Abstinence-only has long been hampered by the knowledge that alcohol is good for the old ticker—as confirmed in a BMJ study in February—a finding that is denied by only the most blinkered anti-drink crusaders.
The new study that came out in the BMJ last week offers hope to the zero tolerance activists and will, I expect, be cited for many years to come. It claimed that:
- alcohol is responsible for 8% of all cancers in men (UK)
- alcohol is responsible for 3% of all cancers in women (UK)
- former (male) drinkers have a 54% increase in cancer risk
- alcohol caused 16,355 cancer cases in 2008 (UK)
- risk increases by 3% for every drink (per day)
It is the last of these points that most excites the temperance lobby since it seems to support the 'no safe level' doctrine. The study does not, of course, try to calculate how many cases of heart disease are prevented by alcohol so the net cost/benefit cannot be ascertained.
The study concludes with a paragraph on 'policy implications' which is always a bit of a red flag.
This strongly underlines the necessity to continue and to increase efforts to reduce alcohol consumption in Europe, both on the individual and the population level.
It's at times like this that I wish I didn't drink. Not because of the cancer risk but because I could better enjoy the schadenfreude as the smug non-smoking pub-goers, CAMRA members and the "drinking's different" brigade struggle to disassociate themselves from the cigarette fiends and fatties. It's no longer just about 'binge-drinkers', alcoholics and lager louts. The temperance lobby has its eye on that agreeable glass of pinot noir and they've got the science behind them.
What has been most interesting for me has been the way in which the study has been attacked by those who now see their own pleasures under threat. Much of it is very reminiscent of the weak arguments made in the 20th century against the smoking/lung cancer link. At the Telegraph, for example, Judith Potts wrote:
The story hit the headlines. However, according to Cancer Research UK’s figures published in July 2010, the total number of cancer cases in the UK is 298,000 – which covers over 200 different types of the disease. This means that 285,000 cancers are not caused by alcohol. I wonder how many of these 285,000 cases are alcohol-blamed cancers which have developed in non-drinkers?
Well, yes but this is not an argument against public health clamping down on booze. You might equally say that most cancer cases are not smoking-related. You'd be right, but some are and they are considered preventable through behaviour modification.
The Science Bit unwittingly took the traditional tobacco industry line that mere statistics do not prove anything:
Rather than establishing a causal link between alcohol consumption and cancer occurrence, the researchers conducted a study that relied on the premise that such a link exists. In other words, a causal link between alcohol and cancer is not a conclusion of the BMJ study — it is one of its assumptions.
Yes and no. Epidemiology can never prove causation. However, the study did control for a large number of confounding factors so it is not unreasonable to assume causality. Saying that an epidemiological study doesn't prove causation is asinine. You need to provide a convincing alternative explanation for the statistics or demonstrate that the statistics themselves are flawed. Otherwise, we must accept the most obvious interpretation—the one given by the researchers—is the correct one.
Instead, this was very much a “What if…?” kind of study. The basic research question was, “If alcohol consumption causes cancer, then how much cancer might it be causing?”
Actually, it wasn't. It collected the statistics like any other cohort study and derived the conclusions from the data.
...it is impossible to know for sure whether all extraneous factors have been accounted for.
It always is. This is an argument against all epidemiology and, again, was an argument used against the smoking/lung cancer link for years. Then, as now, we need to hear what these 'extraneous factors' are otherwise the hypothesis stands. I am very open to hearing criticisms of this study—I'm quite prepared to believe that much of it is wrong, exaggerated or misleading—but general criticisms of epidemiology as a whole just don't cut it.
Regular readers will know that I am no defender of junk science. This study may well be flawed and you can be sure that as more money moves towards temperance work, the quality of the research will decline and the claims will become more sensational.
Where does that leave us right now? The claim that alcohol increases cancer risk from the very first drink certainly needs to be shown in further studies before anyone outside of temperance circles takes it seriously. The claim that ex-drinkers have a 50% increase in risk that is independent of other factors also needs to be reproduced. But while there are reasons to question some of the associations (a causal link with breast cancer, in particular, has never been as well documented as if often assumed), surely we are not denying that alcohol is linked to cancer of the larynx, liver or mouth?
Where does that leave us right now? The claim that alcohol increases cancer risk from the very first drink certainly needs to be shown in further studies before anyone outside of temperance circles takes it seriously. The claim that ex-drinkers have a 50% increase in risk that is independent of other factors also needs to be reproduced. But while there are reasons to question some of the associations (a causal link with breast cancer, in particular, has never been as well documented as if often assumed), surely we are not denying that alcohol is linked to cancer of the larynx, liver or mouth?
This particular study may well overestimate the number of cancer cases but there is strong evidence that excessive drinking, and possibly moderate drinking, increases the risk of several forms of cancer. We've known this for a long time. Whether alcohol causes 16,000, 8,000 or even 4,000 cases of cancer, the temperance lobby will push on with its neo-prohibitionist policies. (Bear in mind that the favoured statistic is 40,000 deaths per year.)
As I've said before, a public health movement that bans smoking in all 'public' places on the basis of 3,000 hypothetical deaths from secondhand smoke—based on much weaker epidemiological evidence that the study discussed here—is not going to think twice about hammering drinkers who are allegedly responsible for tens of thousands of deaths.
The solution to the problem does not lie in quibbling over statistics, but in telling the powers that be that our lives are our own and defending personal liberty in general. As Dick Puddlecote has said time and again:
If the BMJ study is correct and every drink carries a risk—and that even those who give up drinking are in danger—it serves as a reminder that pretty much everything carries a risk so you might as well enjoy yourself. Whether or not the epidemiology is up to scratch, the researchers can file their 'policy implications' over a cliff while we, as grown adults who can make our own decisions, can say "Thanks for the information, I'll take my chances."
You simply cannot pick and choose which freedoms you like and which you don't. You either stand up to all of the dictatorial bullying, or you will inevitably become a target.
If the BMJ study is correct and every drink carries a risk—and that even those who give up drinking are in danger—it serves as a reminder that pretty much everything carries a risk so you might as well enjoy yourself. Whether or not the epidemiology is up to scratch, the researchers can file their 'policy implications' over a cliff while we, as grown adults who can make our own decisions, can say "Thanks for the information, I'll take my chances."
