In both cases I think they would deny it.
I don’t have a solution for the 2nd situation (and I don’t think anyone really does), this is more of a social problem. The point I’m making is that in the first scenario there is a clear pattern of denial for those who need help.
In terms of how you differeniate it, my understanding is if the behavior is impacting your life negatively then you would seek help. But I’m not an expert and that’s not a problem we are solving here.