The Political Tug-of-War
The title of this post reflects the actions the Surgeon General is promoting. It's part of a long-term, well-thought-out, and well-funded campaign against consuming alcohol - any amount of alcohol. The campaign runs circles around anyone wanting to point out the other positive health science behind moderate consumption. But this report shouldn't be a surprise to anyone.
In a September 2019 blog post titled "Get Ready For Cancer Warnings on Wine Labels," I discussed the developing impact of the Cumulative Negative Health Message spread by neo-prohibitionists. Even then, there was a growing push to add enhanced cancer warning labels. By now, you've undoubtedly heard the latest iteration of this skirmish, but if not, let me get you up to speed.
On January 3rd, when many were resetting their circadian clocks back to work time after an extended holiday break, the outgoing Surgeon General released an advisory about alcohol consumption.
The release comes at an interesting time - right before he leaves office and before his parent agency, the HHS, releases a critical scientific paper from their Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). The forthcoming paper from the ICCPUD, a political event in and of itself, will help inform the committee approving the next edition of the alcohol section of the USDA Health Guidelines.
As an aside, the ICCPUD is a horrible initialism. You were thinking it, and I just said it out loud.
The Findings
He is calling for enhanced cancer warnings on all alcoholic beverages and a reassessment of the (USDA) guideline limits for alcohol consumption to account for cancer risk, and advising public health professionals and community groups to highlight alcohol consumption as a leading modifiable cancer risk factor and to expand education efforts to increase general awareness of the link between cancer and alcohol.
It's confusing to read that statement against the government report released by the NASM in December. That Government report said:
"The committee concludes that compared with never consuming alcohol, moderate alcohol consumption is associated with lower all-cause mortality (moderate certainty). The committee determined that there was insufficient evidence to establish certainty for an association of moderate alcohol consumption with... cancers of the breast, colorectum, esophagus, liver, mouth (oral cavity), throat (pharynx), and voice box (larynx)."
The Battleground
The part of the NASM statement that said moderate consumption is associated with lower all-cause mortality (longer life) is a throwback because that is the uncomfortable reality the anti-alcohol movement has been successfully marketing against since the 1990s, but they still haven't been able to fully erase the message.
Living a longer life was an easy metric for the public to understand in the 1990s, but it was in opposition to the World Health Organization's goals. So, being unable to combat the scientific link between moderate consumption and longer life spans, the goalposts were moved to make cancer the threat, and they changed the measures away from lifespan to a new measure: DALYs (Disability-adjusted life years).
The WHO says that "DALYs are calculated by adding together years of life lost due to premature mortality (YLLs) and years of healthy life lost due to disability (YLDs). One DALY represents the loss of one year of full health." There is a greater opportunity to shape a counterargument if you increase the assumptions needed to arrive at a finding. Reading through the definition, how many assumptions do you need to make to calculate the years of life lost due to premature mortality? Using DALYs, you can conclude that no amount of alcohol is safe.
Is This Report Important?
What's Your Opinion?
- Is the wine industry doing enough to reinforce the science behind moderate consumption?
- If not, what should we be doing?
- Does this report matter in the grand scheme?
The beverage alcohol industry faces the problem of any pushback to the SG report sounds self-serving. While it IS self-serving, the SG’s report is designed to be alarming and devoid of perspective. It lacks relevant facts and trade-offs.
ReplyDeleteA quick example of balance is driving a car is the leading controllable cause of death for people 16-25. Should the SG issue a policy for 16-25 year-olds not to drive? No, it’s a reason to learn to drive responsibly and with caution.
It’s a routine condition of life to balance risks and benefits. That message was missing from the SG’s report.
The Beverage Alcohol Industry has to take-on WHO, the SG’s report, and everyone in the neo-prohibition camp. We have to pay to get our message out. We have to join existing Trade Associations and fund the positive messages ourselves. Otherwise it won’t get done. Quit waiting for others to address the challenge, join today.
Thanks for the comments Mike.
ReplyDeleteWe have come a long way from the days when the public widely thought wine consumption contributed to a positive lifestyle and included some health benefits. That thinking wasn't pushed out by the big alcohol industry with profits as the motive. It came from scientists unaffiliated with the alcohol industry who independently arrived at the conclusions.
Since then, the push to change the science has come from the well-funded anti-alcohol industry. The WHO has an $8 billion dollar annual budget and the elimination of all alcohol consumption is one of their top priorities. They like to say they want to remove the harmful impacts of alcohol - which sounds laudable, but when they create science that concludes 'there is no safe amount,' they are pushing for pure abstinence.
I know that the alcohol industry has a very difficult time attributing health benefits to alcohol, but the need isn't to raise money to combat the anti-science. That might provide PR for those poorly done studies. The goal should should be to market and promote wine to the new generations of consumers, and find ways to direct reporters and legislators to the good science on moderate consumption that's been done and provide the rest of the story.
Doing nothing about declining consumption will produce expected results.