STRAIGHT STATISTICS MATTER

In my last article I launched the CPL Nanny State Annual Awards for Fake News and Phoney Statistics. Several people contacted me and asked was this tongue-in-cheek, and did misleading statistics really matter, given the environment in which we live where information on social media sites like Twitter have a shelf-life attuned to the concentration span of a mouse. The answer is that whilst our awards night will be light-hearted and enjoyable, the impact of fake news and phoney statistics can be very serious indeed.

As an example, take the now-infamous quote from Professor Dame Sally Davies, England’s Chief Medical Officer of Health: “There is no safe level of alcohol consumption.” And to illustrate the point she asks women to consider: “Do I want that glass of wine or do I want to raise my own risk of breast cancer?” Notwithstanding the fact that she meant to say: “Do I want that glass of wine or do I want to avoid raising my risk of breast cancer?” it is the alarmist and misleading nature of the warning that is so damaging.

I am very sensitive to the emotional nature of anything connected with cancer, because it touches the lives of almost every family in the country, including my own. But let me explain why Professor Davies’ quotes are so misleading and why they raise women drinkers’ concerns unjustifiably.

Firstly, the implication is that one glass of wine a day will raise a female drinkers risk of breast cancer, and to most people that means raising their risk of dying from it because in the popular imagination cancer = death. The good news is that If you are a middle-aged woman you have just a 0.3% chance of contracting and then dying from breast cancer over the next decade. And this chance is the same whether you drink alcohol or not. There is slightly more chance that as a light-to-moderate drinker your eventual and inevitable death will be from breast cancer, but only because light-to-moderate drinkers are much less likely to die prematurely from heart disease, and you must die from something, eventually.

An analysis of various causes of death of middle-aged and elderly Americans (Thun et al 1997) found that, of the 251,420 women in the study, 0.3% of the non-drinkers and very light drinkers died from breast cancer, over the 10 years of the study’s duration. And the same percentage applied to the moderate to heavy drinkers. These were women drinking 1 to 4 standard drinks a day. In America a ‘standard drink’ is about 14 grams of undiluted alcohol, so approximately 1.4 units. So, a woman drinking 1 to 4 standard drinks is drinking between 1.4 to 5.6 units of alcohol a day and has the same chance of contracting and dying from breast cancer as that of a non-drinker.

In a smaller mortality study (35,000 women, Fuchs et al 1995) the chance of death from breast cancer during the 12-year follow-up period was 0.4%, and this was identical for non-to-light drinkers and moderate-to-heavy drinkers. And again, crucially, there was a much higher chance of death from cardiovascular disease among the non-drinkers.

Reading all this confused me somewhat. I was sure that there were numerous population studies that showed drinkers had a one percentile higher chance of getting breast cancer (from just under 10% lifetime risk to just over 10%), and there are, but these are studies of “incidence” (how many women are diagnosed) not studies of mortality (how many women die). So, women who drink alcohol have a slightly higher chance of being diagnosed with breast cancer, but if they are, they have slightly less chance of dying from it. That didn’t seem to make sense. So, I did a bit more research. It turns out that around 90% of women who are diagnosed with breast cancer don’t die from it, partly because medical science cures many of them, but also because many of the diagnoses are incorrect. Research also shows that women who drink alcohol are more likely to screen more for breast cancer than non-drinkers (Mu and Mukamal 2016), so you would expect them to be disproportionately represented in the diagnostic figures arising from screening activity. So, the link between drinking and the incidence of breast cancer is a statistical correlation, not a causal link – it is, in fact a self-fulfilling prophecy.

So, here’s what Professor Dame Sally Davies should have said: “When asking ‘do I want that glass of wine, or should I not drink at all’, women should balance a slightly elevated risk of getting breast cancer, which may be explained by the fact that drinkers are more likely to screen for it, with the actual elevated risk of cardiovascular disease associated with not drinking at all.”

This is why straight statistics matter.

Nanny State Annual Awards for Fake News and Phoney Statistics

Nanny State Annual Awards for Fake News and Phoney Statistics 

I am pleased to announce the launch of the CPL Nanny State Annual Awards for Fake News and Phoney Statistics. The awards will go to the person or organisation that has perpetrated the most gratuitous porky or porkies, fake news or phoney statistics, in relation to public health. I invite readers to submit examples of fake news and phoney statistics – whether it be in relation to alcohol, sugar, obesity, carcinogenic burnt bacon – or any other claim made by nanny-statists that is designed to foment moral panic, frustrate modern life or otherwise deter us from doing anything pleasurable, on the dubious basis that it is better to die of boredom than anything else.

There will be three categories of award in relation to alcohol, sugar and obesity.

A few examples of fake news and phoney statistics from the past:

“There is no safe level of alcohol consumption.” And: “Do I want the glass of wine or do I want to raise my own risk of breast cancer?” Both quotes are from professor Dame Sally Davies, chief medical officer of health – even though she did get the wording a bit mixed up in the second quote, we know what she meant!

Another example would be chief nanny Dr Sarah Wollaston MP, chairman of the health and home affairs committee, who conducted a PR stunt in parliament on Monday (22 January), to campaign for minimum unit pricing (MUP), a policy she’s been championing for years. At the committee hearing she quoted the fake statistic: “The cost of alcohol is at least £21bn a year.”

At this hearing a couple of the usual suspects gave “evidence” – professor Sir Ian Gilmore from the Alcohol Health Alliance and professor Nick Sheron – both ardent alcophobes who support MUP. The usual lie that MUP won’t affect moderate drinkers was repeated – Gilmore stated its introduction at 50 pence a unit would cost moderate drinkers “just £1.72 a year”. To be fair, professor Sheron was nearer the mark when he estimated the cost at £60 to £150 a year!

Another recent example of fake news is the comment made by Richard Horton, the Marxist editor of the Lancet: “Liver disease is on a trajectory to become the biggest cause of death in England and Wales.” This fake fact is designed to scare us off drinking alcohol. In fact, the Office for National Statistics states liver disease is tenth on the list, causing half as many deaths as prostate cancer and an eighth as many deaths as heart disease.

But the best recent example of fake news in relation to alcohol came from – yes you guessed it – The Sun newspaper, which came up with this magnificent headline: “Boffins claim one pint a day can give you dementia.” As Chris Snowdon, director of lifestyle economics at the Institute of Economic Affairs, put it: “That public health lie went around the world before the truth even got its shoes on.”

The prize for all three categories will go to the perpetrator of the porky we select and will consist of a trophy and a bottle of cheap booze with the label removed and replaced with a health warning, and wrapped in plain packaging, of course.

All suggestions should be sent to me at paul.chase@cpltg.com by the end of February 2018 and should contain the quote and attribute it to the person or organisation being quoted. All quotes should be from 2017 and when we’ve picked the winners all contributors and their chosen porky perpetrators will all meet in a disreputable bar for an award ceremony and a night of responsible drinking.

Alcohol policy and the ‘public health’ succubus

There is no doubt the neo-temperance health lobby’s victory over minimum unit pricing will embolden them to campaign even harder for other measures designed to take the retail sale of alcohol down the tobacco route. During the coming year, we can expect the following:

– Implementation of minimum unit pricing in Scotland with the price set initially at 50p per unit (they’re consulting on the level as I write)

– Legislation to introduce minimum pricing in Wales (the process has begun already)

– Further agitation to introduce it in England (probably not this side of Brexit)

Further action to raise duty on higher-strength products (the UK government has already committed to introduce higher duty levels on high-strength cider regardless of its method of production but I suspect it won’t stop with cider)

Long-term neo-temperance can be expected to campaign for: 

– Tighter controls on alcohol advertising because they mistakenly believe advertising drives market volume not brand or category volume

– Calls to end alcohol producers’ sponsorship of football and other sports

– Health warnings on labels and beer fonts such as “alcohol is linked to seven types of cancer”

– Graphic photographs depicting alcohol-related health problems

– Plain packaging in the name of “save the children”

– Agitation for a ‘health’ licensing objective. The UK government has ruled this out in its response to the House of Lords review of the Licensing Act 2003 but health authorities will continue trying to smuggle in health objections to licensing applications disguised as public safety or crime and disorder objections

Public funding and sock puppets

The collusion between the organisations of neo-temperance and Public Health England (PHE) will continue. The most blatant example of this collusion was the way in which PHE and the Institute of Alcohol Studies, whose members and fellow travellers packed the so-called independent Guidelines Development Group, pressured the Sheffield Alcohol Research Group to massage the figures to produce the new “low-risk” drinking guidelines of 14 units of alcohol per week.

The relentless scaremongering of Alcohol Concern and Alcohol Research UK (ARUK) will continue. These organisations have now merged because Alcohol Concern has found feasting in the public funding meadow has become more difficult. ARUK, of course, relies on legacy funding from investments made when it inherited money from winding up of the Licensees Compensation Scheme, which was a licensed trade levy established in 1904 to compensate licensees whose premises were closed because the authorities decreed there were too many licensed premises in their area.

Alcohol Focus Scotland and Balance Northeast continue to be a pair of taxpayer-funded sock-puppet charities and they will also continue with their relentless anti-alcohol campaigning. However, the daddy of them all is PHE. This organisation is not a charity but an executive agency of the Department of Health that enjoys organisational autonomy from government. In other words, a quango. PHE says it exists to “protect and improve the nation’s health and wellbeing and reduce health inequalities”. I don’t know about you but I always thought most of that was done by the NHS – but no! In April 2013, PHE was set up and lists as it its major achievements the campaigns it has run over alcohol misuse, supporting the introduction of a sugar tax and fighting the obesity “epidemic”. Its goals and world view on beverage alcohol are identical to those of the neo-temperance lobby, as witnessed by its presiding over the “low-risk” guidelines fiasco.

What does PHE cost the taxpayer and how many people does it employ? Its funding from the taxpayer is more than £4bn a year and it employs 5,500 people! About £3.3bn of this money is distributed to local councils, which are meant to shoulder the main burden of promoting public health and wellbeing in their areas, a job they should never have been given in the first place. Stick to emptying the bins guys! It seems to me most of PHE’s expenditure is a monumental waste of money. In terms of the money it retains for its own activities, its main role is to spend government money lobbying for policy change from government. If it was closed, would we miss it? We never needed it before 2013 but now it is apparently indispensable. 

Closing PHE and taking back control of that £4bn a year would enable us to put nearly £77m a week into the NHS. I think someone should get that painted on the side of a bus!

MUP – implications of the Supreme Court decision

MUP – implications of the Supreme Court decision 

So now we finally know! The Supreme Court confirmed, in its judgement on Wednesday, the Scottish government’s legislation to introduce a minimum unit price for alcohol is lawful, and does not offend against European Union competition law. I don’t intend to look in detail at the legal arguments that underpin this decision, but rather to examine the broader question and its implications – where we go from here.

Interestingly, the Supreme Court states minimum unit pricing (MUP) has two objectives – to reduce the consumption of alcohol in a targeted way, that is, the consumption of hazardous drinkers living in poverty in deprived communities; and to reduce consumption at the level of the whole population. Except insofar as reducing consumption of any numerically significant demographic will contribute to a fall in average, per capita consumption, it is hard to see how MUP can be both a targeted measure and, at the same time, a whole population measure. 

The paternalistic nature of both MUP as a policy and the nature of the legal judgement itself, is evidenced by the fact it is explicitly stated this is a measure directed at people on low incomes notwithstanding the fact that hazardous drinking is predominantly a problem located in the moneyed, middle classes. They apparently can look after themselves, because a minimum price of 50 pence per unit isn’t going to affect the products they buy.

The underlying moral judgement is if people on low incomes who buy cheap alcohol, but don’t drink hazardously, now have to pay more, then that is an acceptable trade-off in terms of reducing the hazardous drinking of the poor. Paternalism is alive and well!

So what happens now? The Scottish government has minimum pricing legislation already in place and now needs to do two things – enact secondary legislation (a Scottish Statutory Instrument – SSI) and then amend licensing law to make it a mandatory condition on all premises licences in Scotland that alcohol may not be sold at less than the minimum price. There will presumably be a “big bang” date when this will come into effect, probably in the first quarter of 2018.

I am opposed to MUP because I think it is a bad policy, not because I think it is unlawful – but if the Supreme Court had decided it was unlawful that would have been helpful, but it didn’t, so we’re stuck with it now, at least in Scotland and soon in Wales too. In England the government, obsessed as it is with Brexit, is still taking a “wait and see if it works” approach. The Scottish legislation contains a requirement for ministers to evaluate the effect of MUP in five years’ time and it automatically lapses after six years (the “sunset clause”), unless Scottish ministers specifically order its continuation. Two points come to mind. Firstly, if the evaluation is carried out by the Sheffield Alcohol Research Group – the same people who massaged the statistics to produce the new “lower-risk” drinking guidelines – then I have no faith in this being a proper, objective evaluation. And as for the possibility that Scottish ministers would in any circumstances allow this measure to lapse, don’t hold your breath.

Some intriguing issues arise with regard to enforcing MUP. I imagine some enterprising individuals will establish cheap booze supermarkets in English border towns so a lively cross-border trade can arise. This trade will enable consumers to engage in a domestic form of “booze cruise” and it will inevitably fuel “white van man’s” supply of the illicit cheap booze market north of the border. It’s an ill wind that blows no-one any good! And think of the monumental task of enforcing minimum price legislation in every street corner convenience store in Scotland. The big supermarkets will put a system in place, but will small store owners even know how to calculate how many units of alcohol there are in a can of beer or a bottle of vodka?

I have four big fears. Firstly, MUP will spread to the rest of the UK. Secondly, now we have government price-fixers in the sector we will never get rid of them. Thirdly, MUP will become a modified form of alcohol duty escalator – there will be agitation for the minimum price to rise by inflation plus 1%. Fourthly, this will spread from the off-trade to the on-trade. Those in the Scottish Licensed Trade Association who support MUP, because they see it as harmless Tesco-bashing, will have a lot of explaining to do if local licensing authorities, freed from the constraints of competition law, start fixing a £1 per unit price for pubs and bars in their area. It is only a matter of time.

Alcohol and cancer – again!

Barely a day goes by without some new “threat” to our health being announced by epidemiologists or other health campaigners. For these people, the meaning of life appears to be the elimination of anything enjoyable in order to achieve maximum longevity. Key to this is the elimination of “risk factors” from our diet and lifestyles. The key technique used to frighten us all into abstinence is to concentrate on cancer risks. Here an old trick is used – take a very small baseline risk and measure the increase to that risk that arises if you engage in “heavy” drinking. The effect of this is to give prominence and publicity to very large percentage increases in very small baseline risks.


The Alcohol Health Alliance (AHA) has taken to Twitter to publicise its message that alcohol = cancer = death. The Twitter headline reads: “Alcohol is linked with at least seven types of cancer” and then lists them on a handy infographic of the body as mouth and upper throat; larynx; oesophagus; breast; liver; and bowel cancers.


Of course, a “link” is not the same thing as a “cause” but they would like you to think it is. This scare-mongering is entirely consistent with a revision of the low-risk drinking guidelines on the basis there is “no safe level of consumption in respect of the epidemiological risk of developing cancers”, and “the cancer risks of drinking is a game-changer”. It is, of course, accepted that excessive consumption of alcohol is causally related to a small number of cancers – but the risk is dose-related.


Taking oral cancers as an example, what is the overall risk caused by drinking alcohol? According to Cancer Research UK, about 7,300 oral cancers are diagnosed in the UK a year. Of those, tobacco smoking was identified as the cause in 65% of cases. Alcohol consumption accounted for 30% of these –2,190 cases. In total, 30 million adults in the UK drink at least once a week. Of those, 2,190 of them develop an alcohol-related oral cancer – that is 0.007% of regular drinkers. And remember, these figures include very heavy drinkers as well as moderate and light drinkers – so don’t be panicked into abstention just yet.


Every such death is a tragedy but the actuarial risk is tiny. The proposition anything that raises the epidemiological risk of a cancer “isn’t safe” is therefore problematic. In everyday life people make trade-offs. They don’t ask “is this product or behaviour safe?” they ask “is it safe enough?” We do this all the time and not just in relation to food and drink. We don’t ask whether driving a motor vehicle is safe, we ask is it safe enough? In other words, do the benefits of driving justify me in taking the risks? When we are told tobacco-smoking results in the premature death of half of all smokers, that may deter people from starting or persuade existing smokers to quit. However, if you were told 0.021% of regular drinkers die from an oral cancer, would that put you off? It is this kind of epidemiological paranoia that leads health cranks to call for abstinence, and lowering of the lower-risk drinking guidelines is but a staging post on that journey.


However, what is missing from the AHA’s misleading messaging is any reference to the beneficial effects of moderate alcohol consumption. The life-prolonging effects of moderate alcohol consumption are on a firm scientific footing. Despite the AHA and its cronies’ science denial, Sir Richard Doll (the epidemiologist who discovered the link between tobacco smoking and cancer) has revealed there have been dozens of studies in the past 30 years that have vindicated the J-curve that illustrates the benefits of moderate drinking in terms of greater longevity for moderate drinkers compared with “never-drinkers”. If science indicates that alcohol conveys significant life advantages, why does the AHA act as though alcohol is evil?

LISTENING TO THE DRINKERS’ VOICE

Back in 2013 I discussed with industry trade bodies and leading drinks’ producers the possibility of starting a lobby group that would campaign against the constant litany of scare stories coming from the health lobby. Partly as a result of that discussion a group of drinks’ producers started the Alcohol Information Partnership (AIP) about 18 months’ ago. This organisation, headed-up by its Director General Dave Roberts, does a great job in answering the bogus statistics and one-sided research peddled by so-called ‘public health’.

The problem with AIP is that it is too easy for critics to dismiss it as the voice of Big Alcohol – which is manifestly true and AIP makes no bones about that fact. What has been missing from the alcohol-society debate is the authentic voice of the ordinary drinker. Until now.

A couple of weeks ago, a new organisation was launched called Drinkers’ Voice. This is a Campaign for Real Ale (CAMRA) initiative that aims to get the voice of the moderate drinking majority heard in this debate. CAMRA is in an ideal position to launch this initiative precisely because they are the biggest consumer group in Europe, are often highly critical of big brewers and cannot possibly be portrayed as drinks’ industry shills. The initiative has begun well and DV provided the media with a poll which highlighted that 70% of UK drinkers don’t take any notice of the CMOs revised drinking guidelines, because they’re not based on science and have no credibility with ordinary drinkers.

There have been articles on DV published in the Sun on Sunday, the Sunday Times and the Telegraph as well as a TV appearance by Amy O’Callaghan, DV’s spokesperson, on Sunday Live. DV will be a grassroots organisation with spokespeople in communities across the country who are passionate about their freedom of choice and their right to drink in a sociable and moderate way.

Creating a grassroots organisation of this kind is a bold move and CAMRA, and their chief executive Tim Page, are to be congratulated on taking the lead. To influence the wider alcohol policy debate we must influence the public opinion on which politicians’ ride. This is a fledgling organisation and it needs money. The decision has been made not to accept donations from the drinks’ industry, for obvious reasons. It is being crowd-funded by donation and if you would like to support Drinkers’ Voice as an individual you can donate via the following link:

https://drinkersvoice.org.uk/campaigns/donate/

This initiative is needed, and long overdue. Please get behind it. Further information about DV is available on their website www.drinkersvoice.org.uk

Drinkers' Voice

Back in 2013 I wrote a discussion paper titled “The Industry Perception – a Discussion”. In that paper, which I delivered to a group of trade body representatives and industry insiders, I made the following points – public and political perception of our industry is driven by individual experience of licensed premises, medical temperance campaigning, media distortion of issues and problems, and our failure to engage with the public in the alcohol and society debate.

And I indicated we were in this position because of a failure on two levels. Firstly, a failure to examine, analyse and deconstruct the medical temperance narrative, or to construct a counter-analysis regarding the causes of alcohol-related harms; and secondly a failure to recognise the serious nature of the resurgent temperance threat and lead a co-ordinated response to it.

The difficulty that others at the meeting pointed out to me is we, as an industry, are famously fragmented, so agreeing common positions on some of these issues was going to be difficult. There is no doubt since 2013 our trade bodies have recognised the serious threat posed by medical temperance and the constant litany of scare stories, dire warnings and phoney statistics that have accompanied their never-ending campaign to de-normalise the use of beverage alcohol. And there is now a coherent counter-narrative to medical temperance, which I have tried to play my own modest part in creating.

The difficulty in the past has been finding a suitable vehicle for expressing this narrative, particularly given the fact any drinks’ industry initiative would automatically be dissed as an attempt by “Big Alcohol” to promote its own agenda. What has been missing from the debate has been the voice of the ordinary drinker – until now.

Two weeks ago saw the launch of a new lobby group called Drinkers’ Voice. This is a Campaign for Real Ale (CAMRA) initiative designed to give the ordinary, moderate drinker a voice in the alcohol and society debate. CAMRA is in an ideal position to launch this initiative precisely because it is the biggest consumer group in Europe, is often highly critical of big brewers and cannot possibly be portrayed as drinks’ industry shills. The initiative has begun well and Drinkers’ Voice provided the media with a poll that highlighted 70% of UK drinkers don’t take any notice of the chief medical officer’s revised drinking guidelines, because they’re not based on science and have no credibility with ordinary drinkers.

There have been articles on Drinkers’ Voice published in the Sun on Sunday, the Sunday Times and the Telegraph as well as a television appearance by Amy O’Callaghan, Drinkers’ Voice’s spokesperson, on Sunday Live. Drinkers’ Voice will be a grassroots organisation with spokespeople in communities across the country that are passionate about their freedom of choice and their right to drink in a sociable and moderate way. As Drinkers’ Voice put it itself:

“We believe it is important that people understand the benefits of drinking alcohol as part of a healthy lifestyle. We want people to talk about how enjoying a drink with friends enhances their wellbeing, and how scientific evidence shows that moderate drinking can help heart and cognitive health.”

And then: “You’ll know that for too long this debate has been dominated by the anti-alcohol lobby, which has sought to de-normalise drinking and restrict people’s access to alcohol. As a result, we have seen the UK’s alcohol guidelines reduced last year without credible evidence to justify it. As the poll shows, this has widened the gap between government’s instruction and people who want to just enjoy a drink.”

Creating a grassroots organisation of this kind is a bold move and CAMRA, and its chief executive Tim Page, are to be congratulated on taking the lead. To influence the wider alcohol policy debate we must influence the public opinion on which politicians’ ride. This is a fledgling organisation and it needs money. The decision has been made not to accept donations from the drinks’ industry, for obvious reasons. It is being crowdfunded by donation and if you would like to support Drinkers’ Voice as an individual you can donate here.

This initiative is needed, and long overdue. Please get behind it. Further information about Drinkers’ Voice is available on its website.