetical alcoholic beverage sized to one standard drink varies in volume depending on the alcohol concentration of the beverage (for example, a standard drink of spirits takes up much less space than a standard drink of beer), but it always contains the same amount of alcohol and therefore produces the same amount of drunkenness. [1] Many government health guidelines specify low to high risk amounts in units of grams of pure alcohol per day, week, or single occasion. These government guidelines often illustrate these amounts as standard drinks of various beverages, with their serving sizes indicated. Although used for the same purpose, the definition of a standard drink varies from country to country.

Contents

Labeling beverages with the equivalent number of standard drinks is common in some countries.

Definitions in various countries

There is no international consensus on how much pure alcohol is contained in a standard drink; [2] values in different countries range from 8 to 20 grams (0.28 to 0.71 ounces). The example questionnaire form for the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) uses 10 g (0.35 oz), [3] and this definition has been adopted by more countries than any other amount. [4] Some countries choose to base the definition on mass of alcohol (in grams) while others base the unit on the volume (in ml or other volume units). [1] For comparison, both measurements are shown here, as well as the number of standard drinks contained in 500 millilitres (16.9 US fluid ounces) of 5% ABV beer (a typical large size of beer in Europe, slightly larger than a US pint of 473 mL). The terminology for the unit also varies, as shown in the Notes column.

Amount of pure alcohol (in grams or millilitres) contained in a standard drink, as defined in different countries.
CountryMass
(g)
Volume
(mL)
Ratio to WHO AUDIT's example (10 g [3] )Is 10 gNotes
Albania [5] 1012.71Yes
Albania [5] 1417.71.4No
Australia [4] [6] 1012.71Yes
Austria [4] [5] 2025.32No
Benin [5] 1417.71.4No
Bosnia and Herzegovina [5] 1012.71Yes
Canada [4] [7] [8] 13.6 or 13.45 [9] or 13.5 [10] 17.2 or 17 [9] 1.36 or 1.35NoThis specific unit is computed based on the oz definition as:
  • 12 oz (341 mL) bottle of 5% alcohol beer, cider or cooler
  • 1.5 oz (43 mL) shot of 40% hard liquor (vodka, rum, whisky, gin etc.)
  • 5 oz (142 mL) glass of 12% wine. [11]
Costa Rica [5] 8100.8No
Croatia [5] 1012.71Yes
Denmark [4] [5] 1215.21.2No
Estonia [5] 1012.71Yes
Fiji [5] 1012.71Yes
Finland [12] 1215.21.2No
France [4] 1012.71Yes
Georgia [5] 1012.71Yes
Germany [4] [13] 1113.81.1NoStandardglas defined as containing 10–12 g (central value used here)
Guyana [5] 8100.8No
Hong Kong [14] 1012.71Yes
Hungary 1721.51.7No
Iceland [4] [15] 8100.8Noáfengiseining defined as 8 g but treated as equivalent to 10 mL
Ireland [4] [16] 1012.71Yes
Italy [4] 1215.21.2Nounità standard defined as 12 g
Japan [3] [17] 19.75251.98No"unit (tan'i)". MHLW's conventional unit, based on 1 gō (unit) (approx. 180 mL) of sake. Not any "standard".
Japan [17] 1012.71Yes"drink (dorinku)". Introduced around 2011 to align with the WHO AUDIT, and to avoid the conventional unit (20 g) of giving a false impression of "minimum amount to drink". [18] Sometimes also called "unit (tan'i)". [19] Has no implication of being any "standard".
Latvia [5] 1215.21.2No
Luxembourg [5] 10-1212.7-15.21-1.2No
Malta [5] 8100.8No
Mexico [5] 10-1312.7-16.51-1.3No
Namibia [5] 1012.71Yes
Netherlands [5] 1012.71Yes
New Zealand [4] [20] [21] 1012.71Yes
North Macedonia [5] 14.2181.42No
Norway 12.8151.28No
Philippines [5] 1215.21.2No
Poland [4] 1012.71Yes
Portugal [4] 1113.81.1No10–12 g (central value used here)
Russia [5] 1012.71Yes
Saint Vincent and the Grenadines [5] 1417.71.4No
Seychelles [5] 8100.8No
Singapore [5] 1012.71Yes
Slovenia [5] 1012.71Yes
South Korea [5] 8100.8No
Spain [4] 1012.71Yes
Sweden 1215.21.2Nostandardglas corresponds to 33 cl 5% beer, 13 cl wine, or a drink or shot based on 4 cl 40% liquor [22]
Switzerland [4] 1215.21.2No
Taiwan (ROC) [5] 1012.71Yes
Ukraine [5] 1012.71Yes
United Kingdom [4] [23] [24] 8100.8Nounit of alcohol [lower-alpha 1] defined as 10 mL but treated as equivalent to 8 g. [26]
United States [27] [4] [28] 1417.71.4Nostandard drink defined as 0.6 fl oz (US) pure ethanol, approximately 14 g
Uruguay [5] 1012.71Yes

Calculation of pure alcohol mass in a serving

Chart showing alcohol unit count for drink size and ABV Units of alcohol chart.svg
Chart showing alcohol unit count for drink size and ABV

In the UK, it is sometimes misleadingly stated that there is one unit per half-pint of beer, or small glass of wine, or single measure of spirits. However, such statements do not take into account the various strengths and volumes supplied in practice. [29] [30] Such approximations can lead to people underestimating their alcohol intake. [30] In some countries, the number of units of alcohol in a beverage can instead be read directly on the label. [31]

In countries without labeling, it is possible to calculate the pure alcohol mass in a serving from the concentration, density of alcohol, and volume:

For example, a 350 ml (12 US fl oz) glass of beer with an ABV of 5.5% contains 19.25 ml of pure alcohol, which has a density of 0.78945 g/mL (at 20 °C), [32] and therefore a mass of 15.20 grams (0.536 oz). or

The standard UK units of alcohol in a drink can be determined by multiplying the volume of the drink (in millilitres) by its percentage ABV , and dividing by 1000. For example, one imperial pint (570 ml) of beer at 4% alcohol by volume (ABV) contains:

The formula uses ml ÷ 1000. This results in exactly one unit per percentage point per litre, of any alcoholic beverage.

The formula can be simplified for everyday use by expressing the serving size in centilitres and the alcohol content literally as a percentage:

Thus, a 750 millilitres (25 US fl oz) bottle of wine at 12% ABV contains 75 cl × 12% = 9 units. Alternatively, the serving size in litres multiplied by the alcohol content as a number, the above example giving 0.75 × 12 = 9 units:

In the UK, both pieces of input data are usually mentioned in this form on the bottle, so are easy to retrieve.

When drink size is in fluid ounces (which differ between the UK and the US), the following conversions can be used:

CountryVolume of fl. oz. (mL)Mass of fl. oz. of alcohol (g)
UK28.4122.43
US29.5723.34

One should bear in mind that a pint in the UK is 20 imperial fluid ounces, whereas a pint in the US is 16 US fluid ounces. However, as 1 imperial fl. oz. ≈ 0.961 US fl. oz., this means 1 imperial pint ≈ 1.201 US pints (i.e. 0.961 × 20/16) instead of 1.25 US pints.

Reference standard drinks

A standard drink is often different from a normal serving in the country in which it is served. [33] For example, in the United States, a standard drink is defined as 0.6 US fluid ounces (18 ml) of ethanol per serving, which is about 14 grams of alcohol. [27] [34] [32] This corresponds to a 12-US-fluid-ounce (350 ml) can of 5% beer, a 5-US-fluid-ounce (150 ml) glass of 12% ABV (alcohol by volume) wine, or a 1.5-US-fluid-ounce (44 ml) so-called "shot" of spirit, [27] assuming that beer is 5% ABV, wine is 12% ABV, and spirits is 40% ABV (80 proof). Most wine today is higher than 12% ABV (the average ABV in Napa Valley in 1971 was 12.5% [35] ), hence will be more than a standard drink. Similarly, although 40% ABV is standard for spirits, the amount of spirit in a mixed drink varies widely.

Beers

Wines

A large (250 ml) glass of 12% ABV red wine has about three UK units of alcohol. A medium (175 ml) glass has about two UK units. Red Wine Glass.jpg
A large (250 ml) glass of 12% ABV red wine has about three UK units of alcohol. A medium (175 ml) glass has about two UK units.

Fortified wines

Spirits

Most spirits sold in the United Kingdom have 35%-40% ABV. In England, a single pub measure (25 ml (0.85 US fl oz)) of a spirit contains one unit. However, a larger 35 ml (1.2 US fl oz) measure is increasingly used (and in particular is standard in Northern Ireland [37] ), which contains 1.4 units of alcohol at 40% ABV. Sellers of spirits by the glass must state the capacity of their standard measure in ml.

In Australia, a 30 ml (1.0 US fl oz) shot of spirits (40% ABV) is 0.95 standard drinks.

In the US, one shot of 80 proof liquor is 1.5 US fl oz (44 ml), which is one US standard drink.

Mixed spirits and alcopops

From 1992 to 1995, the UK government advised that men should drink no more than 21 units per week, and women no more than 14. [39] (The difference between the sexes was due to the typically lower weight and water-to-body-mass ratio of women). [40] The Times claimed in October 2007 that these limits had been "plucked out of the air" and had no scientific basis. [41]

This was changed after a government study showed that many people were in effect "saving up" their units and using them at the end of the week, [42] [43] a form of binge drinking. Since 1995 the advice was that regular consumption of 3–4 units a day for men, or 2–3 units a day for women, would not pose significant health risks, but that consistently drinking four or more units a day (men), or three or more units a day (women), is not advisable. [44]

An international study [45] of about 6,000 men and 11,000 women for a total of 75,000 person-years found that people who reported that they drank more than a threshold value of 2 units of alcohol a day had a higher risk of fractures than non-drinkers. For example, those who drank over 3 units a day had nearly twice the risk of a hip fracture.

Relation to blood alcohol content

As a rough guide, it takes about one hour for the body to metabolise (break down) one UK unit of alcohol, 10 ml (8 grams). However, this will vary with body weight, sex, age, personal metabolic rate, recent food intake, the type and strength of the alcohol, and medications taken. Alcohol may be metabolised more slowly if liver function is impaired. [24] For other countries, it may be easiest to convert to UK units. For example, in the United States one standard drink contains 14 grams ≈ 1.75 units of alcohol, and so a US standard drink takes the body about an hour and three-quarters to process. Blood alcohol content can more accurately be estimated by using Widmark's formula. [46]

Labeling

Example of Wine Bottle label in accordance with UK voluntary health labelling scheme Example UK Wine Label.jpg
Example of Wine Bottle label in accordance with UK voluntary health labelling scheme

Australia introduced standard drink labelling in the 1990s, [47] and New Zealand followed with a labelling requirement starting in 2002. [48] The labels were criticized for being too small to read. A focus group study found that most student drinkers used the labels to choose stronger drinks and identify the cheapest method of getting drunk, rather than to drink safely. [47]

In the UK in March 2011, alcohol companies voluntarily pledged to the UK Department of Health to implement a health labelling scheme to provide more information about responsible drinking on alcohol labels and containers. The pledge stated: [49]

"We will ensure that over 80% of products on shelf (by December 2013) will have labels with clear unit content, NHS guidelines and a warning about drinking when pregnant."

At the end of 2014, 101 companies had committed to the pledge labelling scheme. [49]

There are five elements included within the overall labelling scheme, the first three being mandatory, and the last two optional:

  1. Unit alcohol content per container (mandatory), and per serving (optional). Typical servings deliver 1–3 units of alcohol. [50]
  2. Chief Medical Officer's daily guidelines for lower-risk consumption
  3. Pregnancy warning (in text or as a graphic)
  4. Mention of "drinkaware.co.uk" (optional)
  5. Responsibility statement (e.g., "please drink responsibly") (optional)
Further detailed specifications about the labelling scheme are available from the "Alcohol labelling tool kit". [51]

Drinks companies had pledged to display the three mandatory items on 80% of drinks containers on shelves in the UK off-trade by the end of December 2013. [51] A report published in November 2014, confirmed that UK drinks producers had delivered on that pledge with a 79.3% compliance with the pledge elements as measured by products on shelf. Compared with labels from 2008 on a like-for-like basis, information on Unit alcohol content had increased by 46%; 91% of products displayed alcohol and pregnancy warnings (18% in 2008); and 75% showed the Chief Medical Officers' lower risk daily guidelines (6% in 2008). [52]

Studies published in 2021 in the UK showed that the label could be further enhanced by including pictures of units and a statement of the drinking guidelines - this would help people understand the recommended limits better. [53] [54]

See also

Notes

  1. The term "standard drink" was used in the United Kingdom in the first guidelines (1984) that published "safe limits" for drinking, but this was replaced by reference to units of alcohol in the 1987 guidelines and that term has been used in all subsequent UK guidance. [25]

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