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Alcohol deaths public health and fuzzy thinking

Posted by Graeme in Health,Politics,Wrong at 11:38 am on Wednesday, 22 February 2012

This article arguing (yet again) for the government to introduce minimum prices and other strict controls on alcohol consumption. As usual, it contains fallacies, fails to provide important information, and is generally rather vague.

I will leave aside my view that the government should not protect people from themselves, and, just for this post,  and, for the moment, accept the consensus that the role of the government includes forcing people to do what the government judges best.

Lets start with the missing information. What is meant by “More than 200,000 people could die early from alcohol-related diseases, accidents and violence over the next 20 years”? Does it mean that the death rate will be 200,000 more than if no one drank any alcohol? Does it mean that 200,000 people will die from diseases, accidents and violence in which alcohol is one of (many) avoidable risk factors?

Of course, as always, The Guardian, fails to but the numbers in context. 10,000 deaths a year is not a huge number in a country the size of the UK: barely over 1%. Depending on he exact meaning of the numbers, the actual number of deaths caused by (as opposed to “related to”) alcohol could be much lower and comparable with, for example, the 3,000 suicides a year. Given the distressing nature of suicide, and its impact on the friends and families of its victims, I think that is sufficient to argue it should be a higher priority.

Compare the impact of alcohol with that of bad diet (too much sugar, too much, and harmful types of, fat, etc.): . There are at least 30,000 deaths a year related to diabetes, and that is almost certainly an underestimate, and it is worsening rapidly, and it is only one of many diseases caused by unhealthy diets.  Worsening rapidly is something of an understatement: the number of people who have diabetes has doubled over the last thirty years.

Diet bring us to another issue. The health effects of different alcoholic drinks is very different:  the amount of carbohydrates in one pint of beer is comparable to an entire bottle of red wine.

That is one possible reason for the lack of correlation between alcohol consumption and life expectancy. Given that, what reason is there to think that reducing overall alcohol consumption will improve public health. In fact a WHO study found that the countries with the lowest level of alcohol related health problems are the wine drinking countries of south western Europe, many of which have very high levels of consumption.

In fact, it may even worsen public health. Moderate drinking improves life expectancy, so price increases that deterred moderate drinkers would lead to lower life expectancies. Heavy drinkers, especially very heavy drinkers, may be addicted, and will therefore be likely to spend more rather than reduce consumption. Abstaining entirely from alcohol carries a similar risk to heavy drinking, why are there no calls for government action to encourage teetotallers to start drinking?

The criticism of a government strategy that relies on voluntary cooperation from the industry, has two serious fallacies. They claim that “the primary requirement for these industries is to deliver shareholder value by maximising consumption”. This is wrong. Individual firms want to maximise profit, which is not the same as maximising consumption: the profit on one bottle of expensive wine is likely to be far more than on many bottles of plonk. It is even possible that a minimum sales price may may the industry more profitable by killing the lowest margin products.

The other fallacy is that because a businesses aim is to make a profit, it is entirely uninfluenced by anything else. Companies are run by individuals who are just as likely to act from ethical motives as anyone else, they are subject to public pressure, and the ability of governments to coerce companies to act “voluntarily” is enormous. Consider the success the government has had in getting internet service providers to subscribe to the Internet Watch Foundation’s controversial, secretive, undemocratic, ineffective and unaccountable censorship scheme.

I have become very cynical about the reasoning behind calls for action on alcohol. It seems to reflect a fixed, and puritanical, idea that alcohol is bad, rather than an assessment of evidence and likely benefits.

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