Tuesday, 10 July 2018

The drinking guidelines fiddle

I've got an article in the current issue of Wetherspoons News about the lowering of the drinking guidelines in 2016 after a process that I would describe as fraudulent. Wetherspoons recently turned its back on the internet so here it is in pixels...

It is two years since the government changed its official drinking advice. Lowering the weekly guidelines for men from 21 units to 14 units, Britain became one of a small handful of countries to issue the same guidance to both sexes. When she announced the new limits, England’s Chief Medical Officer, Sally Davies, took the opportunity to tell the nation that there is no safe level of drinking and that the health benefits of moderate drinking are ‘an old wives’ tale’.

Such advice is easy to ignore. You are probably ignoring it right now. But guidelines are not always designed to be followed. Sometimes they serve a political purpose.

Every indicator shows that the UK has become a more sober country in the last fifteen years. Rates of binge-drinking, underage drinking and drink-driving have all fallen dramatically. On a per capita basis, we drink no more than we did in 1980, and millennials are particularly abstemious. Lowering the guidelines for men created two million ‘hazardous’ drinkers overnight, thereby inflating Britain’s supposed drink problem and increasing the perceived need for more government intervention.

When the previous guidelines were set in 1995, the government assembled a group of experts who had no known bias for or against alcohol. They issued a call for evidence, held hearings and received dozens of submissions before making their minds up.

The process that led to the new guidelines in 2016 could not have been more different. Most of the committee’s members were openly in favour of heavy regulation and several of them were associated with temperance groups. Their agenda was simple: to regulate alcohol like tobacco. In effect, this means making a pariah of the drinks industry, portraying alcohol as a major cause of cancer and asserting that there is no safe level of drinking.

For the new guidelines, there was no call for evidence and there were no hearings. The names of the committee members were not even made public until after the guidelines had been changed. But the minutes of the meetings were eventually published and they make for interesting reading. As early as June 2013, the chair of the evidence evaluation group, Mark Petticrew, told his colleagues that the number of people who benefited from moderate drinking was ‘very small’ and that the benefits were ‘limited to a low consumption level of half a drink per day’. The ‘beneficial effects’, he said, ‘could be considered not to be relevant in the context of an overall population message, advice or guidance.’

From this starting point, it was a small step to claiming that the benefits of drinking were an old wives’ tale. There was only one problem: the science does not support it. A mountain of evidence stretching over five decades shows that non-drinkers are more likely to suffer from heart attacks, angina, diabetes, dementia and stroke. Studies have shown that people who drink up to 35 units a week live longer than those who do not drink at all. If the guidelines were to be evidence-based, they should have been raised, not lowered.

Since the empirical evidence did not agree with them, the guidelines group commissioned some computer modelling to replace it. A team at Sheffield University that was known to support anti-alcohol policies was hired to build a model to put a figure on a ‘safe level of drinking’, but this, too, failed to support a reduction in the guidelines. And so, in a scandalous move, the committee told the Sheffield team to change the model.

The original model had assumed that chronic conditions, such as alcoholic liver cirrhosis, could only develop in somebody who drank heavily for many years. The evidence for this was indisputable and yet the committee insisted that the model be based on the assumption that even light drinkers were at risk.

The Sheffield Team knew that this was absurd and protested the change, saying that ‘it does not seem right to assign people drinking at very low levels a risk of acquiring alcoholic liver disease and similar conditions’. But they were given little choice and, for a fee of £7,800, they changed their model and came back with new findings which, unsurprisingly, found moderate drinking to be more dangerous than previously thought.

The committee finally had the evidence they needed to justify lowering the drinking guidelines. Admittedly, it was only a hypothetical model that they themselves had rigged by inserting assumptions that nobody could justify, but it was enough. Why did they go to so much effort? Because, as the minutes of one of the meetings points out, ‘while guidelines might have limited influence on behaviour, they could be influential as a basis for government policies’. Lowering the guidelines was a small but important step in the growing war on alcohol.

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