Hmm, not quite sure it debunks the medics Gill. It doesn't say that alcohol is good or bad, merely that the limit recommended may be inaccurate in terms of health/risk benefit, having been arbitrarily decided.
Consider the question - is alcohol good or bad for you? In excess most people would agree that it is bad for you. The trick is trying to define what 'in excess' means. And also how you define risk in health terms. We have been through an analogous situation with smoking. 50 years ago it was 'cool' and everyone did it. Now nobody thinks its good for you but argument still rages over passive/direct inhalation, smoking bans in public places, lung transplants for heavy smokers and so on. We even have a measure - known as packyears for smoking. 1 pack per day for 1 year is a packyear. So 10 cigarettes a day for 2 years is also 1 packyear. Even with this calibrated measure argument rages since some effects are reversible, some are cumulative and so on.
Back to alcohol - if everyone agrees 'in excess' is bad, some form of limit needs to be put on 'in excess' to serve as a recommendation for the general public to keep below. Far better from a health perspective to aim for a low limit, far better from a public behaviour/cause of crime/cause of violence point of view to aim for a low limit. Why then should the limit be based solely on long term medical benefit/risk? Answer - bacause it catches the publics attention and makes a handy yardstick to measure intake by. Perhaps 30 units a week is fine, or 50, rather than the current 21. As with all such measures, its only a guideline. In terms of scientific evidence, I disagree with Mr Smith in the Times article. We do actually know quite alot about alcohol levels and epidemiology in a medical context. We (our group at work) have published on alcohol in stroke risk, suggesting alcohol shows a J shaped relationship with stroke risk, the tipping point being an intake of approximately 30g/day. Above this and stroke risk is increased over the general population risk. Now I wouldn't say this was the only evidence, far from it. The bigger problem is that there is so much evidence, much of it contradictory, or in different populations, or different medical conditions, that finding the consensus point for the safe/not safe boundary becomes almost impossible. There will always be someone willing to appear on TV with 'their' study disproving the governments limits. This is proved not only in alcohol but also red meat and cancer risk, mercury in fish stocks, organic v non-organic health benefits being claimed or debunked, and a range of other risks and measures.
Setting realistic limits also works the other way. Ask people what the recommended level of exercise is and most (if they have heard the government adverts) will say 30 mins of moderate exercise per day. Moderate being defined as anything that raises your heartrate - walking to the shops, doing the gardening and so on. Yet a recent study from Canada suggests this has no effect at all, and that an hour a day of exercise hard enough to make you sweat is needed to produce long term health benefits. Try selling that to the general population and see how far you get. 30 mins walking is more achievable than an hour on a treadmill. Same with alcohol - set the limit at 50 and more people will drink up to the 50 limit and feel its acceptable. Alcohol will last longer in the body since its cleared at a constant rate, and drink drive convictions go up. People turn up hungover for work, or dont turn up, all because 50 units is 'safe' so it must be OK to drink 10 units in an evening.
While the limit may be arbitrary, that doesn't mean you should ignore it and define your own measure of 'excessive' alcohol intake (not that you suggested that!). The evidence is out there that alcohol is bad for you, but there is so much of it that you can find evidence for a range of acceptable limits if you feel 21 is not enough for your lifestyle! Government limits are really there for the (sadly quite large) percentage of the population who do not know when 'enough is enough' and are unable to regulate their own intake to acceptable levels. Nanny state - maybe, depends on which side of the line you are observing from I guess.
Steve
