Policy makers should not treat moderate drinkers like idiot children

A few years ago I attended a conference in Edinburgh of alcohol health professionals, with me being the only one in the room, apart from the moderator, who wasn't. At the time it was stated, without a shred of evidence to back it up, that alcohol misuse cost the Scottish economy some £2 billion. I asked, caveated by stating at the outset that I wasn't saying the figure was necessarily wrong, where the evidence was, as none had been presented.

Colin Valentine, CAMRA

Later on in the conference, a former health minister told us that a third was in respect of one thing, which they proceeded to elaborate on, a third was in respect of another thing, which they similarly elaborated on, and the further third was in respect of other stuff. I’m not convinced that “other stuff” were the exact words used, but that was the gist of it. In other words, a third of the alleged cost was on something so nebulous that even a former health minister could not define it.

This experience sprang to mind when I read a recent article about the rationale behind the decision by the United Kingdom’s four Chief Medical Officers (CMOs) to recommend a maximum weekly intake of no more than 14 units of alcohol a week for both men and women – less than a pint a day of standard strength beer. It was something that I had never seen before in all of the tens of thousands of words written on the topic, namely that the link to suicide in young men is one of the reasons our CMOs have reduced the guideline for men to the same as for women. With the recommended maximum weekly intake for men being reduced by a third, from 21 units to 14 units a week, it was seriously suggested that cutting down from about 10 pints a week to 7 would reduce the rate of suicide in young men. As no evidence was offered in respect of how big a problem it is in young men who drink 21 units a week, how can it be stated that reducing from a modest intake to an even more modest intake is going to have any effect?

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Notwithstanding the above, let me be clear on one point: suicide is one of the biggest killers of young men and I am not trying to score points by using it as some kind of political football. The point that I am trying to make is that what we want to see is policy based on evidence, not evidence based on policy.

When we get to that stage, perhaps we can have a rational debate about what can be done to help the small minority of people who have chronic alcohol problems without labelling those of us whose intake is moderate, and in line with the guidelines in many other countries in the developed world, as problem drinkers.

It seems to me that labelling Scotland a country which has a problem with alcohol, even to the extent that Scotsman leader writers have stated that this is the case, does us no favours when trying to formulate policies to help those individuals who do have problems.

In fact, the CMOs’ guidelines do not single out suicide amongst young men as the reason for reducing the low-risk drinking guidelines for men to the same as for women.

The guidelines review justifies this reduction on the basis that men are more likely than women to be involved in “acute episodes”, such as getting drunk and being injured or killed in fights, but no evidence is produced to support this assertion. Suicide amongst young men is a sub-set of acute effects, not the totality of them, but is cited by anti-alcohol campaigners to dramatise their agenda.

What the new guidelines do is ignore more than 30 years of evidence that regular, moderate consumption of alcohol reduces the risk of premature death from all causes as compared with the risk for people who have never drunk; that alcohol, when drunk in moderation, has a heart-protective effect and appears to act as we might expect a medicine or a good drug to act.

None of this takes away from the fact that excessive alcohol consumption is toxic and causes illnesses such as alcoholic liver disease. The new guidelines appear to have been written by a group of people dominated by temperance opinion, who used these guidelines as a platform for their agenda to reduce consumption of all drinkers, not just those who have a drink problem. Their objection to alcohol is as much moral as it is medical; it is temperance without the hymns.

Treat us like the intelligent adults we are by giving us all of the facts and let us make our own minds up. Treat us like children and we will ignore you.

Colin Valentine, National Chairman, Campaign for Real Ale