Analysis: The Health Lobby

17 July, 2017

Britain is veering towards a situation where guidelines will state that there is no safe level of alcohol consumption, a leading commentator has warned.

Christopher Snowdon, head of lifestyle economics at the Institute of Economic Affairs, has waged a war against nanny-stateism, prohibitionism and dodgy statistics peddled by public health lobbyists and neo-prohibitionists over the years.

He sees alcohol developing into the new tobacco and warns of the tactics being employed by those who wish to clamp down on the availability, affordability and advertising of alcohol.

“Two things that are very important and to watch out for in the next couple of years will be that there is no safe level of alcohol consumption and that there are no health benefits,” he says.

“We are seeing that increasingly. The chief medical officer’s guidelines being dropped [from 21 units a week to 14 for men earlier this year] is all part of it. I am quite sure that within 10 or 20 years, or perhaps sooner, they will drop those guidelines to zero.

“The message will just be do not drink to be on the safe side, just as it is for women in pregnancy. And at the moment we are seeing almost every week or two studies coming out saying that moderate alcohol actually is not good for you, it’s harmful.”

A recent study punted by researchers from the University of Oxford and University College London generated coverage in a huge range of publications, from the Daily Mail and The Guardian to Forbes and Science Times, arguing that moderate alcohol consumption causes dementia.

“A lot of this science is actually very shaky, but the takeaway message is always that moderate alcohol consumption is not only not good for you but it’s actually bad for you and there is no safe level,” says Snowdon. “The reason I think we are going to be moving in this direction is essentially evidence being derived from the policy rather than the other way around.

The people who are up against alcohol and would like to bring in measures against it – banning alcohol advertising, restricting licensing, putting tax up, minimum pricing and so on – find it politically much simpler if we just say ‘this is a bad thing’. It is something you should ideally not touch, that will harm you in any quantity – more or less the same reasons that were behind the scientific temperance instruction of the late 19th and early 20th centuries.”

The temperance movement can be traced back 200 years and it is still powerful, thanks in part to shrewd investment from Methodists back in Dickensian times. The UK Alliance for the Suppression of the Traffic in Intoxicating Liquors purchased a building in Westminster and called it Alliance House in the mid-19th century.

That is now a prime piece of real estate in the heart of London, and space is rented out, with proceeds going to the Institute of Alcohol Studies. The IAS was formed from the ashes of the UK Temperance Alliance in the 1980s, which itself was formed out of the ashes of the UK Alliance for the Suppression of the Traffic in Intoxicating Liquors. It is well funded and keen to “bridge the gap between the scientific evidence on alcohol and the wider public”, aiming to “educate, preserve and protect the good health of the public”.

Snowdon says: “There are still Methodist temperance groups knocking around. This one just happened to invest very wisely 150 years ago and has a lot of money.”

The public health lobby is not necessarily linked to historical temperance movements, and does not have religious overtones, but is very heavily involved in alcohol policy and has a similar mission.

INDUSTRY UNDER ATTACK

“You see these things over the course of two centuries and in different areas of public health policy, such as the current crusade against sugar and an earlier crusade against smoking,” says Snowdon. “You see several identifying features: creating evidence, attacking industry, claiming that there are excess costs on non-drinkers to justify policy against drinkers, and the three As – advertising, affordability and availability.

“The main points of scientific temperance instruction were that alcohol is instantly addictive, there is no medicinal benefit, that it is toxic in any quantity (that there is no safe level, in other words) and that it led to genetic degeneracy. The genetic degeneracy part has been dropped by the modern neo-temperance movement, but the rest of it is still there.”

It is difficult for the industry to fight back as the public health lobby immediately accuses it of being a self-interested big business. “A rhetorical technique, a lobbying tactic is to portray the battle as being between big, horrible industry and nice, lovely health campaigners, and this goes right back to the campaign for prohibition,” says Snowdon.

A US journalist in the 1930s looking back on Prohibition wrote: “Throughout the entire agitation it was the invariable habit of Prohibition advocates to stigmatise the anti- Prohibition forces as representing nothing but the liquor interests. The fight was presented in the light of a struggle between those that wished level, in other words) and that it led to genetic degeneracy. The genetic degeneracy part has been dropped by the modern neo-temperance movement, but the rest of it is still there.”

It is difficult for the industry to fight back as the public health lobby immediately accuses it of being a self-interested big business. “A rhetorical technique, a lobbying tactic is to portray the battle as being between big, horrible industry and nice, lovely health campaigners, and this goes right back to the campaign for prohibition,” says Snowdon.

A US journalist in the 1930s looking back on Prohibition wrote: “Throughout the entire agitation it was the invariable habit of Prohibition advocates to stigmatise the anti- Prohibition forces as representing nothing but the liquor interests. The fight was presented in the light of a struggle between those that wished to coin money out of the degradation of their fellow creatures and those that sought to save mankind from perdition. That the millions of people who enjoyed drinking, to whom it was a cherished source of refreshment, recuperation and sociability, had any stake in the matter, the agitators never for a moment acknowledged.

If someone stood out against Prohibition, he was not the champion of the millions that enjoy drinking, but the servant of the interests that sold drink.”

Snowdon believes it is today the invariable habit of people in the public health lobby to interpret any criticism of themselves or the evidence and policies they are putting forward as being funded by big alcohol or someone allied with big alcohol, and therefore in some way not to be trusted.

“The anti-alcohol lobby would like to keep out anybody involved in the alcohol industry – or indeed the hospitality sector – from speaking to government about their concerns or trying to explain why they disagree with a certain policy,” he says.

A huge bugbear of Snowdon and many in the trade is the stats published by the Alcohol Health Alliance.

“The idea of smokers and drinkers and obese people being a drain on the public purse is probably the most powerful justification for the man in the street wanting to do something about these issues, and the public health lobby knows this and pushes very hard to get very large numbers into the public mind,” he says. “It has to be billions and billions of pounds, it has to be very large numbers because, as everybody knows, we pay a very high amount of alcohol duty.

“Therefore the supposed cost to society, to the NHS and the police force, has to be even larger, thereby justifying more government coercion and even higher taxes. You get someone such as Sarah Wollaston MP saying ‘what about taxpayers? The cost of the alcohol epidemic is out of control and it’s about £20 billion’.

Kevin Barron MP saying in parliamentary speeches, ‘we took evidence that the cost to the NHS could be as high as £55 billion’. Bear in mind the entire NHS budget is only £120 billion a year, the fact that there are people who think nearly half gets spent on alcohol-related conditions is quite worrying, and the fact that he’s also an MP is somewhat worrying.

“The Alcohol Health Alliance concedes alcohol brings in £11 billion [in tax revenue], but says alcohol’s harm to society is £27 billion-£52 billion. This is basically a made-up figure. It has no credibility as a figure. The figures that are invariably used by lobbyists to claim an activity costs society billions and billions of pounds always use, and in fact are dominated by, figures that are not costs to the government, to the NHS and police forces – those are a relatively small fraction of it – and usually around 70% of the figure comes from lost productivity.

Lost productivity is not a legitimate negative in economic terms. If you become less productive you pay the price for it, because wages are tied closely to productivity. But that is not putting a burden on society. It is not a cost to society, and it is not a cost to the NHS. But it is portrayed as being such. And this direct comparison between one broad societal figure and one very literal and monetary figure is how they get away with it.

“I did the sums and the reality is yes, alcohol has a cost, but it does not exceed £4 billion at the very most in England, whereas English drinkers pay around £10 billion in tax on alcohol, so the reality is non-drinkers are actually being subsidised by drinkers. Nevertheless, the point is made again and again about how much drinkers supposedly cost society because it seems to justify more government action.”

PUNITIVE MEASURES

The public health lobby’s approach is all about using a sledgehammer to crack a nut, imposing punitive measures on the entire population – the vast majority of whom drink responsibly – to solve problem drinking among the small minority who are in crisis.

“The idea that drinkers drink too much or drink at all because it’s advertised to them, because it’s cheap and it’s available, these are fairly core beliefs in the temperance movement and the public health movement, and stemming from this is the assumption that the solution is therefore to restrict advertising, to put the price up and to make alcohol less available,” says Snowdon. “All this is based on the total consumption theory, or the whole population approach, which says there is a direct, fixed link between the amount of alcohol consumed in society and the amount of alcohol-related harm.

“You have this theory that is neat and tidy, that you have to get everyone to drink less and that the harms associated with alcohol will fall. There is no empirical evidence to support it, but it does support the three As, that you need to get everyone to drink less, even if you can get moderate drinkers to drink less somehow that will have an effect on heavy drinkers, that everybody is basically tied to the same trend.

“I think actually the reason these beliefs are so core to the public health lobby isn’t because they ever had any strong evidence behind them, but it’s neat and tidy because it justifies some fairly simple policies that you can go out and lobby for and you don’t need to get your hands dirty dealing with people who have genuine alcohol problems. The solution to serious alcohol problems is very complicated and difficult.

“You need to deal with real people who have all sorts of other, different problems. It’s not easy to do and it costs a lot of money. Whereas just getting everybody to drink a bit less by advertising bans and price rises, yes you can possibly get per capita consumption down, it’s easy to lobby for and simple in its approach, but it’s not very effective.”

So what can the industry do to fight back? “The industry needs a quick response [to press releases issued by public health lobbysists] and big, blue chip companies are incredibly fearful of saying the wrong thing and negatively impacting on their share price. The consensus position is therefore often to say nothing and hope it blows over,” says Snowdon. “But since January, the position that there is no safe level of consumption and Sally Davies telling people to think about breast cancer every time they have a glass of wine, some of these guys have belatedly decided that we can’t just ignore this and hope it will go away. They are the new tobacco as far as the public health lobby is concerned.”




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