Alcohol guidelines and the state
30 May 2016
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Economic Theory
Regulation
Lifestyle Economics
15 November 2024
The Times today leads with the news that the government’s new alcohol guidelines were drafted by neo-temperance activists from the Institute of Alcohol Studies – an organisation that is directly descended from the UK Temperance Society and the Alliance for the Suppression of the Traffic in All Intoxicating Liquors. Four committee members are involved with this organisation and several others, such as Ian Gilmore, are eager supporters of anti-drink legislation such as minimum pricing.
I came to a similar conclusion when I read the minutes from these meetings in February. The decision to reduce the drinking ‘limits’ to 14 units for men has been controversial, and with good reason. The Chief Medical Officer’s report departs from a wealth of international evidence and instead relies on a modelling exercise from the same researchers who developed the flawed model that was used to promote minimum pricing.
Those of us who expressed scepticism about the scientific basis of the guidelines when they were published in January were told not to worry. They’re only recommendations, they said. We are free to ignore them, they said. But the far-reaching implications of the change are already becoming clear.
The Scottish government recently told medical professionals to give a Brief Alcohol Intervention to any man who drinks more than 14 units of alcohol a week. This is a waste of NHS resources and an insult to doctors and patients alike. Medical professionals are capable of identifying problem drinkers without being given orders from on high.
There is good evidence that targeted brief interventions work, but alcoholics are unlikely to take them seriously if everyone they know has had one. It is generally accepted that consuming 50 units or more is indicative of problem drinking. By lowering the benchmark to 14 units, the Scottish government is medicalising millions of people for no good reason.
No good can come from making millions of people who exceed the stingy new guidelines but drink moderately by any other measure feel as if they should be in the Priory. There is an epidemic of the ‘worried well’ in Britain. Doctors tell me about healthy young people demanding full body scans because they fear they have contracted some disease or other as a result of not living the obsessively clean lifestyle that society demands. These are the people who are most affected by ‘public health’ messages. Those who are genuinely at risk tend to ignore them.
Successive governments have used doctors as mouthpieces for their hectoring. It is virtually impossible to get through a routine appointment with a GP without being cross-examined about one’s eating, drinking and smoking habits. Countless hours are being swallowed up lecturing healthy, responsible adults about the bleeding obvious. This is time that could be spent helping people who have a genuine drinking problem.
Perhaps the day will come when the guidelines are dropped to zero and medics are forced to interrogate anybody who has ever had a wine gum. We are constantly told that the NHS does not have enough money to heal the sick and yet it seems to have an unlimited budget for harassing the healthy.
I came to a similar conclusion when I read the minutes from these meetings in February. The decision to reduce the drinking ‘limits’ to 14 units for men has been controversial, and with good reason. The Chief Medical Officer’s report departs from a wealth of international evidence and instead relies on a modelling exercise from the same researchers who developed the flawed model that was used to promote minimum pricing.
Those of us who expressed scepticism about the scientific basis of the guidelines when they were published in January were told not to worry. They’re only recommendations, they said. We are free to ignore them, they said. But the far-reaching implications of the change are already becoming clear.
The Scottish government recently told medical professionals to give a Brief Alcohol Intervention to any man who drinks more than 14 units of alcohol a week. This is a waste of NHS resources and an insult to doctors and patients alike. Medical professionals are capable of identifying problem drinkers without being given orders from on high.
There is good evidence that targeted brief interventions work, but alcoholics are unlikely to take them seriously if everyone they know has had one. It is generally accepted that consuming 50 units or more is indicative of problem drinking. By lowering the benchmark to 14 units, the Scottish government is medicalising millions of people for no good reason.
No good can come from making millions of people who exceed the stingy new guidelines but drink moderately by any other measure feel as if they should be in the Priory. There is an epidemic of the ‘worried well’ in Britain. Doctors tell me about healthy young people demanding full body scans because they fear they have contracted some disease or other as a result of not living the obsessively clean lifestyle that society demands. These are the people who are most affected by ‘public health’ messages. Those who are genuinely at risk tend to ignore them.
Successive governments have used doctors as mouthpieces for their hectoring. It is virtually impossible to get through a routine appointment with a GP without being cross-examined about one’s eating, drinking and smoking habits. Countless hours are being swallowed up lecturing healthy, responsible adults about the bleeding obvious. This is time that could be spent helping people who have a genuine drinking problem.
Perhaps the day will come when the guidelines are dropped to zero and medics are forced to interrogate anybody who has ever had a wine gum. We are constantly told that the NHS does not have enough money to heal the sick and yet it seems to have an unlimited budget for harassing the healthy.
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One element in this story was the need to dig around to find connections between some of the people who helped to come up with the guidelines and bodies which are ideologically inclined to argue against alcohol consumption (although the Times story indicates that the connections could be found by reading the declaration of interest forms). Indeed, you draw attention to those connections in your first paragraph, and seem to regard them as significant.
I agree that such connections are prima facie significant, and should be considered when reaching views on reports like the one discussed here – although it would be perfectly possible to consider them and then decide that they were irrelevant. It is the prima facie significance of the connections that explains why any respectable scientific paper in areas where there may be commercial interests (for example, anything in medicine) includes a disclosure of funding and of competing interests, or an explicit statement of their absence.
Now it is the turn of the IEA, and every other think tank. Please, disclose all your funding, and also disclose any competing interests in relation to any report – or explicitly state their absence.
I don’t think anyone is suggesting the UK Temperance Alliance people are financially conflicted. It’s more that they have an obvious bias which, combined with their lack of qualification to assess epidemiological and biological evidence, makes them a strange choice to be on this committee.
We don’t list our donors. Very few IEA reports are supported by specific funding, but those which are have an acknowledgement at the front. The IEA doesn’t take commissioned research and no one, including donors, is given access to IEA publications before they are released.
I agree that the point about the Institute of Alcohol Studies people is not one of financial conflict. But it is a connection about which we should know, and in that respect it is similar to funding connections.
I do not think there should be a law requiring disclosure of funding or of competing interests. People should be free to keep their funding private if they want. But I still maintain that it is much better to disclose, and I would be delighted if encouragement were given, for example by journalists always writing “The think tank X, which does not disclose its funding, has published a report saying …”, or by government departments and Parliamentary committees refusing to take note of any submissions to them which lack disclosure of funding and of competing interests.
You might be interested in Paul Johnson’s comments on funding and the need to take note of it on page 39 of today’s Times. The IFS simply and straightforwardly discloses, and a good thing too. The IEA’s precautions, as described by you, may be helpful, but they are still not as good as disclosure.
With regard to the “twice as much drink bought as reported to be drunk” I wonder what the average person’s drinks cabinet looks like. My parents barely drink, glass of wine with Sunday meal maybe plus less than ten “occasions” per year. Over the past 30 years they have accumulated quite the stash of brandy, whisky, etc. I would be willing to bet that they have about as much booze in there by unit as they’ve drunk in the same period.
I would guess people also underestimate their own drinking because it’s not routine. If you have a tinny every night or a pint down the pub you can add that up pretty easily but if during the year you go on say the works Xmas do, a wedding, a few dinner parties, a skiing holiday, Christmas at home… you are likely to forget about these intermittent bouts of consumption or at least find it very tough to tot them up.