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If you really care about the rise in liver disease, read this

Gin Lane

So the main beer-related headline this morning (given that George Osborne deliberately misled the nation over his 5% alcohol duty rise by saying there was ‘no change’ to beer duty, which most people don’t realise means the punitive duty escalator remains in place) is that deaths by liver disease rocketed by 25% between 2001 and 2009.

This is shocking stuff, and any responsible drinks writer or commentator needs to acknowledge the dangers of excessive alcohol consumption.

What’s actually positive about this news is that alcohol isn’t being blamed for every liver disease death – in the past, the Office of National Statistics has, for the sake of simplicity, recorded every liver disease statistic as being alcohol related, even while admitting this is inaccurate.  At least in this new survey, they admit that it’s only one factor, along with obesity and hepatitis.  But this reveals that alcohol actually contributes to a sizeable chunk – 37% of people who die of liver disease in their forties essentially drink themselves to death, for example.

If alcohol is going to continue to be the life enhancing treat that it is for most responsible drinkers, we need to understand why it becomes something much darker for a significant minority.

Which is why it doesn’t exactly help that every story I’ve seen on this so far this morning is illustrated by – yep, you guessed it – a pint of beer.

This is not me being defensive as a beer writer.  This is me being angry at ignorant media creating a grossly inaccurate picture.

So liver disease increased by 25% from 2001 to 2009.

OK, here are some more numbers.

Over the same period as this rise, beer consumption FELL by 18%.

Most of the beer market is lager, and within this figure, premium lager (around 5% ABV) fell by 18%, while standard lager (around 3.5-4.4% ABV) fell by only 4%.  So less beer is being sold, and within that, the steepest decline is for higher ABV drinks.

Kind of makes it hard to blame beer for a 25% rise in alcohol-related liver disease, no?

At the same time, wine consumption in the UK rose by 8%, and the average ABV of wine rose from 12% ABV to 13.5%.

Want to know what happened to spirits consumption between 2001 and 2009?

Up by 18%.*

As I proved in my last post, I’m no mathematician.  And I do know the difference between correlation and causation.  But it seems to me, reading these figures, that there is a very strong correlation indeed between the rise in alcohol-related liver disease and a trend for people to switch from beer to stronger drinks.

Beer, once again, is being used as the scapegoat.  No doubt it makes sense to some, when we see that the biggest rises are among poor people, especially men, especially in deprived parts of the north, and the media stereotype of beer drinkers remains that of the northern working class male.  But this stereotype is inaccurate, as I’ve pointed out many times before.

Liver disease is increasing because people are switching from beer to stronger drinks.  We already know this though, because this has been true of every major alcoholism epidemic in history.  In the gin epidemic of the eighteenth century, beer was part of the solution, not the problem, as the immortal cartoons by Hogarth show.  It should be seen as that today.

And there’s another factor going on which NEVER gets written about (apart from by my excellent co-writer in this area, Phil Mellows).  Most alcohol consumption takes place among affluent southerners.  Statistically, the wealthier you are, the more you drink.  And yet the poorer you are, the more likely you are to die of drink-related liver disease.

A child could see that alcohol-related mortality therefore has nothing to do with overall consumption.  And yet the government and NHS strategy remains firmly founded on the fundamental belief that the best way to reduce alcohol-related harm is to reduce overall consumption (by measures such as minimum pricing etc).

Not only does this approach stigmatise and punish responsible drinkers, it does nothing to help those drinking harmfully.  Put up the price of booze, and an alcoholic will spend less on food, and so on.  There’s overall pattern of evidence to suggest that reducing overall consumption is the best way to reduce harm.

So what is it that makes poor drinkers in the north more likely to drink themselves to death than affluent drinkers in the south, who on average drink more?  Oh, that’s too hard.  That might involve addressing the societal, cultural and economic problems that are the REAL reasons some people drink harmfully.

Much easier simply to blame beer.

Beer Street

* All figures from the BBPA’s Statistical Handbook 2011



Dave Lozman


You are spot on in my opinion. I wrote a similar, although somewhat less eloquent, post myself a little while ago but my main point was the same. Address the social and economic factors at the cause of the problem instead of picking on the easiest target.



Well, the neo-Pros will be laughing all the way to the sarsaparilla font at the sight of different sections of the drinks industry scratching each others' eyes out.

United we stand, divided we fall. If you think the WSTA are the enemy, then the battle is already lost.

Ray and Gail

Good read. Very pleased that you didn't fall for the knee-jerk 'blame it all on cider' type of post which I've seen too many of since the budget. From close painful family experiences, spirits are the "weapon of choice" if you want to kill your liver then yourself.

Cooking Lager

Oh, you hate Gideon, don't you?

No mention that the accelerator started under McBroon and the trick of doing this to avoid announcing an increase and being able to say "No new increases" meaning "None other than what was coming anyway" being arguably McBroons greatest political invention and has been occurring for years.

Simon Cooke

It takes a fair while to drink yourself to death – this suggests that the decline in overall alcohol consumption reported by the ONS (nearly all of which has been in pubs) won't yet be seen in morbidity figures.

I'm willing to bet that, regardless in any action by government, we will see a decline in death rates from liver conditions in the next few years (or at least the alcohol-related portion of the figures).


When a politician goes into a pub they drink beer because it is politically expedient to do so.
When their at home they probably drink Wine.
This is more to do with blaming the poor (As usual) for their ill health than blaming Beer.
Beer has always been the allegory for transmitting blame onto the poor. It's been an effective wepon for politician's for decades. we all know this. why the suprise?
Even without knowing it Beer conjurs up images of Andy Capp, Whippets, pigeon fancier, smokers and lay abouts.. The poor.

Imagine if Wine was to blame for a nations ill health. That would be like calling all middle classes drunken yobs.
That would be like calling all educated connoisseurs (Is there any other type) drunkards.
That would be like saying (proberbly about 90%) of our politician's where to blame.


It is misleading as it doesn't describe the true units of pints of lager which people need to be affected by liver disease. It ignores harder beverages such as cheap and easily available vodka.

It is also damaging as the evidence there is from another body without the true figures. I resent these fake reports of non real value and scare tactics. They are a cover-up to provide more duty on alcohol.

It is a joke. The health service needs to be more powerful with providing figures and the other bodies should simmer down with their facts. With most of the population drinking and only a small number being affected by liver disease I can't see how they can justify it.

I agree that a large number of idiots go over board and drink far too much but whom pays for that? Responsible drinkers and the NHS. Close irresponsible bars and nightclubs and cheap but potent alcohol and crisis solved. It is really that simple but the Government are blaming us. It's a disgrace.


An excellent post. Yet I can't really see middle-class London journos changing their spots and illustrating their sensationalist pieces with, for example, Right Bank Bordeaux, though – so sadly, the misrepresentation of this problem will in all likelihood continue.

146 Cider


Love the use of the Hogarth images to illustrate your point. Nicely done sir! However, a broader issue comes out of this – the problem has been around for centuries and it has never been successfully or lastingly dealt with.

As so many have said, there are no problem drinks, just problem drinkers… and how do you deal with that?

Great post!

146 Cider


Love the use of the Hogarth images to illustrate your point. Nicely done sir! However, a broader issue comes out of this – the problem has been around for centuries and it has never been successfully or lastingly dealt with.

As so many have said, there are no problem drinks, just problem drinkers… and how do you deal with that?

Great post!


Sceptic, you raise a valid but difficult point. I have no wish to start a war with wine and spirits people and agree that as much as possible we shouldd stand together.

But facts are facts.

I just did a quick trawl and the Guardian, Mail, Express, Sun, BBC, Reuters, Nursing Times, Telegraph, Healthcare Today, even the Press Association are using images of beer – just beer – with this story. Only Channel 4 has used an image of a drink that isn't beer. It's a gross distortion of the truth, and it has to stop.

I hope that people in the wine and spirits world would agree with my conclusion – that we need to tackle the underlying causes of alcohol abuse, and that an overall reduction strategy is not the right way to go.


Simon Cooke is quite right to point out that deaths from liver disease will significantly lag alcohol consumption – I would guess by at least ten years. Alcohol consumption peaked I think around 2004, so perhaps in three or four years' time the figures will start going down.

Isn't the shift from beer to wine and spirits to a large extent a result of the shift from pub to off-trade consumption?


I sent the following to the BBC. You can too at

With reference to your story:

I must complain about the use of a picture of a beer glass to illustrate this story about liver disease.
There are several points I wish to make:
1. Beer consumption in the UK is declining (18% from 2001-2009). It would be difficult to correlate a decline in consumption with a rise in liver disease. For comparison, wine and spirit consumption rose over the same period (8% and 18% resp.). (data available in the BBPA's Statistical Handbook 2011).
2. The fastest decline in beer drinking is being seen in the Premium Lager market (~5% ABV) which has reduced 18%. Normal strength beer (3.5-4.4% ABV) only declined 4% over the same period. People are drinking less beer, and additionally, drinking far less strong beer.
3. The continued portrayal of a low strength alcoholic drink as the cause of ill-health will surely only drive people to stronger drinks such as wine, cider and spirits. These stronger drinks will (according to the health professionals) cause more damage to health and society as a whole.

Your continued use of stock photography portraying beer in a negative light does much to undermine the efforts of over 800 small and medium sized breweries. It is estimated that over 10,000 people are employed by these breweries which are facing yet another squeeze from the Chancellor this week, followed by the sucker-punch of a negative health story, mainly illustrated by pictures of beer.

I urge you to make a more careful consideration of the photography and VT you use to illustrate these stories in future.


Iain Clark

Funnily enough, as a bit of a drinker I found this story quite reassuring, not what was intended no doubt. 4,000 alcohol-related liver disease deaths a year aren't that many considering how many heavy drinkers there are in the country.

Publican Sam

Spot on sir, I made this point to the Gruaniad last month over an article on alcohol consumption etc using a pint of beer as the image … lazy journalism, lazier sub-editing and even lazier editor … not even had the courtesy of reply …

Have A Pint At...

My nan wouldn't bat her near 90 year old northern eye lid at me talking about drinking beer.. mention drinking spirits and I get a look followed by questioning and a word of advice.

Every time. She knows the score.

Yet, as pointed out, beer is to blame for this increase in poor liver health, as oppose to access to education, employment, etc, etc.

Poor journalism as usual from the British media.



A great post. I agree that the maths look well out of whack, and it is a cheap pot shot at beer from the government.

But should there not also be a word of warning to all of 'us' in the beer community – given most of us now who read beer websites and blogs, whilst we might be careful with quantity to some extent, are the 2 or 3 small daily bottles or 25cl drafts of New World IPAs or Sasions (8%?) Double Imperial IPAs (10%?) or barrel aged whiskey flavoured Imperial Russian Stouts (12%+) that we want to be imbibing and ticking off as a rating on a website in our quench and thirst for more samples, not likely to be doing just as much damage to us as 7 or 8 pints of wife beater lager?

And our experimenting with stronger beers is likely to increase, no? (though long may it continue)

Just a thought. I know you alluded to the dangers of excess, but it’s something I rarely see or read about on the blogs……….

Now I am thirsty and need to go to my local craft beer bar on this sunny day………

Martin Wisse

One thing also left out of the picture is the economical-sociological situation during 2001-2009 and why this might lead to people drinking more and heavier…


A close friend of mine was an alcoholic who died before Xmas. It wasn't the beer he used to drink over many years in the Rugby Club. It was the bottles of vodka he drank secretly every day over the last three years.

Mark Hoult

We also get these regular stories saying "Scientists prove a glass of wine a day is good for you".

But we never get stories saying "Scientists prove a pint of ale a day makes you healthier"

Ale is a second class citizen when it comes to booze health coverage.

Jeff Alworth

The numbers you cite are strongly suggestive that beer has less to do with the rise in liver disease than other factors. That said, it would be great to get more figures on these questions:

1. What's the base consumption for beer, wine, and spirits? Percentage increases can be misleading. An 18% spike among liquor drinkers looks different depending on how much was being drunk in the first place. An 18% increase on a million gallons is 180,000 gallons. It's nearly two million gallons on a base of ten million.

2. Habits are a factor: are people binge-drinking? Is drinking correlated with other liver-damaging behaviors?

3. Total numbers are a gross measure, but possibly misleading. Are people with alcohol-caused liver disease equally distributed among the types–33% beer, 33% liquor, 33% wine–or disproportionately? My guess is that those who drink themselves to death are very unlikely to be wine drinkers. But possibly more of them are beer-drinkers than in, say, Russia.

There's a lot more to numbers than meet the eye. In the US, no one tracks this stuff, and it really irritates me. We're left with an incomplete picture of the harm different types of alcohol cause a nation. Because we treat "alcohol" as a single category, we miss a lot of nuance. While I expect beer has something to answer for, no one can actually say what. Which cripples our efforts to combat it.



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