Sunday 3 January 2016

Here We Go Again

The doom-mongers of the public health racket have been fast out of the blocks this year, wasting no time reminding us that we really shouldn’t enjoy ourselves without consulting the doctor first. But let’s start with some good news: minimum unit pricing.

Minimum Unit Pricing (MUP)
On the 23rd December the European Court of Justice (ECJ) released its final opinion on the compatibility of MUP with EU law. To no one’s surprise this confirmed the draft opinion, published in September, that MUP is contrary to EU law if less restrictive tax measures can be introduced. It is worthy of note that the ECJ refers to “less restrictive tax measures” not confining itself to alcohol duty – which is controlled by Westminster, not Holyrood. The Scottish Government will now get a range of new tax raising powers so cannot say they have no powers to deal with alcohol abuse other than minimum pricing.

Putting a brave face on it, First Minister Nicola Sturgeon again noted that it was for the Scottish court to decide on the legality of MUP. It’s as if she regards the ECJ as an advisory body to which she can say “thanks very much for your opinion, duly noted, but we’re going ahead anyway.” She would do well to read the Note at the end of the ECJ’s press release. The Note states that courts and tribunals of Member States can refer disputes that have been brought before them to the ECJ for an interpretation of EU law. Crucially it adds: “The Court of Justice does not decide the dispute itself. It is for the national court or tribunal to dispose of the case in accordance with the Court’s decision, which is similarly binding on other courts or tribunals before which a similar issue is raised (my bolding).”

This is hugely significant. Unless the Scottish Government can provide evidence to the court that proves MUP, and only MUP, can address Scotland’s particular problems with alcohol and health – something they have singularly failed to do so far – then the Scottish minimum pricing legislation is incompatible with EU law and cannot be enacted. In addition, the ECJ’s ruling will apply to current minimum unit pricing proposals in Wales, Northern Ireland and the Republic of Ireland.

This may well chunter-on to a final ruling in the UK’s Supreme Court in London, but I think this measure is effectively dead in the water.

Revised lower-risk drinking guidelines
We await the official publication of these, but it has been widely reported that lower-risk guidelines for men should be reduced to the same level as for women – 2 to 3 units a day – but with an added proviso that we should all have two alcohol-free days a week. This is odd. The lower limits for women are based upon the fact that women metabolize alcohol differently to men, because pound for pound they have less water and more fatty tissue than men. Because fat retains alcohol and water dilutes it, alcohol remains at higher concentrations for longer periods of time in a woman’s body, exposing her brain and other organs to more alcohol. Women also have lower levels of two enzymes – alcohol dehydrogenase and aldehyde dehydrogenase that break down alcohol in the stomach and liver. As a result women absorb more alcohol into their bloodstreams than men.

Have these simple biological facts changed? No. So it’s hard not to reach the conclusion that chief medical officer Sally Davies just wants to simplify the message regardless of the science because of some highly theoretical risk factors that arise out of very low levels of consumption. A more rational approach to setting lower-risk guidelines is to ask at what point a moderate drinker’s risk of dying from all causes exceeds that of a person who doesn’t drink. We know from the meta-study done by Augusto Di Castelnuovo in 2006 that for men that level is between 3.4 and 6.8 units a day, and for women it is between 1.7 and 5.1 units a day. Sorry Sally, but your revised lower-risk guidelines will lack credibility with the public and serve little purpose except for providing another stick with which to beat the alcohol industry

Calorie labelling on beverage alcohol products to combat obesity?
The Local Government Association has called for calorie labelling on bottles and cans of alcohol, calling on breweries and drinks’ producers to “show leadership in tackling the obesity crisis”. Dr. Sarah Jarvis told Sky News she was “amazed at how little people understand” about the calories in alcohol. I sympathise Sarah, I’m always amazed when people don’t share my obsessions too. Well, I have good news! Diageo is introducing calorie labelling on all its products in 2016 and is presently consulting on the most effective way to communicate this information. Other drinks producers are likely to follow suit.

But here’s a thought: the calories contained in an alcoholic drink are contained in the alcohol. A gram of alcohol has 7 calories (as compared to 4 in a gram of sugar and 9 in a gram of fat); there are 8 grams of alcohol in a UK unit. Therefore there are 56 calories in a unit of alcohol – so a small measure of whisky (1 unit) has 56 calories; a pint of session beer with 4% abv has 2.27 units and therefore 127 calories; a pint of lager with an abv of 5% has 2.84 units and therefore 159 calories – so not massively calorific products. And through the industry voluntary responsibility deal we’ve removed 1.2 billion units of alcohol from circulation. This equates to reducing the calorific intake of drinkers by 67.2 billion calories. Name me another industry that has done more than that to fight obesity! 

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