alcohol

Alcohol-free beer offers a harmless way to transform our mistaken beliefs about alcoholic drinks into something positive, so we should welcome its increasing availability.

Alcohol is the opposite of the joyful, relaxing “social lubricant” we are led to think it is. Drinking more than a small amount—the UK guideline maximum being around 14 units (140ml) a week—is liable to making us grumpier, tenser, more socially clumsy and sleep less soundly. 

Alcohol-free beer, by contrast, helps us fulfil many of the hopes we have of alcohol without suffering any downsides. Experiments show placebos like it make us more prosocial and at ease with each other, while leaving our brain function intact giving us no nasty side-effects.

This is partly because alcohol-free beer does a convincing impression of alcoholic beer, making us imagine some of the effects we want from its alcoholic brethren. Having a beer in hand also gives others the unmistakable signal we are up for some fun and laughter.

This amazing psychological freebie is growing ever more popular. Sales are spiking. Sainsbury’s said recently it is opening an alcohol-free pop-up pub to showcase its range of faux tipples. Heineken 0.0 launched in the US this year and alcohol-free Guinness is on Diageo’s drawing board.

Too good to be true?
The involvement of such corporate giants in the alcohol-free area raises understandable concerns. Surely they are using alcohol-free drinks as a trojan horse to turn consumers towards their alcoholic offerings? Surely they hope to gain the brand loyalty of our children?

Some liken selling alcohol free beer to minors to selling children candy cigarettes. We might be encouraged to get interested in Heineken 0.0 in our childhood to prime us for the real thing at 18. So it is that age restrictions for alcohol-free beer get the thumbs-up from many health advocates. 

The concern is not any harmful substance within, but that the crossover branding may smooth a psychological pathway to heavy alcohol drinking. The concern is understandable, but it is unclear whether it is justified or if alcohol-free beer sales-restrictions help?

Habits picked up in our teenage years are likely to be sustained later in life. Earlier alcohol drinking, as we know, significantly increases the chances of problem drinking later. This is one reason it seems wrong to bar teenagers from buying alcohol-free beer, by far the better choice.

As teenagers we experiment with being grown up, finding problems and solutions in the process, depending on which experiments we select. How can we sensibly deny a low risk product many adults find helpful? I was boggled by this anomaly as a teenager already drinking alcohol.

And the branding-blur that causes worries can is also part of the value of alcohol-free products. The confusion it causes allows us to drink socially sans alcohol without being singled out as oddballs, as we almost certainly would if we were, say, sipping a cup of tea.

It pays to be wary, of course, but stymying alcohol companies’ for the sake of it may not always be the best strategy. Co-branding does expose non-drinkers to an alcohol brand, but the reverse is also true: a popular alcohol brand is broadened to embrace a non-alcoholic alternative.

There might also be resistance from retailers concerned that some might think they are wrongly thought to be selling alcohol to minors. Some kind of solution could surely be found to minimise the risk of this happening. Perhaps they could use a “not alcohol” bag or sticker?

And others arguing for maintaining age restrictions may have less charitable motives. Keeping age restrictions hinders access to a harm-free alternative to their addictive product. I, for one, would have been better off for being allowed to discover alcohol-free beer’s potential earlier.

Staying open to solutions
This debate clearly needs to be informed by more research. We need to know how alcohol-free beer is used and seen by different age-groups. We also need to discover the real effects of alcohol-free/alcoholic co-branding rather than simply speculating.

There are some untoward effects we should investigate. People trying to curb their drinking sometimes complain that alcohol-free beer can trigger craving. This is not surprising when images of alcoholic drinks are enough to do this. And relying too much on alcohol-free beer could mean we enter social drinking situations where relapse is more likely.

But, while accepting these potential downsides, it seems alcohol-free beer does also help many adults in their bid to reduce their alcohol consumption. And it may well also help teenagers practice the key skills needed to establish a low-risk drinking habit from the off. It may prove to be a help overall, rather than a first step on a slippery slope to problem drinking. 

Alcohol-free beer has some profound lessons for us. It opens our eyes to the fact that having positive expectations and beliefs, coupled with an accepting social environment, can have uplifting effects. This part of our nature we would do well to recognise and harness early. 

Anyone involved in the discussion around alcohol can be forgiven for developing a cynical streak, but we must also be ready to make the most of solutions whenever they appear. ■

With a welcome spotlight being shone on rising inequality this week it is worth noting that alcohol makes it harder for poorer people to succeed in a game already heavily weighted against them.

This fact is not as widely acknowledged as it should be. A large charity told me to call elsewhere because it focuses on poverty not alcohol. Of course, specialism is necessary, but not when it means neglecting clear links. Luckily it seems they will not be ignored much longer.

On the radar
“One cause for concern is a rise in ‘deaths of despair’” said the IFS Deaton Review, launched in the UK this week, referring to deaths from suicide, drug and alcohol overdose and alcohol-related liver disease. They have overtaken deaths from heart disease in recent years (see chart).

Of course death is the most stark outcome. With luck, the review’s army of sociologists, demographers and epidemiologists will also shed light on a myriad more nuanced inequalities to which alcohol contributes. As the Alcohol Change UK campaign pointed out alcohol harms poorer people more in many other ways.

Poorer people tend to live with fewer healthcare facilities, more crime, more stress and higher levels of alcohol availability, so slipping more easily into heavy drinking. The middle classes have their difficulties, but generally nothing to compare with the perils faced by people struggling to get by.

A dicey game
The board game snakes and ladders, or chutes and ladders in the US, can help picture how circumstances alter our chances of success or mishap. Each player moves along the board and when landing on a ladder takes a big step up and when they land on a snake they slip a long way down.

But, crucially, we do not all play on the same board. Poorer people start further away from the giddy heights of their terrain. And, to reflect their less fortunate circumstances, they face more penalties and fewer bonuses, so fewer and shorter ladders, and more, longer snakes. Consequently a smaller percentage of poorer people make as much progress.

To make it more realistic we should test a skill to decide whether we necessarily slide down a snake or climb a ladder. Maybe we have to answer an exam question or, something silly like catch a ball in a cup, anything really to mimic a real life test. Adding this extra obstacle simply multiplies the extra difficulties faced by poorer people.

Now, finally, we can add another level of realism to the model, alcohol. Consuming alcohol impairs our skills, judgement and planning, so meaning we fall down even more snakes and can take advantage fewer lucky breaks. Adding alcohol to the equation tips the balance of an unfair game even further against poorer people.

At the same time advertising relentless associates alcohol with success and winning, deliberately obscuring the fact that it is far more likely to increase our chances of losing.

Clear, not less subtle
The “alcohol paradox”, the name often given to the way alcohol disproportionately harms poorer people is unhelpful, adding intrigue to something which is not mysterious. It is not paradoxical that poorer people are harmed more It is simply a testament to the combined effect of more challenging circumstances and substance blunting our abilities.

It is, of course, vital for the review unveiled this week to go beyond this simplistic model and to shed light on the details. But, as a starting point, the reason alcohol tends to compound inequality can be an unfortunate effect everyone can readily understand and find ways to avoid. With luck, more policies will emerge to make it easier. ■

The leaders of a UK organisation representing traditional pub and ale enthusiasts have decided to hold an investigation into the effects of minimum alcohol pricing.

The move comes in response to a motion passed at the Campaign for Real Ale (CAMRA) annual conference in Dundee last month calling for the organisation to back the “urgent introduction” of minimum pricing in England, after it was introduced in Scotland last year.

“The national executive are carrying out further investigation into the issue to determine the best way to deliver the decision taken by conference,” a CAMRA spokesperson said. “We are unlikely to have any different updates imminently.”

Alcohol has retailed for more than 50p ($0.66) per 10ml UK unit in Scotland since May last year. Supporters hope it will curtail the drinking of very heavy drinkers who gravitate towards cheap sources of alcohol. In England the price per unit starts at 16p.

The price of beer sold in pubs is unaffected by minimum pricing, typically being more than three times the 50p minimum price. Supporters within CAMRA argue minimum pricing may help counter the decline of British pubs by narrowing the price gap with supermarkets.

Others do not see it this way, saying on social media the pro-minimum price motion panders to “anti-alcohol” forces, threatening to cancel their CAMRA memberships. Some, however, wonder if an appreciation of untainted liberal economics is a necessary part of appreciating traditional beer.

Help may be at hand. An initial evaluation of the short-term economic impact of minimum pricing in Scotland is due later this year. And some insight into its effectiveness in achieving its goal of reducing harmful drinking is expected next year.

The conference also saw the arrival of a new CAMRA chairman, Nik Antona. ■

Creating change around alcohol and elsewhere requires us to describe dynamic situations accurately, an area where English could be improved.

Our language often ties us to a static picture of situations more usefully seen as being in dynamic change, so blinding us to possibilities.

We are not, for instance, smokers in the same way we are right-handed, brown-eyed, male or female.

Being a smoker is a status we acquire as a result of what we consume and something we can change by making different choices.

English we say, “I am a smoker,” in the same way as, “I am from Manchester,” or “I am human.” But they are not the same.

In this way, as my brilliant friend and first giveaway book recipient pointed out,  we English-speakers have made a hash of it.

“There is no escape save by stepping out of it into another [language],” as Enlightenment polymath Alexander von Humboldt put it.

Not “to be”
If we are serious about change we should distinguish between inherent states and transient ones.

Making the distinction clear would  help us all see better where fruitful change is possible.

Portuguese and Spanish—and other Iberian languages—have a way to do this built in, using the word “estar” for potentially passing states.

Mixing it into English unforgivably, “I estar alcohol dependent,” would mean we are currently alcohol dependent, but not always and forever.

Using estar like this would convey a sense of changeability to a state of illness, boredom, sadness, or being a smoker too.

I am told estar is not often used to emphasise that substance use problems are shifting and dynamic, but doing so would be easy.

In English it is more difficult. A new word, an English estar, has only a very remote chance of catching on.

Emphasising change
Given introducing a new English verb is impossible we could still make better use of the language we already have.

“Now” is, perhaps, useful: I am now a smoker; I now have a cold; I am now alcohol dependent; I am now not alcohol dependent.

Yes, it is clunky, but perhaps we should accept some clunk if it means we avoid binding ourselves to things which we can change.

It offers the potential to soften and shift our outlook and allows, if we wish, our self-image to adapt to new circumstances.

Routinely acknowledging change is possible, in alcohol consumption, smoking and much else, can surely help us realise our choices. ■

So it is welcome news that the government is pressing for the official guidelines to return in September (see video), albeit two years after they were quietly dropped.

I have joined calls for official health guidelines to appear on all alcoholic drinks labels since revealing that they had been dropped from the UK’s voluntary code in my reporting in late 2017.

It seems extraordinary that robust, scientific information about the safe consumption of a product could ever omitted from packaging, so undermining our right to make informed choices as consumers.

If official health guidelines do reappear on labels in September, as the government hopes, some can be forgiven for looking back and wondering whether self-regulation is an effective way to safeguard consumers?

The responsibility for such concerns about the current system of regulation lies with the alcohol industry. ■

As many as 4.2m people are planning to go alcohol-free in January 2019, according to a YouGov poll, being on course to enhance their drinking choices all year round by doing so.

“Dry January can change lives. We hear every day from people who took charge of their drinking using Dry January, and who feel healthier and happier as a result,” said Richard Piper, head of Alcohol Change, the charity behind the initiative.

A survey of 2018’s participants, reckoned to number over 3m, found: drinking fell from an average of four days a week to three; drunkenness fell to twice a month from three times; eight out of ten felt more in control of their drinking; nine-in-ten saying they saved money.

People can sign up for Dry January online, receiving support from a website, app and a new book on taking a month-long alcohol break, called Try Dry.  ■