The issue of alcohol-related harm and how it gets reported to the public is one that concerns me. We’re all very busy, so we tend to absorb headlines and not question the numbers or the conclusions based on them. That’s understandable when it comes to members of the public, but rather less so when applied to journalists writing stories. While the pursuit of a sensational headline may be what drives the tabloids, we ought to expect more from companies such as the Guardian and the Telegraph than the kind of lazy journalism we’ve seen recently.
What seems to drive so-called “public health” is the determination to relay simple messages repeatedly so they become “established fact” – things that “everybody knows”. The way in which they make claims about alcohol as a cause of cancer, and how that gets reported in the press is a case in point. The evidence of a link between drinking beverage alcohol and most cancers is extremely weak. Even where such a link has been established the numbers are usually vanishingly small. Here are some examples:
In England and Wales in 2014 there were 6,754 deaths from cancer of the oesophagus, of which just 26 – 0.4% – were recorded as having been caused by drinking alcohol. The biggest link between alcohol and cancer is in relation to liver cancer, but it is still extremely rare. There were 4,442 liver cancer deaths in 2014 of which 439 were alcohol-related – 9.9%. (Source: Office for National Statistics data).
The public often confuses alcohol-related liver cancer with alcoholic liver disease. The two are not the same. Alcoholic liver disease accounts for about 65% of deaths caused by excessive alcohol consumption. Contrary to what sensationalist headlines in the Guardian and the Telegraph said recently, in which it was claimed such deaths would “soar” in the next five years, the reality over the past five years is deaths from diseases caused by alcohol are stable. In 2011, there were 8,748 such deaths and in 2015, 8,758. The average is 8,597 per year. (Source: Office for National Statistics data).
If 65% of these deaths arise are from alcoholic liver disease, then that is about 5,588 deaths per year. Each of these deaths is an avoidable tragedy. But most of them were in men (65%); most were people aged 55 to 65 years old, and the average level of consumption was 200 units of alcohol per week – the equivalent of a bottle of scotch a day. So, the picture that emerges is one of a discrete group of alcoholics who are drinking vast quantities of alcohol over many years and dying prematurely. It is only when you understand these sorts of specifics you realise that whole population measures such as minimum pricing will not impact on the delinquent drinking behaviour of this minority of consumers.
Talking of delinquent behaviour – the latest drink-driving statistics have just been released. According to the Department for Transport (DfT) there were 1,170 serious injuries or fatalities in 2015 as a result of drink-driving. This is up from 1,070 in 2014 – an increase of 9.3%. But if you separate deaths from drink-driving from the combined figure they fell by 17% from 240 to 200. Confusingly the DfT defined the increase of 9.9% in the combined figure as statistically significant, but the decrease of 17% in fatalities as statistically insignificant, merely representing the “continuation of a period of stability”.
Predictably, campaigners are calling for a reduction in the drink-drive limit to bring England and Wales in line with Scotland, where the measure has had a devastating effect on pub businesses. The problem is not so much a dearth of accurate information, but the way in which lobby and research groups frame the dissemination of information and how it gets picked up and used in the media.
By Paul Chase