There is a lot of noise in the alcohol research field. There are competing interests, and everyone is looking at everyone else with suspicion. Alcohol researchers looking at each other saying “That study is weak”; looking at alcohol producers and saying that they’re just in it to make a buck so they can’t be trusted; producers looking at the researchers saying “What the hell, guys, are you all just neo prohibitionists? We want people to drink responsibly, too. Can’t you give us a break!?” and consumers looking at all of this and wondering where they stand.
The biggest problem for me is that all of this suspicion has two major outcomes. First, people are not sure what do do with all this information, and second people begin to mistrust the public health officials whose job is to offer information and strategies to protect health.
I have made my position pretty clear: there is a lot of narrowly cast information about alcohol harms, and it does not contextualize it in a way that individual consumers can act rationally.
As a result, we have confusion, suspicion, and a general disconnect.
What I hope to do here is wade through all of this and provide some perspective, rooted in my historical work but also in my background teaching and researching public health, government agencies, and control policies.
I will be very upfront about my agenda: I want to provide contextualized information. In my view, using broad population health data and applying a series of sophisticated statistical analyses to identify patterns offers hypothetical outcomes, but no usable information.
Saying for example that drinking raises a woman’s risk of breast cancer does not address the very real fact that a range of factors go into breast cancer risk. Most of these have little to do with drinking. As a result, such statements as 7 drinks per week increase a woman’s risk of breast cancer by 25% can sound terrifying, but without understanding one’s risk, it is disconnected from lived reality.
Not to mention that all of this does not generally discuss braoder issues of health, notably social determinants of health, which can affect our lives much more than moderate drinking, and which at the same time can exacerbate any negative impacts of moderate drinking if someone does not have access to decent food, education, housing, health services and so on.
At the same time, and outside of the discussions that rest on abstractions and statistical probabilities, there is the important issue of culture. Alcoholic beverages have been part of human culture for millennia. Not only have we evolved the ability to metabolize alcohol as a survival mechanism (alcohol is a compact calorie source so at times of famine having access to easily metabolized forms of calories was essential for survival)but also drinking, and even getting drunk, has helped form connections among communities and spark innovation.
So the bottom line is its complicated. I hope to address some of those complications here.
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