Wine or cancer? If it’s that bad, curb the drinks makers

Feb 7, 2016

(TheGuardian) - As one already in awe of Dame Sally Davies, Britain’s charismatic chief medical officer, I did not hesitate to trial her latest advice. Think first – wine or breast cancer? Result: a glass of increased-breast-cancer-risk (house white) concluded the first experiment, which was conducted, by way of mitigation, in a melee of similar risk-takers.

An objective cancer versus wine risk-assessment – factoring in age, family history, quite a depressing play, no interval and so forth – is hard, I conclude, to conduct in haste, in a bar where social norms are putting up a death-defying fight against medical advice.

But all credit to Davies for following through with practical advice, however idiosyncratic, on her radical new drink guidelines, of 14 units a week, for both sexes, with no safe level. Outside the public health and temperance communities, her advice seems to have met, possibly unhelpfully for public health, with enormous indignation.

On what was it based, some patriots asked, when a Spaniard’s intake is double a Briton’s? How come the limits are now the same for men and women?

What, anyway, is their likely impact in a country where, as testified by the occasional brawl, parliament itself is daily sluiced down with buckets of subsidised gin, and, indeed, where the state’s alcohol policy is run by the alcohol industry?

How to treat one’s body as a temple, when, the prime minister treats Matthew Freud, PR to Diageo, as a mate? Cameron has been a regular at the parties where, with his health educator’s hat on, Freud presumably never opens a bottle without reminding his guests of the liver disease and drunkenness that unaccountably accompany the availability of incredibly cheap drink, 24 hours a day.

But as Davies reminds us, on this as on obesity and exercise, there is such a thing as personal responsibility. “I would like people to take their choice knowing the issues and do as I do when I reach for my glass of wine,” she told a Commons committee last week. “Think – ‘do I want a glass of wine or do I want to raise my risk of breast cancer’ – and I take a decision each time I have a glass.” Although Davies has been ridiculed for her hint, it’s perhaps no more absurd, if a little more statistical, than an old-fashioned memento mori. A beaker of the warm south, with carcinogenics winking at the brim – while you calculate your life expectancy?

And who knows, since it works so well for Davies, that her signature, personal evidence-based technique will not turn out to be the missing link in the light-touch paradise adumbrated in early coalition documents. “Strong-armed regulation,” said the new nudge unit, in applying behavioural insights to health, “is not the answer to rebalancing our diets, changing our desire to drink too much alcohol on a Friday night or making our lives more active.”

And there is no reason why the individual, Davies approach to everyday hazard assessment should be limited to alcohol. Think: do I want that cake or do I want to raise my risk of diabetes? Think: do I want to go by bike or do I want to increase the probability of being killed by a lorry? Think: do I want to go for a country walk or do I accept the near certainty of being killed by a stampeding horse?

Then again, in a science-based health service, there must be doubts about the impact of the chief medical officer’s “do as I do” mantra. Could it be counterproductive? Since it helps, research has established, to have some of the media on side in a health campaign, as opposed to many of them labelling you – however unfairly – a nanny or, more politely, a sanctimonious alien from planet Islington. Even without such media trolling, which must hugely delight the drinks industry, the chief medical officer’s exhortations conflict with earlier Tory precepts on reforming unhealthy lifestyles.


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