Canada’s Guidance on Alcohol andHealthby
Canadian Centre on Substance Use and Addiction with the support of Chantale Audet andAmélie Bourret from Autrement dit

The need: simplifying the new guidelines
The Canadian Centre on Substance Use and Addiction (CCSA) was commissioned by Health
Canada to update Canada's drinking guidelines. The results of this rigorous scientific workneeded to be communicated in a clear and accessible way to all Canadians.
The new guidelines are very different from those published in 2011. In 2011, people wereprovided with numerical limits for weekly and daily amounts of alcohol use. In comparison, the2023 guidance recommends people consider reducing their alcohol use. To help them make an
informed decision about possible alcohol use reduction, the 2023 guidance presents acontinuum of risk according to which:● 1–2 drinks a week represents a low risk of harm
● 3–6 drinks a week represents a moderate risk of harm, and● 7 or more drinks a week represents an increasingly high risk of harm.
The guidance also recommends that if you drink more than 2 drinks a week, you must makesure that you don’t exceed 2 drinks on any day.
The 2023 guidance recommends that people consider reducing their alcohol use because
overwhelming evidence confirms that when it comes to drinking alcohol, less is better.

The objective: developing a visual communication
Our goal was to communicate the new guidelines as clearly and as visually as possible, on a
one page infographic. This infographic is intended for the general Canadian population. It isintended for people who are not specialists in public health or epidemiology. Therefore, it wasnecessary to clearly communicate only information relevant to all groups of people and all typesof drinkers.

The approach: using a plain language process
We developed an implementation plan to guide us in creating the one page infographic. The
plan set out our plain language process, required resources and timeframe. Our plain language
process follows the 4 principles of the ISO standard for plain language.

To create the infographic, we first worked with the project's scientific expert panels to select theright information to communicate to the public. We produced several versions of the infographic
before arriving at a balance that was satisfactory to the experts, but most importantly useful tothe public. Consultation with members of the target audience, which was central to the project,helped us choose appropriate content.
We consulted with the target audience several times during the process, often informally, as wedeveloped new versions. These consultations resulted in several versions of the text, thegraphic, and the illustrations. The table below summarizes these consultations.

Consultation on firstversion

The first version of the infographic was the subject of a consultation
with 30 people. This consultation led to several changes. It became
particularly clear that many people had strong beliefs about alcohol.
For example, the health benefits of drinking red wine, or that thehealth effects of alcohol differ by gender.
In order for the new guidelines to be understood, it seemed
essential to deconstruct this knowledge. Thus, at the beginning of
the infographic, we read, "We now know..." and "The science isevolving...". Subsequent consultations showed that these phrases
had achieved their goal.

Second informal
consultation

After several iterations with the scientific expert panels to ensure thescientific accuracy of the content, we consulted with 5 people toverify how the changes were understood. Some adjustments weremade to the text and graphic.

SurveyWe asked 3 open-ended questions about the infographic on asurvey. The CCSA distributed the survey through their networks.
A total of 744 people responded to these questions and commented
on either the French or English version of the infographic.
This consultation confirmed that overall, even if the new data
surprised and sometimes provoked strong reactions, the infographic
succeeded in communicating it clearly. Nevertheless, the results ofthe consultation led to several improvements. The most notable ofthese regarded the risk continuum graphic: we reversed thepresentation of the drinks and added text describing theconsequences of drinking. This made the graphic more visual andcomprehensive.

Final consultation

After this major consultation, it was essential to consult again to see
if the changes made were working. Ten people were consulted: 5francophones, and 5 anglophones from different regions of Canada.
Some minor corrections were made to the text for clarification. This
consultation reassured us of the effectiveness of the infographic.

We faced a number of challenges during the project:
Complex information
Communicating about alcohol requires dealing with concepts that many people are not familiar
with: risk, probabilities, standard drinks are complex. Communicating these concepts as clearlyas possible in a few words was a challenge. Another challenge was to illustrate a risk curve ofexponential proportions.
A lot of information to communicate
The new guidelines were developed by CCSA and a group of experts. The experts had more
information to communicate than an infographic can contain. They also wanted the infographic
to address other alcohol-related topics, such as breastfeeding or drinking and driving.
Bilingual infographic
The infographic needed to be produced in both official languages of Canada. We had found avery eloquent expression in French that, despite our research and efforts, did not translate aseffectively into English. Although the text did not have to be literally translated, we had toachieve similar content.
Emotional topic
Alcohol is an emotional topic: we had to find the right tone to make the content informative andengaging without being prescriptive and moralistic.

The result: an infographic that illustrates a continuum of risks
We created an infographic with a clear, simple, strong, andwell-positioned key message from the start: drinking less is better.
The infographic features familiar text accompanied by a graphic
illustrating a continuum of risks associated with alcohol-relateddiseases and harms. The continuum uses colour coding anddrinking glasses to show the increase in risk. A section isdesigned to encourage people to assess their drinking and think
about their drinking targets. Finally, tips on how to drink less areoffered.

​​​​​​Download PDF version

The new guidelines were released in January 2023. They have generated tremendous media
coverage in Canada and internationally. The CCSA team has given hundreds of interviews tonewspapers, radio, and television.
The infographic has been one of the preferred communication tools in many of the stories todate and is the entry point for quickly understanding the new guidelines published in the detailedreport. It has been used to summarize and explain the results of the CCSA's work in plain
language. The fact that reporters use the graphic or entire sentences from the infographic
shows that the information is being communicated effectively. The infographic can be used inhealth centres by professionals in discussions with patients. Several people consulted during
the process mentioned that the infographic made them think about their alcohol use. This isdefinitely the most important impact!
Autrement dit won 3 ClearMark Awards in 2023 for their work on the infographic: infographic
category winner; French language winner; and Grand ClearMark Award winner.