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Thursday, 14 January 2010

Answering the neo-prohibitionists 7 of 10: “The best way to reduce the harmful effects of alcohol is to reduce overall consumption”

Here’s what the HSC Report says:

“There is a good deal of evidence to show that the number of heavy drinkers in a society is directly related to average consumption. Living in a culture which encourages drinking leads more people to drink to excess.”

“The most effective way to deal with alcohol related ill-health will be to reduce overall consumption.”

Two key points of rebuttal:

(i) The HSC’s own data contradicts this assertion

Alcohol consumption in the UK is declining. Binge drinking is declining. Alcohol-related crime is declining. So far, the correlation holds – albeit in the opposite direction to the one the HSC would like to convince you is true. And the key thing in all this – the availability of alcohol in the UK is increasing.

But alcohol related hospital admissions – even if we question how they are calculated – are still rising, as are deaths by liver cirrhosis (some of which are alcohol related, though not as many as the HSC would like to claim).

If availability of alcohol is increasing, but people are drinking less, and binge drinking less, but the number of people with alcohol related illnesses is rising, the relationship between overall consumption and alcohol abuse cannot be directly linear.

And the rising percentage of the UK population that is teetotal (estimates vary from 11% to 25%) suggests that in a time of declining overall consumption, light drinkers are dropping out of the market altogether rather than problem drinkers cutting down.

Other factors are at work here. There is something in modern society that is causing a minority to drink to excess even as the majority cut down on their drinking. We can all speculate on what those other factors might be, and I’ve done so elsewhere, but I want to keep this series of posts as factual as possible.

Whatever they may be though, these factors are being ignored by the anti-alcohol lobby and not given enough attention by health professionals, which is letting down people who need help. They don’t need to be told not to drink. They need help addressing what is making them turn to drink in the first place.

(ii) International comparison refutes this assertion

This keeps coming up in rebuttal to various points the anti-alcohol lobby makes, but seemingly it needs constant repetition. There are countries in Europe with higher per capita alcohol consumption than the UK, and fewer alcohol-related health problems than the UK.

And work done by Professor Dwight Heath emphatically refutes the notion that a culture that welcomes alcohol is a culture that encourages drinking to excess. Extensive scientific studies around the world (clue: you don’t just look at countries that have a problem. You look at countries that do and countries that don’t and you compare the two to see what’s different) has shown that in countries that are positive towards alcohol, it is integrated into normal society, drinkers are not stigmatised, and drinking is no big deal.

But in countries that are ambivalent towards alcohol, the stigma also brings with it a mystique. Alcohol is something errant, transgressive, consumed behind closed doors. On the one hand, it has a transgressive allure. On the other, people who drink feel they are already doing something wrong, and the line between moderate and excessive drinking is more blurred.

The most obvious proof of this point is Scandinavia: Sweden has more restrictive alcohol regulations than Denmark, and has a bigger problem with harmful drinking. In turn, Finland has more restrictive alcohol regulations than Sweden, and has a correspondingly bigger problem with alcohol drinking. There is a linear relationship not between overall consumption and harmful drinking, but between the social unacceptability of alcohol and problem drinking

The argument about families normalising alcohol with teenagers rather than letting them discover it with friends in an unsupervised, transgressive setting is a strand of this point. It has been dismissed by neo-prohibitionists as a “dangerous myth”. Unfortunately for them, it’s a myth that has a great deal of scientific research behind it.

In summary

When you look at the data objectively, there is no straight linear relationship between overall alcohol consumption and propensity to alcohol abuse.

The best way to reduce alcohol related ill-health is NOT to reduce overall consumption – it’s to identify what’s making a minority of people drink to harmful levels while the majority are drinking less.

And it’s to normalise alcohol consumption as part of a functional society – the opposite of what the neo-prohibitionists are trying to do.


David Strange said...

Another excellent blog post, Pete. You write in a clear, analytical style which demolishes the twisted propaganda of those who think they have the right to tell us how we should behave. If only the wider press would report the scare-mongering neo-prohibitionist press releases in the critical, right-thinking way as you do. Keep up the good work!

Woolpack Dave said...

The figures from the scaniavian countries; do you have charts? Figures? For that matter any other examples of countries where this can be shown?

I'm not doubting you are right, but others might.

Stephen Beaumont said...

The extreme of the Scandinavian illustration is Iceland, which only legalized beer in 1989 and still has a national spirit (Brennivin) nicknamed "Black Death" for the mandated skull illustration - to indicate how dangerous it is! -- that once adorned its label. Prohibition and restriction don't get much stronger, yet when I visited the capital I found a population entirely ill-equipped to drink responsibly. You think SoHo is bad on a Saturday night, you should see Reykjavik!

California Pete said...

Pete, this continues to be a fantastic series. I'm even thinking about incorporating it into an assignment for my students on critical thinking--something we may be even more lacking here in the States.

I do, however, have a geographer's nit to pick. While reasonably called one of the "Nordic" countries, Finland is decidedly not "Scandinavian". The Finns, of course, are tied through language to their Baltic neighbors in Estonia, and are in fact closer cultural cousins to relatively distant Hungarians than to their neighbors in Norway, Sweden, and Denmark. This doesn't invalidate your argument, but we might as well use the correct geographic terminology.

David said...

Interesting one. I think comparing behaviour and laws in different countries is not so easy. Some countries do not have a culture of drinking to excess and people getting shitfaced and acting like idiots (ie as the UK and, I think to a lesser extent, Australia does). These countries also tend to have lesser restrictions on alcohol.

However, I suspect that the culture is not due to the restrictions, but rather the other way around.

The real question is how to change a culture of getting shitfaced and violent as a habit to one of enjoying alcohol as part of a life well lived.

I don't think laws do it. One idea, which I don't think has been proposed before, is that this is part of a broader problem of people in the UK (and Australia) not having a sophisticated food culture. What, you say??

Well think about all the people you know who like cooking a good meal for their friends and family, who think about what it is they eat before they put it in their mouths. How do they drink? Chances are they think about their alcohol in the same way they think about their food. I dare say almost none of the yobs think about their grog. Once you start thinking about it, having 10 pints of stellar seems a little, well pointless (as you said to me once).

So introduce cooking into primary and high school and treat it as seriously as English. Educate the average pommy or aussie so he thinks about food as much as a frenchman or Italian does.

I bet you'd see idiot drinking fall over time if you did this.