Malcolm Jolley: Somebody tell our health authority busybodies that alcohol and cigarettes are not the same

The American wine and drinks writer Jason Wilson calls for a campaign of “drinking literacy” in his Substack newsletter, Everyday Drinking. In a post that is a reaction to the recent media coverage of the U.S. surgeon general’s suggestion that bottles of alcohol in the States carry warning labels, Wilson characterized the last days of the Biden administration recommendation as “childish, illogical, and unscientific misunderstanding of how drinking works.”

The thrust of Wilson’s argument is that Americans tend to see alcohol in “black and white” terms like healthy or unhealthy, wherein the reality of, say, the relationship between alcohol and cancer risk is more complex. So, while the absolute risk of developing cancer may be higher, the increase in relative risk is still very small, and (citing Nassim Nicholas Taleb) Center for Disease Control data suggest about three-quarters of cancers linked to alcohol manifest in “heavy drinkers,” who are less than 10 percent of American drinkers, generally.

Presumably, a Wilsonian literate drinker would raise an eyebrow at the newfound public health interest in “risk.” And as Canadian author and risk management expert Dan Gardner has pointed out in his own Substack, PastPresentFuture, while evaluating risk is a scientific problem, how should we respond to that risk is not a scientific question.

This is not to suggest that drinking alcohol is particularly good for the human body, just that it may not be as bad as some of the authorities suggest. Most adults understand and accept some risk when they have a glass of wine. Anyone who has experienced a hangover understands there’s danger in the bottle. The difference between medicine and poison, the saying goes, is dose.

So why is there suddenly a push for warning labels, and news stories about alcohol and health risks? Europe-based Felicity Carter publishes the Drinks Insider Substack and a spin-off called Wine + Health. In a recent edition of the latter, Carter reports on the activities of Alcohol Change UK, the organization that promotes Dry January in Britain and part of what Carter calls the “public health lobby.”

Carter explains that most Western governments use a mix of policies to reduce the worst societal harms that come from alcohol abuse. They range from taxes to keep alcohol from being too cheap to access to treatment help for alcohol abusers to criminal penalties for drunk driving. Beyond policing these extremes, the consensus for the last 100 years has been if people would like to have wine at dinner or host a cocktail party, it’s their business.

The public health lobby, Carter reports, holds a different view:

[They] see alcohol as a population level or ‘whole of society’ problem, where people who drink moderately and stay out of trouble are actually enabling heavy drinkers; this is known as the Total Consumption Model. So their goal is to get everybody to drink less—or, better still, stop drinking altogether—regardless of who has an alcohol problem and who is just fine.

To achieve this their strategy, Carter goes on to explain, is to turn to the tactics once employed against tobacco against meeting a friend for a drink after work, or toasting a landmark event with a glass of Champagne:

To reduce the level of drinking in the population, the public health lobby want governments to raise taxes on alcohol, restrict its availability, ban marketing and advertising, and change fundamental social norms around drinking—basically, they want to take all the tactics they used against smoking and apply them to alcohol. It’s a strategy called ‘denormalisation.’

In Canada, the pre-eminent anti-alcohol health lobby is the Canadian Centre on Substance Use and Addiction. Tellingly, when the Centre shrinks its name to an acronym, the CSSA, it forgoes the “u” altogether, as though any “use” was tantamount to “abuse.”  (I wrote about the strange origin story of the CSSA, rooted in the Reagan-Mulroney era War on Drugs at The Hub in 2023, around the time the organization published they recommended “No amount of alcohol is safe and that consuming any more than two drinks a week is risky.”)

CCSA CEO Dr. Alexander Caudarella, a family physician, was interviewed by the CBC earlier this month on the occasion of the U.S. surgeon general’s labelling recommendation. Caudarella was eager to jump in on the latest prohibitionist project. He glowingly explained:

“It is good news because it’s about helping people understand things better. It’s about letting people know. And, ultimately, they can do what is best for them.”

And we all know what’s best for us, don’t we?

As a young man, I was foolish enough to be a regular consumer of cigarettes. A slang word for a cigarette my smokers and I used at the time was “coffin nail.” The black humour in the term came from the idea that each smoke was bringing us closer to premature death. The new prohibitionists of the 21st century would like us to view every glass of wine or beer or cocktail in the same way.

Absent Wilson’s drinking literacy, many probably already do. That’s ridiculous. Unlike cigarette smoke tar that settles on the tissues of the lungs, alcohol in the bloodstream is metabolized by the many enzymes of the liver whose sole job is to do just that. Humans have literally evolved to process alcohol, and can painlessly as long the body is not overwhelmed.

The archaeological record tells us that people have been making alcoholic drinks since before the written record. The written record tells us that the societies that made alcohol also regulated it, either by social norms or hard law like the Code of Hammurabi. Booze has been around human society for 10,000 years or so; people have thought about it.

Nobody wants to end up as a drunk. This is as true now as it has ever been. Nor is anyone confused about whether too much alcohol too much of the time is bad for you. Anyone who has known someone with “alcohol use disorder,” the new clinical term for alcoholism, understands this empirically and instinctively.

It is patronizing and insulting to be given selective data about risk by those who would speak on the presumed authority of public health. It is equally patronizing and insulting to be given the false promise of a world without risk. That world is equally impossible and undesirable. Nothing ventured, nothing gained.

The old prohibitionists applied their version of the Total Consumption Model with moral suasion, herding us with threats of the eternal damnation of the soul. The new prohibitionists have pivoted from the spiritual to the material and are trying to scare us by suggesting that every sip is a step closer to the grave. To them, I say, “santé.”