Pleasure versus risk, the honest alcohol debate

If Dame Sally Davies had really wanted to be honest, she would have said: “Here’s my advice on how to live a possibly longer but almost certainly less pleasure-filled life …”

Rose in Bloom frontInstead the chief medical officer for England completely failed to address why people drink – because we enjoy it – and concentrated solely on why we shouldn’t, insisting that the new recommendations on alcohol limits were “hard science” based on the health risks of even moderate drinking. With the old guidelines for men, compared to the new lower ones, “an extra 20 men per 1,000 will get bowel cancer. That’s not scaremongering, that’s hard science.” But why did she say “20 per 1,000” instead of the equally accurate “two in a hundred”? Because 20 sounds worse than two, of course. Scaremongering …

I realised recently that it will be 50 years this summer since I first drank beer, in the garden of the Rose in Bloom in Seasalter, Whitstable. My father (illegally) bought a pint of bitter for me, thinking correctly, that though I was only just 14, I would enjoy it, and thank you, Dad, I did, greatly: that cellar-cool, floral, hoppy initial pint was the start of a lasting love. If Dame Sally Davies had popped up over the fence as I was drinking and assured me that I was increasing my chances of cancer of many kinds, I hope that my 14-year-old self would have replied: “If all the pints for the next 50 years are as good as this one, I genuinely don’t care.”

The point about risk is that, as we all see every day, it’s calculable, all right, but totally random. My mother hardly drank at all: a Snowball, advocaat and lemonade, at Christmas, with a cherry on a cocktail stick balanced across the glass, was her limit. She certainly never smoked. She died, aged 60, having survived breast cancer when she was 45 but eventually being taken out by cancer of the oesophagus. My brother – a cancer survivor himself, having come through Hodgkin’s Lymphoma nearly 40 years ago – still rides motor bikes at the age of 59, big ones, Harley Davidsons and the like, and in the past few years he has taken motorbike tours through South Africa and the eastern United States. For a rider, the chances of dying in a motorcycle crash during your lifetime are about the same as the chances of getting bowel cancer through drinking alcohol. Do we see Dame Sally Davies on daytime TV urging us to cut down on the number of motorcycle journeys we take each week, to reduce the risk?

Rose in Bloom backWe do not, of course, because it would be preposterous. Risk is part of motorcycle riding, as it is of many activities, from mountaineering to hang-gliding. As it happens I had a friend who died in a hang-gliding accident in his early 50s. The risk of dying in a hang-gliding accident is one in every 116,000 flights, apparently. Let’s make the mathematics easier and say you go hang-gliding every weekend, and get in two flights each time for 100 flights a year. In a lifetime’s hang-gliding that gives you just over a three per cent chance of dying in a crash. Set the undoubted joy of soaring silently over fields and woods, one with the winds and sky, against a risk of death if you did it every weekend for 40 years of 33 to one against, and I’m sure most of us would vote with my friend Bryan.

And now we know, because Dame Sally won’t let us forget, that risk is a part of even moderate drinking, too. But as another friend of mine says, stay in bed to avoid all risk, the ceiling will probably fall on your head. Indeed, Professor Sir David Spiegelhalter, the Winton Professor of the Public Understanding of Risk at the University of Cambridge, declared that the risk level Dame Sally wants us to lower ourselves to while drinking alcohol is lower than the risk from eating a bacon sandwich, or spending an hour watching a film.

The lifetime chances of a woman who doesn’t drink getting breast cancer, like my mother, are 11 in a hundred. If a woman drinks, that risk goes up to 13 in a hundred. It’s an entirely valid decision to weigh decades of the pleasures that drinking wine and beer bring against a one-in-50 greater chance of breast cancer, and say: “I believe the risk is worth it,” just the way a hang-glider or a motorcyclist weighs up similar risks.

The big problem in the health-and-drink debate is that the pleasures of drinking are seldom discussed, and never calculated. Winston Churchill, speaking around 1953, after 60 years of regular solid drinking, including pints of champagne, and having Carlsberg invent Special Brew for him, declared: “I have taken more out of alcohol than alcohol has taken out of me.” I have had huge enjoyment from drinking beer since that first pint of Fremlin’s bitter in the garden of the Rose in Bloom – in a coincidence Carl Jung would have appreciated, the pub’s address is Joy Lane – and if Dame Sally popped up at the end of my bed tomorrow with a scythe and hourglass to declare my time was over, adding that if only I had been a teetotaller I could have had an extra ten years, I’d spit in her eye and say it was more than worth it.

Why Sir Liam Donaldson is a tosser

It was good to see the Government getting its retaliation in first, and dumping all over the Chief Medical Officer’s proposal for a minimum 50p-a-unit price for alcoholic drinks. Even before the annual report from Sir Liam Donaldson, on the nation’s health had been officially published, The Times was reporting that “a source close to the Prime Minister” (doubtless speaking in a soft Fifeshire accent) had declared: “The majority of sensible drinkers should not have to pay the price for the irresponsible and excessive drinking by a small minority.”

Well, yes, but it’s more than that. Much of Sir Liam’s argument seems to be heavy on assertion and light on evidence. He claims that Britain has “a spiralling drink problem”. He invents an entirely bogus concept, “passive drinking”, which is supposed to reflect the effects on people of drinking by others, and which is clearly meant to have the associations that “passive smoking” has. But “passive drinking” doesn’t exist: it’s not the drinking of others that people are victims of, it’s others’ aggression, violence and anti-social behaviour. And aggression, violence and anti-social behaviour aren’t caused by drink, they’re caused by poverty, lack of opportunity and crippled expectations. Raising the price of drink won’t solve those problems.

Sir Liam’s report, available here, declares that” Every week, two thirds of adults in England drink alcohol”, so that’s about 45 million people, but then says that “alcohol is immensely harmful. In 2006, 16,236 people died from alcohol-related causes.” In other words, every year alcohol kills 0.035 per cent of the people that use it. In addition, there are half a million deaths a year in the UK – so alcohol-related deaths make up just 3 per cent or so of the total. “Immensely harmful”? I’d suggest not.

The report goes on to assert that “Alcohol has a major impact on individual drinkers’ health.” No – it adversely affects the health of only a tiny minority. “It causes cancers of the liver, bowel, breast, throat, mouth, larynx and oesophagus; it causes osteoporosis; and it reduces fertility.” Yes, but in each case it increases the risk by only a tiny amount. For example, of women who don’t drink, 9.6 per cent get breast cancer; of women who do drink, 10.7 per cent do. In other words, one woman in a hundred gets breast cancer because she drinks. The same is true of other cancers: if you drink, it increases your chances of cancer by a tiny percentage. That does not, I suggest, justify the scare headlines in, for example, today’s Guardian that “no level of alcohol is safe”.

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Publican panics as poll goes pear-shaped

The Publican newspaper, written for pub managers and pub tenants in the UK, is having a small panic right now because the voting in the current poll on its website is going seriously in the wrong direction – and Publican staffers are now emailing around trying to drum up votes for the “right” answer.

The Publican is asking visitors to its website to vote on the proposition: “Should the government introduce a minimum price per alcohol unit?” Obviously, since pub people understandably hate the deep discounting and (alleged) below-cost selling of alcohol found in supermarkets, it expects an overwhelming “yes” from its readers. Unfortunately for the Publican, right now the vote is running 60:40 in favour of “no” – not the pro-pub message the newspaper wishes to present.

The result, apparently, is that “friendly” contacts are receiving emails from Publican staffers like the one below, from someone who, to protect them, will remain nameless:

Help me please!

We run a poll on our website but I think its been infiltrated by an anti-pub group who have corrupted the result. Can you help me by simply visiting the website http://www.thepublican.com/ and clicking ‘yes’ on the poll on the bottom left hand side of the screen. The idea is that a minimum price on alcohol will help stop chavs necking cheap tins of stella and causing bother on our streets. Please help me in this!

If you can get anyone else to vote yes too I’d be ever grateful – I might even buy you a four pack from Tesco.

Cheers

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Bonkers Boris backs barmy booze-buying ban

If you’re 20 and planning a big party for your 21st, or you’re 20, soon to be married, and arranging a jolly wedding reception, and in addition you live in London, you should buy all the drink you’ll be needing for your guests now, because Boris Johnson, the new Mayor of London, and a rising number of local councils in the capital want to ensure that you will be refused service in off-licences and supermarkets.

The idea of getting off-licences and supermarkets to refuse to sell alcohol to people aged 18 to 21 comes from Croydon Council, where a local councillor called Steve O’Connell apparently thinks stopping young adult tax-payers and voters from exercising their legal right to buy beer or wine in Tesco or Threshers “could help to significantly reduce disorder”.

Naturally, O’Connell offers no evidence on how much disorder is caused by people aged 18, 19 or 20 bladdered on booze legally bought, with their own money, from off-licences or supermarkets. I’m willing to say he doesn’t have a clue: he’s just a petty politician after some publicity. All he can say in favour of the plan is that “it would affect [off-licences’] profit margins” – no it wouldn’t, you economic illiterate, it would affect their takings, but not necessarily profits or margins – “but it would stop some violent incidents taking place.” Really? How many? How do you know it “would” stop even one incident? What actual statistics do you have to back this up?

It doesn’t bother this idiot that seriously inconveniencing the non-disorder-causing 99.99 per cent of the population aged 18 to 20 who might want to buy a bottle to take to a party while the 0.01 per cent who cause drunken aggravation continue to nick their drinks supplies from their parents is a steamhammer that won’t come anywhere near cracking the nut of alcohol-fuelled drunken disorder.

Sadly, neither does it seem to bother Boris Johnson. I’d always thought London’s new mayor looked as if he had a libertarian side to him, which would reject this sort of blanket restriction on people’s rights. Nope: the same old economically libertarian, socially authoritarian Tory mindset runs through Johnson, like “Brighton” through a stick of seaside rock, as you’ll find in the rest of the Conservative Party. He told the Evening Standard, London’s daily paper, that it was “the type of solution that Londoners would welcome to the ‘huge problem’ of binge-drinking by the young.” Really, Boris? That would be why every comment so far on the story on the Standard‘s website has said what a stupid idea it is, and how it will make no difference at all except to hack off 18 to 20-year-olds. How huge a problem is it, and how is it not already affected by the ban on under-18s buying drink?

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Binge drinking: a brief history

I love etymology. To binge, the Oxford English Dictionary reveals, was originally a Lincolnshire (and, it implies, East Midlands generally) dialect word meaning “to soak (a wooden vessel)”.

The metaphorical extension of meaning from soaking wood to soaking yourself was an easy journey, and by 1854 a book called A Glossary of Northamptonshire Words had recorded this figurative use for the word: “A man goes to the alehouse to get a good binge, or to binge himself.”

A dictionary of slang published in 1889 said of “binge” that it was used at Oxford to mean “a big drinking bout”. By the early 20th century the word was being used for parties at which large amounts of drink were consumed, with no particular sense that there was anything to criticise: the OED has a quote from 1922: “This is only a binge . . . just a jolly old bachelor-party.”

The word also took on secondary meanings, “to encourage”, and “to liven up”, as in a quote from the children’s novel National Velvet, published in 1935: “The information having been looked over and binged up here and toned down there . . . Reuter sent round the world the following message . . .”

It was probably from this sense of “livened up” that General (later Field Marshal Lord) Montgomery used to ask his officers in the Second World War: “Are you 100 per cent full of binge?”, according to The Times in 1942. Monty meant, apparently, were they full of spirit – zing – and confidence in their own ability and fitness, rather than whisky-ed up to the hairline. It was not a use that caught on.

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I Told You Those Lying Bastards Were Making It Up

It was fantastically satisfying to see the front page splash in The Times declare what I’ve been saying for years – that the government’s “safe drinking guidelines” of 21 units of alcohol for men and 14 for women a week have no basis in fact, and were literally made up on the spot with no evidence to support them 20 years ago, solely because the “experts” thought they ought to be saying something rather than nothing.

To quote The Times:

Richard Smith, the former editor of the British Medical Journal and a member of the college’s working party on alcohol, told The Times yesterday that the figures were not based on any clear evidence … “David Barker was the epidemiologist on the committee and his line was that ‘We don’t really have any decent data whatsoever. It’s impossible to say what’s safe and what isn’t’. And other people said, ‘Well, that’s not much use.’ … So the feeling was that we ought to come up with something. So those limits were really plucked out of the air. They weren’t really based on any firm evidence at all. It was a sort of intelligent guess by a committee.”

On that basis, as The Times says, public health care policy, and private advice by doctors to individuals, has been conducted ever since, with the figures treated as if they were stone-hard, incontrovertible fact, wheeled out again for the latest report that claimed the middle classes are the new danger drinkers. To quote The Times again:

Professor Mark Bellis, director of the North West Public Health Observatory, which produced this week’s study, felt able to say that anyone exceeding the limits was “drinking enough to put their health at significant risk”. That a host of epidemiological studies had filled the intervening years with evidence to the contrary seemed not to matter one jot.”

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More anti-alcohol brigade rubbish

Sky TV rang me up at 1.45pm today to come into their studio in Isleworth to rant at the latest rubbish from the anti-alcohol brigade. Drinkers in middle-class areas are more likely to consume “hazardous” amounts according to the North West Public Health Observatory, commissioned by the Department of Health. But “hazardous amounts”, according to these people, starts at one and a half pints of beer a day, or a large glass of wine ditto. What planet are they on?

Second, while all the newspaper headlines today are about how the allegedly greatest number of “hazard level” drinkers are in affluent areas such as Runnymede in Surrey, and Harrogate in Yorkshire, the Department of Health have literally made these figures up. Their own report admits they don’t have figures to anything like that degree of geographical detail:

Sample sizes are not sufficiently large enough to allow for annual analysis of the data below Government Office region and even combining years does not allow local authority measures to be derived except through the use of synthetic estimates. Although many local areas conduct local lifestyle surveys it is currently difficult to aggregate the data from such surveys since the questions asked and the methods of collection can be sufficiently different to not allow consistent data definitions.”

What they have done is take the percentages of particular social types nationally who “drink to a hazardous level”, who tend to be the more affluent, settled, secure types found in areas such as Runnymede, Guildford, Harrogate and so on, and mapped those social classes to their percentages in individual local authority areas, multiplied one by the other, and claimed this as the percentage of “hazard level” drinkers in those areas.

Sadly, I had an unbreakable appointment to be elsewhere, so I couldn’t get out my soapbox and enlighten Sky’s (small) audience with my views on rubbish statistics, distortions and mythical and invented drinking limits.

Of course, the proper response to health fascists has to be: “Sod off and mind your own business. ” It is the responsibility of individuals to freely weigh up for themselves the risks of their freely chosen actions, from hang-gliding and mountaineering to taking the top off a bottle of beer. Self-appointed nannies should present the evidence, if they wish, and then butt out, and certainly not presume to lecture, harass or threaten.

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Spinning the stats

I’ve known a number of journalists who were brilliant before 1pm and useless after 2.30: Private Eye, the British satirical magazine, had a raft of reasons for naming its archetypal Fleet Street reporter character Lunchtime O’Booze. The advance of new technology into journalism, however, has sunk the five-pint lunch: you just can’t fly a computer keyboard after a good session in the Stab in the Back the way you could a manual typewriter.

It may be because bibulous, red-nosed excess has almost entirely vanished from British journalism that our national newspapers get so up their own posteriors about any story involving alcohol consumption, pub opening hours, “binge drinking”, teenage drinking, “alcohol-fuelled violence” and other staples of the Daily Mail-style scare story. They credulously accept all the propaganda that the anti-alcohol lobby puts out, and spin stories themselves to put the worst possible interpretation front and centre.

The Times last week splashed on crime figures it claimed showed “alcohol-fuelled crime figures rose in the first full year of relaxed licensing laws, with a particular jump in the hours after midnight”. The page one headline roared: “Drink, Drugs and All-Night Violence”, But the figures eight paragraphs down in the story showed serious violent crimes, woundings, assaults and criminal damage cases between 6pm and 6am were up just 0.74 per cent. There had been a “surge” of 22 per cent in the number of such cases between 3am and 6am since pubs and clubs stayed open later, the paper shouted – but the actual number of cases was tiny, and had risen by fewer than five per police force per week. The average police station probably saw one extra case a fortnight. Surge? Not even a ripple across a teacup.

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