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.

12 thoughts on “Pleasure versus risk, the honest alcohol debate

  1. Excellent post. We really do need to switch to looking at this issue in terms of risk rather than attempting to engage in “health” arguments. By any standards, the risks of moderate alcohol consumption are very tiny.

    And there are plenty of activities that are officially approved but involve far more risk, but it’s not good form to point out that any form of exercise beyond a regular brisk walk increases risk.

    I think the authorities actually seriously disapprove of motorcycling, and there have been calls to ban or seriously restrict it, particularly in National Parks.

  2. Wise words well written, Martyn. I have already noted on Facebook that the revised ‘safe’ limits indicate that I shall not be turning 62 this year, but will in fact be 225…surely worth a celebratory drink!
    I await an explanation as to how ‘hard scientific’ facts can lead to such variation in ‘safe’ limits around the planet. Are the Spanish (35 units per week for men) just thick at science? I suspect not – rather that they embrace concepts of the ‘quality of living’ with somewhat more enthusiasm than these ascetic prudes who need to find a new target to keep them employed now that they have conquered tobacco.
    We should congratulate ourselves on our ability to put pen to paper with such articulacy, in spite of the alcoholic fug that is apparently hampering our capacity to live our lives to the full. (I did have to check that articulacy is a real word!)

  3. There is a flaw in the statistical presentation of dame sally anyway: there are not 2% more cancer death through alcohl, but to those, who die of colon cancer anyway, MIGHT 2% added. As far as I can quickly find, there are 28 bowel cancer deaths for every 100,000 males. And this is enhanced by 2%. Would there be 2% more dead men in the UK, that would account to 640,000 men. However, there are roghly 8.800 colon cancer deaths, accordingly, the 2% are 176. This is, I belive, within the statistical uncertainty. I agree that the plump attempts of modern times Puritans, to spoil the pleasure of life, are disgusting at least,

  4. Excellent post Martyn. I am going to continue to proudly enjoy a regular glass of wine, pint of ale and dram of whisky, knowing that I gain more than most from them in terms happiness, something I value far more than longevity of life.

  5. Spot on, Martyn, brilliantly summing up my thoughts on the depressing anti drink messages which are regularly released to the media, which of course thrives on scare stories. The latest dismal drink news is invariably accompanied by film of lovely pints being poured via handpump and enjoyed by nice folks in jolly pubs, who when interviewed feel pressurised into agreeing that yes, I suppose i am drinking too much, and yes I suppose I’d better cut down. I remember one item from a couple of years ago when the experts picked on elderly people who enjoy a glass of wine or three with their evening meal. Oh they’re drinking two or three units every night, it’s terribly bad for them, will shorten their lives and is costing the health service billions. Sure enough a tv crew was depatched to the house of a couple of 70 somethings, who agreed that they would abandon their shared nightly bottle of red.
    Why? You’re 75 and enjoy it, you’re still going to die of something.
    Beer, and all that goes with it, a hobby shared with friends who love it too, has been an absolute joy in 43 of my 59 years, from the love of the 100s of different ales I’ve tasted, to classic old pubs discovered in various parts of the country, and the fascinating social and industrial history of brewing.
    Most of us who have loved beer all our lives just chuckle at the latest limits on our recommended units, ignore it all and carry on enjoying our favourite tipple. I suppose the time will come when everyone’s been brainwashed and beer is finally banned. But it won’t happen in our lifetimes as long as we keep drinking and shorten our lives enough… .

  6. The problem is that it’s pseudo science.To begin with , nobody knows just how much each individual drinks. I don’t even know exactly what I drink! My doctor tells me that when he asks a patient his alcohol consumption the rule of thumb is to double what the patient says.So to relate consumption to risk is guesswork.
    In any case, drinking is a leisure pursuit.Most of these carry an element of risk be it cycling , tennis and running.Going ro a health club exposes you to risk (how are you going to get there except on the roads ?)
    I don’t notice that doctors live for ever.

    1. Martyn, et al,
      There is also a political side to this. I don’t necessarily mean “Tory vs. Labour vs. Liberal Democrats, etc.” Definitely dangerous waters for a yank to venture into British politics :-). What I’m alluding to here is credibility. If a high-placed, high-profile official makes public statements that the populace knows to be suspect, at best, then, what other statements are they making that may also be twisted or downright untrue? There is a real potential for backlash here! After this debacle, what credence will you lend to Dame Sally Davies the next time she makes a pronouncement?

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