A sober reflection on ‘dangerous drinking’
You’d have to be completely hammered to take seriously the government’s latest bizarre claims about booze.
‘Apparently, two large glasses of wine, or more, a day could make me three times more likely to get mouth cancer.’ Cue shocked gasps from the two plasticine characters in the new TV advert for Change4Life, a National Health Service campaign. Which is, in case you hadn’t guessed, designed to make us drink less.
None of us wants to die from mouth cancer. So wouldn’t we all want to avoid something that triples our chances of getting it? But what is the risk of getting mouth cancer? Let’s see: in 2010, 1,975 people in England and Wales died of cancer of the lip, oral cavity and pharynx. Out of these, 663 were women, just like the hypothetical female plasticine drinker in the advert. So of the 31,753,620-ish women living in England & Wales in 2010, 663 died of mouth (or voicebox) cancer. That’s one in 47,894. Multiply that risk by three, and the risk goes up to three in 47,894, or a one-in-15,965 chance of dying from mouth cancer.
To put that another way, the campaign is suggesting that if 48,000 women all drank two large glasses of wine every night (it doesn’t specify for how long - a year, 20 years - this is a health campaign after all, so why would we need to see proper research citations?), then out of those assiduous drinkers an extra two would die in a year because they drank more than the government guidelines suggest.
It’s a classic case of RRSHS - Relative Risk Scary Headline Syndrome. Why bore people with a sober assessment of how likely something is to kill them when you can scream a terrifying figure at them instead? So what if they’re far more likely to die of something else?
And in fact, moderate drinking offers significant protection against heart disease, which kills one in three of us. ‘Apparently, two large glasses of wine, or more, a day could make me half as likely to die from a heart attack’, the plasticine figure could truthfully have said.
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In 2010, 80,824 women died of heart and circulatory diseases. It’s true that heavy drinking damages your heart, as well as other organs, and that women don’t benefit as much as men from alcohol because our hormones also protect us against heart attacks. But still, even a 25 per cent reduction in those deaths would save over 20,000 lives.
And yes, heavy drinking has other negative health effects, including a probable association with increased risk of breast cancer (which, unlike mouth cancer, is a significant cause of death for women). But even according to Cancer Research UK, alcohol causes just around 3.3 per cent of cancers in women and 4.6 per cent in men. That’s less than the cancers caused by infections, mainly HPV, in women (3.7 per cent), and by work-related cancers in men (4.9 per cent).
So it’s no wonder that the government’s Change4Life campaign pulls in all the least appealing effects of drinking it can find, including the ‘spare tyre’ and the fact it makes your penis shrink and your pubic hair fall out. (I say ‘fact’, but I admit that I haven’t bothered looking for evidence on those claims.)
Why didn’t they just cite the 8,790 alcohol-related deaths in 2010, mainly from liver disease and alcohol poisoning? Because the new campaign is not aimed at heavy drinkers. It’s aimed at the majority of us who drink a bit more than what is said to be the medically optimum two to four units a day.
It’s not that we don’t understand the effects of that relaxing pint or two on our bodies. It’s that official health campaigners just don’t understand why we drink alcohol. We don’t drink for its medicinal effects. Drinking is a social activity that we share with friends, family, or somebody we’d be too shy to chat up sober. We may even drink because we like the taste or (whisper it) because we like the feeling of being drunk.
We’re not idiots. We simply don’t organise our lives around optimising our eventual health outcomes. We have to die of something, sooner or later. These days, it’ll probably be in old age. And most of us don’t want to devote those 70, 80 or 90 years we get to being our doctors’ most perfect exhibits.
So health ministers and campaigning groups, please treat us like the adults we are. If we’re hitting the booze a little more than doctors would recommend, that’s nobody’s business but ours.
Timandra Harkness is a journalist and the co-writer and performer of the Edinburgh Festival Fringe smash hit Your Days Are Numbered: the maths of death, which is on tour in the UK and Australia in 2012.