Excessive alcohol use accounts for 9.8% of deaths among working-age adults in the United States and continues to be a leading cause of premature mortality (Stahre, Roeber, Kanny et al. 2014). The threshold for safe levels of alcohol use has been discussed since the mid-19th century (Anstie 1870). Currently, the National Institute of Alcohol Abuse and Alcoholism (NIAAA) and the Centers for Disease Control (CDC) set the threshold at up to one drink daily for women and up to two drinks daily for men as within the U.S. Dietary guidelines (Division of Population Health ; U.S. Department of Health and Human Services and U.S. Department of Agriculture 2015; National Institute on Alcohol Abuse and Alcoholism 2016). Because of the complexity of drinking behavior itself, defining these guidelines is difficult, and therefore these recommendations have evolved over time (Stockwell and Room 2012). Research on multiple components of drinking behavior, including number of drinking days per week, average drinks per day, and binge drinking, has informed the development of these recommendations.
