must be August. Last week the mainstream media was drunk with
anti-alcohol headlines after chugging back countless units of public
health research. It felt like a concerted assault. Perhaps it was.
Institute of Alcohol Studies, in collaboration with Sheffield
Alcohol Research Group (SARG), continued its ongoing campaign to remove
from matters of alcohol policy those who make, distribute and sell the
stuff, claiming that the drinks industry had a vested interest, to the
tune of £13bn, in keeping people drinking above the recommended
have exposed the flaws in this research. Here’s Rupert
Millar at The Drinks Business, for instance.
£13bn figure is inflated not only by being based on revenue rather than
profit but by deploying the new alcohol guidelines that recommend
consuming no more than 14 units a week for men and women alike.
a good example, as I’ve argued
elsewhere, that the guidelines are, in the words of one insider,
more useful to “shift public discourse on alcohol and the policies
that can reduce our consumption” than directly affect people’s
guidelines question itself was taken up last week by another, very
serious, paper that got hopelessly
lost among the more sensationalist soundbites.
too, comes from SARG which, between working on commissions from other
bodies, comes up with some really interesting stuff in the tea-break.
it played a key role in providing evidence to the Chief Medical Officer
in setting the latest guidelines, it was shut out of the final
decision-making and, if I’m reading between the lines correctly, was
not too happy at the way it turned out.
experience seems to have driven it to a systematic critique of the
business of recommending thresholds for drinking. For example, SARG
argues that the framework for developing guidelines should be set out in
advance and the process must be transparent.
transparency might avoid embarrassments like Christopher
Snowdon’s allegations of “massaged evidence” and
behind-the-scenes dealing that reduced the threshold for men to 14
SARG’s analysis cuts into deeper and more difficult areas. To attempt
a summary of some complex statistical epidemiology, the guidelines were
chosen on the basis that they represent an ‘acceptable’ 1% lifetime
risk of dying from something alcohol-related – roughly the same risk
as driving a car every day.
is, to anyone who enjoys a drink that sounds like a bargain. They might
even feel a 2% or 3% risk is worth it. (Fortunately, people don’t make
those kind of calculations, since the risk curve actually gets steeper
the more you drink.)
is, as SARG points out, the guidelines as they are currently construed
don’t readily translate into an effective individual health message.
On this occasion, a lay epidemiology that tells you some people are able
to drink considerably more than others without ill-effect – and that
others shouldn’t drink at all - is also scientifically correct. The 14
units is an average low-risk amount across the population, yet people
drink as individuals rather than collectively (unless they’re in a
round, I suppose).
raises the spectre of some future dystopia in which people swap alcohol
units in the same way that states trade carbon credits.
simple solution might be to simply tell people to stop drinking
altogether, and that seems to be the ploy of another piece of research
published to great attention in the Lancet
of the media picked up the angle urged by the accompanying editorial
comment, headed ‘No
level of alcohol consumption improves health’, which explicitly
reinforces the UK chief medical officer’s view, as she forces another
glass of wine to her lips, that there is no safe amount you can drink.
Lancet’s assertion is based on research that says while 914
non-drinkers out of 100,000 suffer an alcohol-related health problem or
injury, the number leaps to 918 for those having one drink a day.
totally miniscule nature of the increased risk from drinking is well
nailed by the statistician David Spiegelhalter.
It seems to me that any rational actor would conclude that if
even non-drinkers face a 1% risk of alcohol-related harm you might as
well have a drink.
It’s important to note that, judging by the reaction on social media, the abstention message is going too far for many in the public health field. See, for example, this Twitter thread from SARG’s John Holmes and James Nicholls’ blog post for Alcohol Concern.
purpose of health guidance should not be to create unnecessary
anxiety,” says the latter, yet there are some out there for whom the
more extreme the message you can squeeze from a piece of alcohol
research, the better.
this is not just winding up the drinks industry. It’s making it more
difficult for those who genuinely want to address the problems of those
who drink too much. The credibility of public health is at stake.
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