alcohol

Recent headlines saying alcohol drinking “cleans brains” should not persuade humans to drink more.

“It is by no means a green light for people to drink more alcohol,” says Dr Claire Walton, research manager at the UK’s Alzheimer’s Society, about a study on mice which has triggered coverage hinting otherwise.

It is a “big leap” to take a research finding for mice and apply it to people, she said. “There are just too many differences between mice and people to do this.” Drinking more than 14 UK units (140ml) of alcohol a week, meanwhile, definitely increases human alcohol-related dementia risk.

The study investigated the mouse’s brain waste-disposal system which might play a role in the development of Alzheimer’s disease. “This is a relatively new area of research, where there is a lot still to be learned.”

Alcohol had a long history of use as a medicine, but it has since been found to be counterproductive in all cases and fraught with other risks. It is no longer put to any medical use other than as a sterilising fluid because of its ability to kill cells.

Dubious ideas that alcohol drinking can have health benefits can help support our decisions to drink, in what is known by health professionals as alcohol’s false “health halo”. ■

Jurisdictions trying to introduce health warning labels on alcoholic drinks face a daunting battery of legal challenges intended to discourage them and others, say experts.

Hardly any country or province currently provides labels warning people that drinking alcohol increases the risk of a range of mental, physical and social problems, including cancer, heart disease, birth defects, anxiety and depression.

Jurisdictions which try to change this face the threat of being hit by “legal big guns”, according to analysis published last week.* The most recent case was in the sparsely-populated Yukon territory in Canada which halted a trial in December after receiving worrisome legal warnings.

“The raising of legal doubts, threats of litigation and the actual commencement of litigation have the potential to sway all but the most resolute and well-resourced governments from prioritising public health over industry interests,” the paper says.

The law allows the alcohol industry to make legal challenges at the national, supranational or international courts, as well as tribunals. Australia’s defence of plain tobacco packaging, the paper says, drawing a comparison, has been costly and time-consuming, although it seems set to be successful.

Thailand was the first to hear the drumbeat of possible litigation from the alcohol industry after proposing graphic warning labels in 2010. It planned to introduce labels warning that drinking alcohol causes liver cirrhosis and can undermine sexual performance.

But Thailand’s labels never appeared after they were discussed in the World Trade Organisation’s Technical Barriers to Trade Committee, a diplomatic forum. Concerns raised by the EU, US, Australia and New Zealand may have been taken as the signs of impending legal action.

Jurisdictions can have some confidence courts will take their side when their labels are designed to reflect “good scientific evidence”, the paper explains, but opponents can play on nagging doubts by introducing the prospect of long and expensive litigation.

The alcohol industry may, the paper argues, be looking for a “domino effect” in which governments lose their resolve to introduce alcohol labels. Dr Margaret Chan, a former director-general of the World Health Organisation, described the tobacco industry using this strategy in 2015.

The alcohol industry will be “extremely pleased” to halt the Yukon trial (pictured), says Professor Robin Room of Melbourne University, one of the authors of the paper. It also saw the disappearance of a label in place for 27 years warning that drinking while pregnant can cause birth defects.

“We are still a little hopeful that our study may resume in some capacity,” Erin Hobin, a researcher on the trial, told Alcohol Companion. Supporters of plans for health labels in Australia and Ireland, meanwhile, say they are undaunted by Yukon’s legal difficulties.

Continuing to use trade and investment treaties to launch legal action, the paper says, would be “substantially against the public interest and public health”. With overwhelming public support for health labels, the dominos could yet fall the other way. ■

*Paula O’Brien, Deborah Gleeson, Robin Room, Claire Wilkinson; Commentary on ‘Communicating Messages About Drinking’: Using the ‘Big Legal Guns’ to Block Alcohol Health Warning Labels, Alcohol and Alcoholism, https://doi.org/10.1093/alcalc/agx124

Drinking more than a small amount of alcohol can cause cognitive decline in middle and old age a new study has confirmed.

The decline increases with the amount of alcohol we drink above a low threshold and rises with age. The UK guidelines suggest no more than 14 units (140ml) of alcohol a week.

The new study, however, caused a stir because it found the negative effects begin above 9 units a week, five units below the current guidelines.

Professor David Spiegelhalter, a statistician and communicator at Cambridge University says a graph in the study simply confirms 14 units a week, or 16g a day, is where decline is least (see chart). 

“It’s not as straightforward as looking at the graph,” says Professor Simon Moore, one of the study’s authors, who says its lower threshold comes from the calculation involved in fitting the curve to the data.

The debate was fueled by Sun newspaper coverage of the study which came under a headline saying a pint a day might increase our risk of dementia. It seems to be correct:

A daily pint of 5% lager comes to a total of 16 units of alcohol a week, above both the official low-risk limit as well as the lower one suggested by the new study. ■

As responsible adults we should be presented with accurate, eye-catching and timely information about alcohol’s immediate and long-term effects. Anything less is to squander the benefits of decades of scientific research.

Whether we are from the left, right or centre politically, we cannot deny we are better off for encouraging choices which serve our long-term interests. And there is a mountain of scientific evidence showing alcohol impairs this kind of decision-making.

As a sedative alcohol causes a kind of acute cognitive near-sightedness, with our mental life more than usually occupied with attending to our immediate surroundings. Matters beyond these narrow confines often slip our minds, whether next door or tomorrow morning.

The haze of inebriation can also mean we do and say things which, to coin a phrase, “seem like a good idea at the time”, only to prove otherwise later. These can range from the faintly embarrassing to the life-changingly serious, depending on the circumstances we encounter.

Regularly drinking above a low level of around 14 UK units (140ml/4.7 fl oz) a week can disturb our sleep, lower our mood, impair our sexual function, increase our anxiety and blur our memories.  These largely ignored side-effects can undermine our quality of life and limit our choices.

Should we drink more than a little for a period of weeks, months or years we may unwittingly slip into a degree of alcohol dependency, where our brains adapt to alcohol inebriation. We might then start to find we act more on the spur of the moment and have trouble making and fulfilling plans.

As a species we look for solutions and drinking alcohol can seem to be one off the peg. It relieves our discomforts, particularly after we are dependent. So it is hard to remember it is a sticking-plaster and the cause of many difficulties and discomforts we hope to escape.

Alcohol’s interference with our mental capacities and effect on our behaviour are undisputed science. Its fascinating complexity fills Alcohol Companion, which provides an accessible account. The problem is not that its contents are contentious, but that knowledge is not widespread.

Also scientifically unquestioned and too-little-known are the effects of alcohol drinking beyond our brains. Above a low level it increases our risk of cancers, heart problems, liver problems and physical injuries, as well as trouble with the law, relationships and employment. It is involved in most early-onset dementias and triples the risk of all types of it.

Warnings need to reach us reliably at the times and places it is most helpful to us. One simple remedy is to provide more informative labels. Such labels are now in the pipeline in Ireland and Australia. Efforts in Canada and the EU, however, are delayed, and blocked in the UK.

The invective used to justify the lack of label information is a reversal of the truth: It is the killjoy who fails to warn fellows of the risk of fueling depression and anxiety; And the crudely caricatured “nanny” of pro-alcohol cliché would be the first to shield us from disconcerting facts.

Few of us find cause for alarm or resentment in a road sign. Keeping alcohol drinkers in the dark at the moment we make our decisions to drink or not is to deny us the benefits of science.

Alcohol drinking impairs our short- and long-term decision-making, especially around alcohol drinking. It is self-serving flattery to suggest otherwise. We should be treated like adults, rather than taken for fools. ■

Legal threats of the kind which abruptly halted the first trial of cancer warning labels in Canada’s Yukon territory before Christmas are not altering plans elsewhere.

Measures proposed last month in Australia call for “readable, impactful” warning labels. And Gerald Nash, an Irish senator, introduced an amendment to a recent alcohol bill to include cancer warnings.

“Given the strength and level of support expressed in the Senate, I expect that the bill will receive the same level of support when it moves to the Dàil [Ireland’s Lower House],” Nash told Alcohol Companion.

Donal Buggy of the Irish Cancer Society says he is confident, “The public health imperative for inclusion of cancer-specific labelling warnings will prevail over the narrow sectoral interests of the alcohol industry.”

Legal threats are “not an issue” in Australia, says Michael Thorn, head of Foundation for Alcohol Research and Education: “Australia took it up to the tobacco industry on plain packaging and won.”

The initial focus of Thorn’s efforts will be to  secure mandated warning labels on the dangers of drinking while pregnant, paving the way for others. This might happen in the next 18 months, he says.

In Ireland, meanwhile, one seasoned observer suggests public support for the alcohol bill would mean any attempt by the alcohol industry to stand in its way would be a “PR disaster”.

The next phase of alcohol industry resistance there seems more likely to be quibbling about the format and wording of warning labels than whether they appear.

It is currently unclear whether the Yukon trial will restart. ■

Legal warnings from alcohol brand-owners have halted the world’s first trial of labels warning that consuming alcohol increases the risk of cancer, raising question marks over similar plans elsewhere.

Unnamed alcohol brand owners have warned the state-owned alcohol retailer applying the labels in Canada’s Yukon territory that it may be infringing trademarks and guilty of defamation, say local media reports.

The Yukon trial had been running from one shop for little more than one of the eight months intended. No new labels have been applied to bottles and cans, but those already applied have be left in place. The trial began late last month.

The enforced hiatus may have implications elsewhere: Ireland decided this month to introduce labels warning of the risk, while Australia’s newly-released draft alcohol strategy mentions alcohol’s contribution to cancer cases and suggests “readable, impactful” warning labels.

Campaigners have also raised concerns that the labels have replaced rather than supplemented labels warning of the risk of drinking alcohol in pregnancy. Labels saying “Warning, drinking alcohol during pregnancy can cause birth defects” had been applied since 1991.

The trial is part of the second phase of the Northern Territories Alcohol Study led by researchers from Public Health Ontario and the Canadian Institute for Substance Use Research at the University of Victoria. Its research suggests enhanced labelling could have benefits.

Yukon has the highest alcohol sales per head in in Canada. ■