The alcohol guidelines set in 2017 by Santé publique France, the French public health agency, fit in one sentence: no more than 2 standard drinks a day, not every day, and no more than 10 drinks a week. In France, a standard drink contains 10 g of pure alcohol. The prevention check-up gives you a chance to talk about it without judgment and to be referred for help if needed.
What are the lower-risk alcohol guidelines in France?
The lower-risk drinking guidelines were defined in 2017 by a group of experts brought together by Santé publique France and the French National Cancer Institute (Institut national du cancer): no more than 10 standard drinks a week, no more than 2 standard drinks a day, and some alcohol-free days each week. Santé publique France sums them up with the slogan “For your health, alcohol means 2 drinks a day at most, and not every day.” Alcool Info Service, the French national alcohol information and helpline service, adds: at least two alcohol-free days a week.
These guidelines are not a “recommended dose”: they are limits beyond which the risk rises sharply. Alcool Info Service says it plainly: there are health risks from one drink a day, and the World Health Organization points out that no form of alcohol consumption is risk-free. The less you drink, the better; the guidelines are there to help you see where you stand, not to give you permission.
What surprises our patients most is the notion of a standard drink. In France, a standard drink contains 10 g of pure alcohol, whatever the beverage, provided it is served in the usual bar measures:
| Beverage | “Standard” measure = 1 drink (10 g of pure alcohol) | What that means at home |
|---|---|---|
| 5% beer | 25 cl (a French “demi”) | A 50 cl can = 2 drinks |
| 12% wine | 10 cl (one glass) | A 75 cl bottle = 7.5 drinks |
| 12% sparkling wine, champagne | 10 cl | A 75 cl bottle = 7.5 drinks |
| 40% spirits (whisky, vodka, rum, gin) | 3 cl | A 70 cl bottle = just over 23 drinks |
A drink poured at home is almost always more generous than a bar measure: this is the most common source of underestimation we see during the check-up. Measuring your usual pour once with a measuring cup is an eye-opening exercise.
When does drinking become risky?
As soon as one of the guidelines is exceeded: more than 2 drinks in a day, more than 10 drinks in a week, or drinking every day with no day off. In 2024, 22.2% of people aged 18 to 75 had exceeded at least one of these guidelines in the previous week (30.3% of men and 14.6% of women), according to the Santé publique France Health Barometer survey. In 2021, 8% of adults drank every day.
In practice, we distinguish three very different profiles:
- Regular, moderate but daily drinking. A pre-dinner drink and a glass of wine with dinner every day add up to 14 drinks a week without ever feeling like “drinking.” This is the most common profile after 45, and the most underestimated.
- Heavy episodic drinking, six or more drinks on one occasion, more common among young adults: in 2021, 24.9% of men and 8.6% of women reported at least one such episode a month. The risk is immediate: accidents, violence, alcohol poisoning, unprotected sex.
- Dependence. Needing to drink to feel normal, being unable to cut down despite wanting to, withdrawal symptoms on waking. It calls for specialized medical care, never for stopping abruptly on your own.
There are also situations where the only guideline is zero: pregnancy (from the moment you plan one) and breastfeeding, driving, taking certain medications, practicing high-risk sports, and certain diseases. After 65, French National Health Insurance (Assurance Maladie) relays the lower guidelines of the French Society of Geriatrics and Gerontology: no more than one drink a day for daily drinkers, no more than 2 drinks per occasion and 7 per week for occasional drinkers. We come back to this in the prevention check-up at ages 60–65.
What are the health risks of regular drinking?
Alcohol causes about 41,000 deaths a year in France, according to 2015 figures published by Santé publique France: 39% from cancers, 24% from cardiovascular diseases, 16.5% from digestive diseases, 13% from accidents or suicides. That same year, 28,000 new cancers were attributable to alcohol.
Less well known is the list of cancers involved: mouth, throat, larynx, esophagus, stomach, liver, colorectal, and breast. For breast cancer, the risk increases even at low amounts; this is something we discuss with our female patients at 45–50, when the organized (national) screening program is getting under way. Worldwide, the WHO estimates that 4.4% of cancers diagnosed in 2019 were attributable to alcohol, that alcohol consumption plays a role in more than 200 conditions, and that it caused about 2.6 million deaths that year.
For the heart and arteries: alcohol raises blood pressure and promotes heart rhythm disorders; the idea of a “protective glass of wine” is no longer accepted by health authorities, which point out that no level is risk-free. For the liver: fatty liver, alcoholic hepatitis, cirrhosis. For the brain: sleep problems, anxiety, depression, memory problems. Alcohol also interacts with many medications, sleeping pills and anti-anxiety drugs first among them, something the pharmacist can check each time a prescription is filled. Finally, combining it with smoking sharply increases the risk of cancers of the mouth, throat and esophagus.
How does the prevention check-up address alcohol?
The prevention check-up is a 30- to 45-minute consultation, fully covered (100%) by French National Health Insurance, offered at four stages of life: ages 18–25, 45–50, 60–65 and 70–75. Alcohol is one of its official topics, and the self-assessment questionnaire completed before the appointment, which we describe in the prevention check-up questionnaire, includes direct questions about frequency and amounts.
Our method is what the French National Authority for Health (HAS) calls early identification and brief intervention (RPIB), set out for primary care professionals in a tool updated in 2021: a few standardized questions (the AUDIT or FACE questionnaires), factual feedback (“you are at 14 drinks a week; the guideline is 10”), and a conversation about what the person wants to do about it. No lecturing: brief, non-moralizing advice is often enough to reduce risky drinking in someone who is not dependent.
What the check-up picks up, and what people are often unaware of: the build-up of “small” daily drinks, generous pours at home, combined use with tobacco or medications, alcohol used to fall asleep or to unwind. It also identifies signs of dependence, which change the strategy entirely and require medical support.
What comes out of it: a Personalized Prevention Plan that, if alcohol is chosen as a priority, includes a realistic, quantified goal (“get back under 10 drinks a week with two days off” rather than “quit”), a first dated action, and named resources. The plan is sent to your regular doctor (médecin traitant), unless you object. At ages 18–25, the goal usually focuses on heavy episodic drinking, as we explain in the prevention check-up at ages 18–25; at 45–50, on daily drinking and its effects on blood pressure, weight and the liver, detailed in the prevention check-up at ages 45–50. The overall framework of the program is described on our page about the prevention check-up.
How can you cut down on alcohol day to day?
French National Health Insurance sums up the method in two parts: drink less often, and drink less on each occasion. Here is what we suggest in practice during the check-up.
- Count for two weeks, without changing anything. Alcool Info Service’s Alcoomètre, or a simple note on your phone, is enough. Most people discover they were underestimating.
- Build in alcohol-free days, starting with the easiest ones. Two consecutive days without alcohol also let you check that you can go without it comfortably; if you can’t, that is a sign to mention to your doctor.
- Decide how many drinks you will have before the occasion, alternate with water or an alcohol-free drink, eat while drinking, drink slowly: four habits recommended by Santé publique France.
- Use smaller glasses and measure your usual pour once.
- Replace the ritual, not just the drink. The pre-dinner drink is often a way to unwind; a walk, a shower or a call to a loved one can play that role. Regular physical activity also helps reduce alcohol, and vice versa.
- Use an app: Option Zéro, a free app recommended by French National Health Insurance, helps you manage your drinking at your own pace.
An important reminder: for someone who is dependent, stopping abruptly without medical support can be dangerous. Withdrawal should be planned with a doctor, sometimes in the hospital.
Where can you find help with alcohol?
- Alcool Info Service, the public helpline run by Santé publique France: 0 980 980 930, anonymous call at the standard rate, 7 days a week from 8 a.m. to 2 a.m. The website alcool-info-service.fr also offers a one-on-one chat with a professional, forums, and a directory of local services.
- Your regular doctor, who can assess your drinking, support a gradual reduction, prescribe treatment if needed, and refer you. French National Health Insurance stresses that alcohol is not a taboo subject in a consultation.
- CSAPAs (French specialized addiction treatment, support and prevention centers), which provide specialized follow-up.
- Hospital addiction clinics and, for 12- to 25-year-olds, the Consultations jeunes consommateurs (youth addiction consultations), which are free and confidential.
- Self-help groups (Alcoholics Anonymous, Vie Libre and others), useful for staying on track over time and for family and friends.
Key takeaways
- Santé publique France guidelines (2017): no more than 2 standard drinks a day, not every day, no more than 10 a week. One French standard drink = 10 g of pure alcohol = 25 cl of 5% beer, 10 cl of 12% wine, 3 cl of 40% spirits.
- There is no risk-free level of drinking; in 2024, 22.2% of adults exceeded the guidelines.
- Alcohol causes about 41,000 deaths a year in France, 39% of them from cancers, including breast cancer.
- The prevention check-up uses a short questionnaire and non-judgmental feedback, then sets a realistic goal in the Personalized Prevention Plan, sent to your regular doctor.
- Help: Alcool Info Service at 0 980 980 930 (7 days a week, 8 a.m.–2 a.m.), your regular doctor, CSAPAs, addiction clinics.
What Sokrate lets you do
Sokrate lets you prepare your prevention check-up online: an adaptive questionnaire covering nine dimensions of health, including alcohol, tobacco, sleep and mental health, which are often linked, followed by a Personalized Prevention Plan written and signed by a doctor and sent to your regular doctor unless you object. A coordinating nurse provides long-term follow-up. The check-up remains fully covered (100%) by French National Health Insurance when carried out by an authorized professional. To be notified when the service opens in your area, join the waitlist.