U-turn Our Complacency in Dealing With the Potency of Alcohol

Abstract

This article argues that we need to reverse our complacency in dealing with alcohol, a drug that kills at least 2.7 million people worldwide annually. Ecological studies suggest that humans have evolved to be active and functional in relation to alcohol use; the present problem is that alcohol is too easily available in too potent a form. Toxicological analyses indicate that European adults consume, on average, 1,000 times the dose of alcohol that would normally be set for voluntary exposure to a consumed carcinogen. Political analyses find that a predominant driver of alcohol-related harm is the potency of business influence on policy making. Complacency would be reversed by compulsory warning labels that alcohol causes cancer; by holding producers accountable for the harm that their products cause; and, by governments moving toward a global legally binding agreement for alcohol.

Keywords:

• alcohol
• human evolution
• potency
• toxicology
• margin of exposure
• alcohol producers

Notes

¹ The reader is asked to consider and explore the implications of effective interventions between information, which relates to knowing, and the process and outcome of creating and achieving knowledge, which relates to understanding and the ability and choice to use that knowledge. Editor's note.

² The reader is asked to consider that with the advent of artificial science and its theoretical underpinnings (chaos, complexity, and uncertainty theories), it is now posited that much of human behavior is complex, dynamic, multi-dimensional, level/phase-structured, nonlinear, law-driven, and bounded (culture, time, place, age, gender, ethnicity, etc.). Pharmacological actions of alcohol, and a range of causative as well as associated risk-outcomes, however these are defined and delineated, would be such processes. There are a number of important issues to consider, which are derived from this: (1) Using linear models/tools to study nonlinear processes/phenomena can and does result in misleading conclusions and can therefore result in inappropriate intervention; (2) the concepts of prediction and control have different meanings and dimensions than they do in the more traditional linear “cause and effect” paradigms; (3) uncertainty, unpredictability, and the lack of real control, and not just attempts at influencing, are the dimensions of reality (Buscema, 1998). An additional useful reference is Hills's (I965) criteria for causation, which were developed to help assist researchers and clinicians determine whether risk factors were causes of a particular disease or outcomes or merely associated. Editor's note.

³ The reader is asked to consider and explore that the concepts of “risk factors” and “protective factors” are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development and decay; anchoring or integration, cessation, etc.), their “demands,” the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso to a macro level) which are necessary for either of them to operate (begin, continue, become anchored and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically based, individual, and/or systemic stake holder-bound, based upon “principles of faith doctrinaire positions,” “personal truths,” historical observation, precedents and traditions that accumulate over time, conventional wisdom, perceptual and judgmental constraints, “transient public opinion,” or what. It is necessary to consider and clarify whether these terms are not to remain as yet additional shibboleth in a field of many stereotypes, tradition-driven activities, “principles of faith,” and stakeholder objectives. Editor's note.

⁴ AB InBev, SABMiller, Heineken, and Carlsberg (http://www. barthhaasgroup.com/images/pdfs/reports/2014/BarthReport_2013-2014.pdf).

⁵ This is a crude estimate for illustrative purposes. Based on Lim et al (2012), over the next 10 years, there will be at least 27.4 million alcohol-related deaths worldwide (0.45 × 0.36 × 27.4 = 4.4).

Additional information

Notes on contributors

Peter Anderson

Peter Anderson, MD, MPH, PhD, FRCP, is Professor, Substance Use, Policy and Practice, Institute of Health and Society, Newcastle University, England, and Professor, Alcohol and Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands. He is the international coordinator of the ALICE RAP project (www.alicerap.eu). He has been regional advisor for alcohol with the World Health Organization, where he was responsible for the WHO European Alcohol Action Plan.