Tag: answering the neo-prohibitionists

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Answering the neo prohibitionists, 5 of 10: “Alcohol related hospital admissions – and the cost of alcohol to the NHS – are soaring”

This is the longest, most detailed and technical post of the ten. If you’re not too interested in detailed liver cirrhosis stats, take a quick scan of the sub-heads then go to the summary. But I wanted to put all this out there for the record. Christ, it’s taken me long enough to work out – I don’t want it to go to waste. Firstly, another caveat: I have no desire to trivialise the burden alcohol abuse places upon the NHS – I know someone who used to work in casualty on a Friday night and she was deeply traumatized by what she had to deal with. I recognise that there’s an issue here. And for the record, I love the NHS – it’s one of the things that makes me proud to be British. I intend no disrespect to the people who have to clear up after drunks and stitch some of them back together. But there several points that need answering around the whole issue of the size of the burden alcohol supposedly places on the NHS. I can’t say what the true figures are in this – I don’t know. My intention here is merely to cast reasonable doubt on the figures that are quoted, and to suggest that the true cost of alcohol to the NHS is being overplayed. But I can’t say by how much.

(i) The difference between partial cause and total cause

Figures for alcohol-related hospital admissions are bandied about and roughly estimated by the people giving evidence to the report, and then taken as fact by the time the Report is published. In terms of official figures, what they don’t tell you is that when they are compiled, there’s a sharp difference between hospital admission and deaths that are considered wholly attributable to alcohol, and those where alcohol is a secondary or partial factor. And guess what? Only 25% of total ‘alcohol related’ hospital admissions are judged to be entirely due to alcohol.

In the rest, alcohol is one of several factors. In these situations, who is to say whether or not alcohol was the thing that tipped the balance or not? If someone is admitted with high blood pressure or heart attack and they drink heavily, smoke heavily and eat chips every meal, alcohol is part of an overall pattern that’s clearly rooted in a lifestyle. But their condition is still be counted as ‘alcohol related’ To get over this, NHS analysts have come up with a system of ‘attributable factors’, where you try to give each element in admissions and fatalities a percentage of the total cause, to get to an overall statistic. If I had a year to work on this, I might be able to figure out how this works. After spending half a day on it, I only hope someone else with a better statistical background than me can take up the challenge.

(ii) ‘Passive’ alcohol abuse: the difference between correlation and causation

(At this point I’d like to give huge props to Phil Mellows, a longstanding drinks industry journalist and fellow anti-neopro campaigner, who highlighted this point in a recent blog post here.) This question of partial versus total causes gets more complicated and inflammatory when we look at the secondary effects of alcohol abuse and how alcohol’s contribution to these is weighed. Here are three quotes from the Report: “The passive effects of alcohol misuse are catastrophic—rape, sexual assault, domestic and other violence, drunk driving and street disorder—alcohol affects thousands more innocent victims than passive smoking.” “Heavy drinkers are more than twice as likely to commit suicide as non-drinkers. Between 16 and 45% of suicides are thought to be linked to alcohol and 50% of those ‘presenting with self harm’ are regular excessive drinkers.” “Alcohol [is] a factor in 40% of domestic violence cases, 40% of child protection cases, and 74% of child mistreatment cases.” By stating these ‘facts’ without giving them any further analysis, the Report is implying that if you drink, you are more likely to be a rapist, a child abuser, a wifebeater, a suicide, and that the fact that you drink makes you so. As Phil pointed out when he addressed the rape issue, this is not only inaccurate, it is astonishingly offensive to drinkers. It willfully confuses causation (alcohol made them do it) with correlation (they happened to drink a lot and they also happened to do this). Let’s be careful here: I’m not disputing the fact that suicides, wifebeaters etc are more likely than average to be heavy drinkers. But there are no grounds whatsoever to say that alcohol consumption led directly to their appalling behaviour. I’m no psychologist, but based on both personal experience and common sense, I would suggest that in many cases, alcohol abuse and domestic violence/attempted suicide etc are both symptoms of a deeper underlying condition or issue. Sure, the alcohol doesn’t help. But when someone does something appalling and then says, “The drink made me do it,” they are denying personal responsibility for their actions and we tend to dismiss this as a lame excuse. The Report seems to buy it 100%. Added to this personal speculation, when you look at studies into the social effects of alcohol on a global, scientifically sound level, such as those carried out by Dwight Heath at Brown University, there is no direct causal link between violent and dysfunctional behaviour and alcohol consumption. If there were, the Czech Republic would have much worse rates of anti-social behaviour, drunk driving, domestic violence etc than the UK, because that population drinks significantly more than we do. But they don’t. Alcohol abuse is a symptom of something else – not a cause. We can demonstrate that this is true by looking at the body of the Select Committee Report itself, and the evidence given to it by the BMA. Here’s what the BMA says about the relationship between alcohol consumption and class: “Individuals in managerial and professional occupations are more likely to have drunk alcohol in the previous week, and to drink more frequently than those in routine and manual occupations.” And here’s what the Report says about the relationship between alcohol abuse and class: “People from lower socio-economic groups were more harmed by a given level of alcohol consumption. In the most deprived areas of the UK, men are 5 times more likely and women 3 times more likely to die an alcohol related death than those in the least deprived areas.” If alcohol is a cause of these problems, how can both statements possibly be true? If alcohol consumption was the cause of dysfunctional and anti-social behaviour, most people fighting on a Friday night, beating their wives or children or committing suicide would be managerial or professional people. They’re not. And if people from a lower social class are more likely to be harmed by a given level of alcohol consumption, then it is patently obvious that alcohol is not the issue – it’s something else that goes with being a member of that class. That’s logic that even a child could understand – but the Committee chooses not to.

(iii) The issue of liver disease, particularly liver cirrhosis

To be clear: it would be foolish to argue against the simple fact that alcohol misuse is one of the main causes of liver disease, and that figures for liver disease and liver cirrhosis in particular are increasing. Even in countries that don’t share the alleged link in the UK between heavy alcohol consumption and crime, violence, anti-social behaviour etc, those that are heavy consumers of alcohol tend to have higher rates of liver disease.But claims such as “The WHO has put alcohol as the third most frequent cause of death after hypertension and tobacco” cannot go unchallenged. It completely mixes up factors contributing to death with cause of death. Otherwise, what is ‘death by alcohol’ exactly? And are we honestly expected to believe that it causes more deaths than heart disease? Than cancer? Globally, are we expected to believe it causes more deaths than malnutrition or Malaria? Really?The truth is that 1.3% of deaths in England and Wales are due to alcohol consumption.But the Report argues that these are only deaths where alcohol is stated as a cause of death on the death certificate – and it’s fair to say it does play a contributory role in other deaths too. But the report then goes on to claim that alcohol consumption is “probably a significant factor in 30 to 40,000 deaths per year.” That ‘probably’ betrays the fact that there is no scientific calculation behind this figure. But naturally, the ‘probably’ and the ‘significant factor’ disappear by the time we get to press coverage, where alcohol is simply ‘responsible for 30-40,000 deaths per year’. But the biggest health-related story in the report is the shocking rise in deaths by liver disease in the UK over recent decades. Now that is undeniable, and obviously worrying. And given that cirrhosis is caused by long term alcohol abuse, I’m not disputing alcohol’s role in this, given that consumption was increasing over the 1970s, 80s and 90s. But we must acknowledge the link between current cirrhosis deaths and past alcohol consumption. But there are other factors contributing to liver disease that are being ignored. Firstly, there are various causes of liver cirrhosis. Here’s an estimated breakdown from a health consultancy in the US (I’ve been unable to find UK figures so far):

Liver cirrhosis can also be caused by fatty liver syndrome, which is the result of a bad diet. When the health lobby or the media choose to attack the obesity epidemic, they are very quick to point out that obesity can lead to liver disease, even cirrhosis. But they neglect to mention this when attacking alcohol. Why does this matter? Because in the UK, every single death by liver cirrhosis is counted as being caused by alcohol abuse – even if the person was a non-drinker! When calculating deaths from liver disease, the ONS states, “Very few of the deaths coded to these causes include a mention of alcohol on the death certificate. However they are included in the current ONS definition on the assumption that in England and Wales many of them were caused by alcohol, even if this was not explicitly stated,” and goes on to say “All liver disease deaths where alcohol is not mentioned (other than biliary cirrhosis) should contribute to the count of alcohol-related mortality.” So the ONS makes a calculation it knows to be wrong, in order to make up for the fact that across the board, alcohol-related deaths are under-reported. But then, the Royal College of Physicians inflates the resulting figure massively, also to account for under-reporting. The alcohol-related deaths that are not on death certificates are being – at least – double counted. The surge in liver cirrhosis correlates with increased alcohol consumption. But it also correlates with the obesity problem in the UK. I’m not arguing obesity is more of a cause than alcohol consumption. I’m arguing that it is a cause alongside alcohol consumption, as are “autoimmune inflammation of the liver, disorders of the drainage system of the liver (the biliary system), metabolic disorders of iron and copper (hemochromatosis and Wilson’s disease), and drugs such as pain-relievers such as acetaminophen and non-steroidal antiinflammatory drugs (NSAIDs), certain antibiotics, antidepressants, anti-cancer agents, and drugs used in controlling high blood pressure, high cholesterol , diabetes, and irregular heart rhythms”. Somewhere in these statistics, the Beer Widow’s Uncle George is being counted as having drunk himself to death, despite the fact that he died of liver cirrhosis after being a lifelong teetotaller.(This sounds like a bit like one of those arguments that smokers make to deny the link between smoking and lung cancer. I’m not trying to deny the link between drink and liver cirrhosis. But while we’re comparing the two, as far as I’m aware no one is trying to argue that 100% of lung cancer deaths are smoking related.) A final point on liver cirrhosis: one of the most disturbing charts from the Report, which has been extensively reproduced, shows cirrhosis rates soaring in the UK while they decline in several European countries. Two points on this:

  • The countries shown were chosen selectively: if you look at the data objectively, death from liver cirrhosis in the UK (6.5 per 100,000) is still considerably lower than in the USA (9.3 per 100,000) or the average for the whole of Continental Europe (10 per 100,000) (Source: the International centre for Alcohol Policies)
  • One of the countries that shows a steep fall in cirrhosis that’s almost a mirror image to the UK’s rise is Spain. Per capita alcohol consumption in Spain and the UK is roughly the same. Clearly then, the relationship between cirrhosis and alcohol consumption is not as linear and direct as is being claimed

(v) “The cost of alcohol to the NHS has doubled in recent years”

Radio 4’s More or Less programme demolished this one on January 8th. The claim from the NHS Confederation is that the cost of alcohol abuse to the NHS (however it is calculated, given all we’ve said) doubled between 2001 and 2006. As Radio 4 calculated: this is based on a report in 2001 that said the cost was £1.4-1.7 billion, and a second report in 2006 that claimed it was £2.7bn (so for a start, even from the very lowest base it’s not quite a doubling). If you adjust these figures for inflation – and take into account cost inflation inside the NHS, which is higher because of the amount of money pumped into the NHS in the early noughties, a figure of £1.4bn equals £2bn in 2006 prices – which would mean an increase in real terms from £2bn to £2.7bn. However, the people who compiled the 2006 numbers had better information, and claim that the 2001 figure was probably an underestimate. So if you take the upper limit of the 2001 estimate – £1.7bn – and adjust for inflation, you get £2.4bn, meaning a net increase of £0.3bn to get to that £2.7bn figure. Not a doubling at all then, but an increase of 12-13%. In addition, between the two periods the total percentage of the NHS’ budget spent on treating alcohol remained constant at 3%. Hardly ‘soaring’ then. Hardly a problem ‘raging out of control’.

In summary

Britain does have a health problem in which alcohol plays a part. But the Select Committee Report:

  • Confuses where alcohol is a partial or contributory factor with it being the primary cause
  • Confuses correlation (the presence of heavy drinking) with causation (heavy drinking being the main driver of the problem)
  • Quotes data selectively and partially
  • Wrongly implies that every single case of liver disease in the UK is alcohol related

And the true cost to the NHS is deliberately being deliberately exaggerated.

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Answering the neo prohibitionists, 4 of 10: “Alcohol is becoming cheaper/more affordable”

While the consumption of alcohol has increased, taxation on spirits has declined in real terms and even more so as a fraction of average earnings.”

The Health Select Committee Report

Did you see what they did there?They start the sentence talking about alcohol, then switch to how taxation on spirits has declined, hoping you won’t spot the change in subject mid-sentence.The BMA adds:“Studies have also reported that price increases have the effect of reducing rates of alcohol problems including alcohol-related violence and crime… As part of a range of measures to reduce alcohol misuse, it is essential that the level of excise paid on all alcoholic beverages is increased at higher than inflation rates and that this increase is proportionate to the amount of alcohol in the product.”The implication here is that excise paid on alcohol is currently not being increased at a rate higher than inflation. The only problem with this is that if you don’t do that weasel thing by switching to talking about spirits, the price of alcohol is already increasing higher than inflation – and always has been:

The Report ignores this, and talks about how alcohol is becoming more affordable. How can this be true? Well, alcohol is becoming more affordable because average household income is increasing. Alcohol is becoming more affordable because everything is becoming more affordable.

But as alcohol prices have on average risen by 20% more than retail prices generally since 1980, alcohol is becoming more expensive versus other goods. As income increases, and the cost of high ticket items such as household electricals falls, people can afford to spend a greater proportion of their increased income on discretionary items such as drink – ‘affordability’ in this case is not directly linked with the price of alcohol. But should we still increase duty to offset this effect anyway? Well, how much duty increase do you want? Duty on beer increased tenfold between 1965 and 2007, and increased by 18% in 2008 alone. Duty on wine trebled between 1976 and 2007. It does seem utterly bizarre that duty has increased in reverse proportion to how strong drink is – beer has increased most, then wine, then spirits. Clearly that’s wrong and I support the Committee’s view that, relative to other drinks, duty on spirits should be increased. But affordability and price are being treated as the same thing – they’re not. By deliberately confusing ‘affordability’ (which is a function of rising disposable income) and price (which is a function of – well, price, but controlled chiefly by duty), you allow newspapers like the Telegraph to interpret these findings in the following syntax-strangled bullet point:

  • “69 – percentage alcohol is cheaper by than it was in 1980.”

This is a lie. Alcohol is NOT cheaper. It is already increasing by more than inflation, and in recent decades, it always has.

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Answering the neo prohibitionists, 3 of 10: “25% of the UK population is drinking at hazardous or harmful levels”

First, a disclaimer – I have no intention or desire to suggest that there is no such thing as a harmful level of alcohol consumption, or that some people in the UK drink to a level that presents a danger to themselves and/or others. We know that’s true. What I’m objecting to is the deliberate alarmism at the scale of the problem, and the attempt to define so many people as problem drinkers when the majority are patently not. OK, this is where we have to start getting a bit more technical and detailed. But to sum it up briefly: (i) The definition of hazardous drinkers is confused and essentially meaningless (ii) Even if you accept the definition (which you really shouldn’t) harmful and hazardous drinking are conflated by the report – and they’re quite different. (iii) Even when you take all that into account – ‘hazardous’ drinking as it’s defined – to the best we can measure it – is either static or declining.

(i) The definition of hazardous drinkers is confused and essentially meaningless

Let’s get harmful drinking out of the way first – it’s defined as “A pattern of drinking alcohol that causes harm to a person’s health or wellbeing. The harm may be physical, psychological or social.” When no harm is visible, the proxy used is drinking 50 units a week for men, 35 for women. Those limits may be high or low, but let’s accept them for now. The real problem is with ‘hazardous’ drinking. The Select Committee Report uses the BMA definition of harmful drinking: A pattern of drinking alcohol that increases the risk of harmful consequences for the person. This term is used for males who regularly consume more than 21 units per week and females who regularly consume more than 14 units per week.” However, to arrive at their data, they then use ONS data. The question ONS asks if you’ve exceeded the daily recommendation (4 units for men, 3 for women) on any one day in the last week. The BMA has taken people who have exceeded the limit on one day, and claimed that these people regularly exceed the limit on most days – thus, if you drink 4+ units on a Friday, and are teetotal the rest of the week, you are counted as someone who drinks 4+ units most days. Even having done this, hidden in the body of the text, the BMA and the Report state that “In contrast to harmful use, hazardous drinking refers to patterns of use that are of public health significance despite the absence of any current disorder in the individual user.” (My italics) This is incredible – what they’re saying is that hazardous drinking is still hazardous, despite the absence of any ill effects of drinking in the individual. I can understand that while effects in the individual may be negligible, if you gross it up to a societal level you may see a statistical effect. But that is quite different from the overall implication that drinking at this level is likely to cause harm. Sorry, did I say implication? I meant assertion. Because after having quite specifically said that ‘hazardous drinking’ is defined as there being an “absence of any current disorder in the individual user”, the BMA then goes on to say: “The 2004 Alcohol Needs Assessment Research Project (ANARP) estimated that, for adults in England aged 16-64:

  • 38 per cent of men and 16 per cent of women have an alcohol use disorder, corresponding to 26 per cent overall (8.2 million people)
  • Of the 26 per cent with an alcohol use disorder, 23 per cent (7.1 million) consume alcohol at hazardous or harmful levels (32% of men and 15% of women)”

This terminology is then repeated throughout various documents. Yes, if you’re a hazardous drinker – that’s consuming more than 4 units a day for men and 3 for women remember, (equivalent to 1.5 pints of strong lager or one drop more than one large glass of wine) you now officially suffer from an ‘alcohol use disorder’ – even though their own definition of hazardous drinking specifies an absence of any disorder. The BMA also admits that: “The effects of alcohol on an individual are dependent on various factors including age, weight, type of drink, level of dehydration, previous exposure to alcohol, level and timing of food intake, and gender of the drinker.” Having acknowledged all this, they are still content to count anyone who drinks more than 4 units a day as a ‘hazardous drinker’ – irrespective of any of the above factors which, by their own admission, have an impact on the effect of alcohol. This definition of hazardous drinking is incoherent, self-contradictory, and makes profound errors in how the figure is calculated. And yet it libels a good proportion of 25% of the population as suffering from an ‘alcohol use disorder’.

(ii) Even if you accept the definition (which you really shouldn’t) harmful and hazardous drinking are conflated by the report – and they’re quite different.

The only thing to say here is that throughout most of its content, and as shown above, the Report refers to the two groups in one breath as ‘hazardous and harmful drinkers’. Having drawn a clear distinction between the definitions of the two groups, in terms of recommendations they are discussed as one – to the extent that ‘interventions’ are proposed for hazardous drinkers to warn them about their drinking! In fact, only 9% of the UK population are ‘harmful’ drinkers – surely it would be more useful to focus on them.

(iii) Even when you take all that into account – ‘hazardous’ drinking as it’s defined – to the best we can measure it – is either static or declining.

The report claims that “the latest ONS figures show that hazardous drinking had in fact increased between 2000–2008 from 24% to 28% in men, and from 15% to 17% in women. Remember what the ONS said about making comparisons like that? That’s right: It should be noted, however, that changing the way in which alcohol consumption estimates are derived [in 2006] does not in itself reflect a real change in drinking among the adult population.” The Report here is quite deliberately and consciously ignoring the advice of the people who gathered the data it uses. Even if we were to pretend that the definition of hazardous drinking had any merit whatsoever, if look at that data in more detail:

Among men, even taking into account the revision upwards in 2006, ‘hazardous’ drinking is at worst static over the last ten years. If you were to disregard the recalculation, it would be falling. The fall is more pronounced for that ‘problem’ group, 16-24 year old men. It shows a decline – even a year-on-year decline – even taking into account the recalculation: The figure for women shows a marked increase, but this is clearly due to the recalculation of the units in a glass of wine:

It’ll be interesting to see what happens to this figure over the next few years – before the recalculation, levels are static.

So what’s the truth?

Well, according to the NHS, if we put aside the definitions of hazardous and harmful and look at some other data: “Among adults aged 16 to 74, 9% of men and 4% of women showed some signs of alcohol dependence. The prevalence of alcohol dependence is slightly lower for men than it was in 2000 when 11.5% of men showed some signs of dependence. There was no significant change for women between 2000 and 2007.” Alcohol dependence is a different measure. But I’d argue, given the above, that it’s a more useful one. It’s much lower than 25%. And overall, it’s declining.

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Answering the neo prohibitionists, 2 of 10: “Binge Drinking in the UK is increasing”

The Health Select Committee Report says, “The last 50 years have seen several important changes in the sale of alcohol which have led to a great increase in binge drinking with all its harmful consequences.”
Every newspaper report on binge drinking refers to it as an “increasing” or “soaring” problem. If we were to commission a poll, I’m pretty sure the majority of the population would agree with the Select Committee Report when they refer to binge drinking as “a growing problem”.
Except it’s wrong to say binge drinking is increasing. Who says? Only the people who compile the data on binge drinking, that’s who.

(i) Unit consumption calculation has changed over time

The only way to estimate how much people are drinking is to ask them. The government recommended definition of a binge is more than twice the recommended daily consumption on any one day in the last week. Official figures for drinking are gathered as part of the General Household Survey – they ask how many beers or glasses of wine you’ve had, and work out your unit consumption from that.
Of course, if you ask people, they might well underestimate, so in 2006 the GHS recalculated the unit amount of what people claim they drink. Now, I don’t have a problem with this at all – over the last two decades we’ve started drinking more premium lager and premium ale, wine is becoming stronger on average, and when we say a ‘glass’ of wine we’re increasingly talking about a 250ml glass rather than a 175ml glass. I’ve looked in detail at how the calculation of unit consumption was revised, and I don’t have a problem with it.
The problem comes from the fact that the new calculation was not backdated. 2006 onwards is calculated in an entirely different way from years up to 2006. This means you cannot make comparisons over time. Of course, the calculation led to a one-off jump in claimed alcohol consumption if you look at it on a graph. But the Office of National Statistics – who did the calculation – says It should be noted, however, that changing the way in which alcohol consumption estimates are derived does not in itself reflect a real change in drinking among the adult population.” Their words. Not mine.
Without the recalculation, there is a general downward trend.
The biggest leap in alcohol consumption is among older women – just as the ONS said it would be – because they’re most likely to drink the drinks that have been most affected by the change in methodology – glasses of wine.
So, to summarise: there’s not that much evidence of a surge in binge drinking rates. And where there is such evidence, according to the people who compile the statistics, it’s probably due to a change in methodology – not an increase in actual drinking.

(ii) Even ignoring that, there’s no evidence of a significant increase!

Data only goes up to 2006/7. It’s too early to see if the increase from 2006 to 2007 on overall figures is part of a trend or not – but even so, 25% versus 22% in 1998 is not much of an increase. And when we break the figures down by age, we see some interesting stuff:

16-24 year old drinkers are widely acknowledged to be the biggest problem group of binge drinkers. They’re the people we always see in any illustration of binge drinking, the people who are allegedly turning out town centres into no go areas for normal people, the villains starring in every episode of Bravo’s Binge Britain and every tabloid depiction of town centre carnage.
In this age group, even if we ignore the advice of the people who compile the figures and do a comparison over time anyway, binge drinking has fallen significantly over the decade.

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Answering the neo prohibitionists, 1 of 10: “Alcohol Consumption in the UK is increasing”

“Over the last 60 years English drinking habits have been transformed. In 1947 the nation consumed approximately three and a half litres of pure alcohol per head; the current figure is nine and a half litres.”The Parliamentary Health Select Committee Report on Alcohol

Why choose 1947? Oh, that’s why!

The Select Committee acknowledges that “The history of the consumption of alcohol over the last 500 years has been one of fluctuations, of peaks and troughs.” So why choose 1947 as your point of comparison? Isn’t it odd to say “How have drinking patterns changed over the last 63 years?” The reason for choosing this seemingly random date is that it represents a really low consumption point – any comparison is only going to look better if you deliberately choose the lowest point.[1] By choosing 1947, the Committee is deliberately ‘spinning’ the figures – manipulating data to suit their case. That in itself is statistically weaselly, but would be just about valid were it not for one key fact: alcohol consumption in the late 1940s was atypical of British drinking patterns over time, thanks to extraordinary and never repeated factors, and therefore does not represent a valid point of comparison. In World War Two:

  • Thanks to material shortages, the average strength of beer decreased markedly. Even though people were drinking more beer, they were consuming less alcohol through beer.
  • Spirits consumption virtually disappeared because (a) there were acute grain shortages. Production of Britain’s indigenous spirit – whisky – collapsed, and any existing volume was exported for valuable income; and (b) imports of spirits virtually ceased thanks to dangers to shipping – essentials had to be prioritized.
  • Many pubs were bombed out

The post-war years (including 1947) were even leaner than the war, as a broke country started to rebuild itself. It took years before the British economy got back to normal. When it did, alcohol consumption began to rise again. 1947 is therefore a ridiculous point with which to make comparison.

Changing British Drinking Patterns: The Truth

Alcohol consumption rose through the second half of the twentieth century because society became more prosperous, people had more income, and the economic foundation of Britain changed from being a manufacturing economy to a leisure/service economy. Nevertheless, if we were to choose 1870, or 1900, or 1914 as our year of comparison, the story would be one of declining consumption. Too far in the past to be relevant? OK, how about 2004? Not long enough? OK, how about 2000?

Over the last ten years, alcohol consumption has declined. It rose between 2000 and 2004, but has since declined – per capita alcohol consumption in the UK in 2009 was the same as it was in 1999, and 0.9% lower than in 2000. In other words – over a statistically relevant time scale, UK alcohol consumption is NOT increasing. The Select Committee Report is forced to acknowledge this inconvenient truth. Deep in the text, it admits that “since 2004 when consumption peaked, there has been a slight decrease in alcohol consumption in terms of litres of pure alcohol,” but says it is “unclear” whether this is just “a blip”. But by the time they get to their conclusions and Executive Summary, this inconvenient ‘blip’ has been forgotten. There is no mention of a recent fall in consumption, only that “the rising levels of alcohol consumption and their consequences have been an increasing source of concern in recent years”. The Select Committee also argues that the decline is not a “clear and consistent pattern of falling consumption since 2003”. But look at this chart:

I guess their point is that the increase in 2007 means the decline is not ‘consistent’. But any statistician or data analyst I’ve ever met (and I’ve met more than I would have liked) would say that this graph represents a very ‘clear’ downward trend. At the very least then, the Select Committee is being wilfully misleading about one of the central tenets of its report.

Finally – a note about international comparisons

The Committee reports that the UK has “One of highest consumption rates in Europe”. The truth is we’re actually 9th – behind Luxembourg, Ireland, Hungary, Moldova, the Czech Republic, Croatia, Germany and Spain. At the time of writing, Fulham are 9th in the Premier League. Would even Fulham fans attempt to argue that their team is ‘one of the highest’ in the Premiership?

[1] The only time in the twentieth century when alcohol consumption was lower was the final years of the First World War – probably too tenuous a date even for the Committee.