Temperance academics get triggered

Has Mark Petticrew finally been driven completely mad by the existence of the alcohol industry? He and his fellow clowns at LSHTM have written countless articles about the booze industry and the organisations it funds, always looking for the worst interpretation and often cherry-picking relentlessly to get the conclusion they want (see various old posts for examples).

Their latest, published in Lancet Gastroenterology & Hepatology is the weirdest yet. It is based on a short statement from the (industry-funded) Portman Group in response to the news that alcohol-specific deaths rose again in 2021, following a sharp rise in the first year of COVID-19. The full statement reads as follows:

 

In response to the release of the Alcohol-specific deaths in the UK ONS report for 2021, Matt Lambert, CEO of the Portman Group – the alcohol social responsibility body and marketing regulator said:

“Today’s figures show an increase in alcohol-specific deaths on top of last year’s increase, every death is a tragedy for the people concerned and their family and friends. The longer-term impact of pandemic drinking for a small group of drinkers continues and there is increasing evidence that targeted, health focused action is needed for those drinking at the highest harm level.”

 

That's it. That's all they said. I don't know what it was about this bland, 61 word quote that triggered Petticrew and his colleagues but boy did it trigger them. Their article can only be described as a rant. Having quoted the offending press release, they give it the Cathy Newman treatment ('so what you're saying is...').

 

In other words, a large and increasingly globally consolidated industry, which expends a substantial amount on marketing, and whose existence depends on its ability to sell alcohol, is telling a good news story about wider declines in alcohol consumption it claims partial responsibility for...

 

In what universe is the Portman Group statement "telling a good news story"?? 

 

...and implying that its heaviest consumers, whose consumption is increasing, are doing so because they are irresponsible and need targeted, medical help.

Perhaps I don't have the antennae for subliminal messaging that Petticrew has, but I don't infer anything about irresponsibility in that statement. The only thing that vaguely resembles his characterisation is the fact that the Portman Group said "health focused action is needed for those drinking at the highest harm level". 

 

It is widely acknowledged that a lack of face-to-face treatment was a factor in alcohol-related deaths rising during the lockdowns. The British Liver Trust said that: "Stress, loneliness and the lack of access to alcohol support services have resulted in many people drinking more alcohol and putting their livers at risk." If too few people are getting what Petticrew rightly describes as "targeted, medical help", the obvious solution is for more people to get it.

 

Being 'public health' academics rather than medics, Petticrew et al. aren't interested in treatment at all. They're only interested in ineffective, willy-waving, population-level policies.

 

The evidence suggests this narrative masks two crucial realities: the industry's long-standing obstruction of evidence-based means to reduce alcohol harm, and its disproportionate reliance on the heaviest consumers for a large proportion of overall revenue.

They then blether on about minimum pricing (which didn't work) and alcohol advertising bans (which don't work). They conclude...

A different account of the recent alcohol trends can therefore be told. The industry lauds a responsible majority for decreasing consumption, and seeks to claim a role in this decline.

 

It hasn't, has it? Why would anyone try to take credit for decreasing alcohol consumption during the pandemic when we know it was accompanied by a rise in alcohol-specific deaths? The question the 'public health' lobby have to answer is why that decline in consumption didn't lead to a decline in deaths.

 

These claims ignore the inconvenient fact that it is disproportionately reliant on the heaviest consumers.

 

Name me an industry that isn't. This is basically a tautology.

 

These record alcohol deaths are a reflection of greater alcohol sales among individuals at the greatest risk, facilitated by the obstruction of evidence-based policy.

 

As I have explained elsewhere, the rise in deaths occurred at a time when there was far less alcohol advertising than usual, when most alcohol outlets were closed and - in Scotland and Wales - where minimum pricing was in effect. For months on end, the temperance lobby got most of what it wanted. The results were... not great. Since the marketing and retail environment moved in the direction 'public health' ideologues have always desired, it might be worth them asking what went wrong.

 

Through these efforts in pursuit of profit at any cost, the industry has played an outsized part in shaping our current reality, in which the UK faces record increases in alcohol-related liver disease and a health system in crisis.

 

Really? You wouldn't say it was the pandemic and lockdowns that caused the number of deaths to shoot up after being more or less flat for a decade? You don't think there might have been psychological factors at work that undermine your child-like view of the issue?

 Nah, let's blame the pursuit of profit.

We can choose between accepting the industry's own reports of its motivations and good works, or acknowledging its pursuit of profits and reliance on the heaviest consumers and consumers at high risk. The UK is in need of a new alcohol policy to reduce alcohol-specific and alcohol-related mortality. For it to be effective and equitable, the industry and the organisations it funds can have no part in writing it. The UK public deserve nothing less.

 

There endeth the lesson.

Remember that this diatribe was inspired by a two-sentence comment from the Portman Group saying that it was sad so many people were drinking themselves to death and pointing out that treatment works. Is this how academic publishing works in 'public health'? Is any head-banging fanatic who gets triggered by a statement from an industry-linked body that doesn't say "It's all our fault, we're going to disband" allowed to vent spleen in a peer-reviewed journal? Does Lancet Gastroenterology & Hepatology always print communiques from the green ink brigade or does it sometimes publish stuff about gastroenterology and hepatology? 

 

It just bizarre.

As a chaser, Petticrew and friends also mention several industry-funded initiatives to reduce harmful drinking and dismisses them all in a sciency way.

...corporate social responsibility initiatives like the UK Responsibility Deal (which an independent evaluation found to not be effective⁵), funding DrinkAware (which independent research has shown communicates misinformation on alcohol-related harms⁶); and supporting community alcohol partnerships (for which there is little evidence of effectiveness⁷).

 

Reference 5 is one of Petticrew's studies. Reference 6 is one of Petticrew's studies. And reference 7 is - you guessed it! - one of Petticrew's studies. How very independent!

 

According to an independent evaluation (i.e. me), these people are fruitcakes.