Drinking is ingrained in our social life – much as cigarettes were until public health campaigns led to a huge cultural shift. With many young people eschewing alcohol, the beginning of the end of booze Britain is in sight
Mon 23 Apr 2018 17.00
More than a quarter of 16- to 24-year-olds are teetotal, according to a 2017 study.
A cool glass of sauvignon canalside in the summer. A soothing beer by a pub fire as the leaves turn red. Mulled wine with a Christmas mince pie. Alcohol is shot through British life like, well, shots on a night out. But recent trends suggest that might be changing. Could the British love of booze be drying up as surely as our passion for cigarettes?
Consider this: in 1974, half of British adults smoked; by 2017, that figure had fallen to just 16%, according to the Office for National Statistics (ONS). The decline was a result both of public health campaigns and legislation encouraging people to cut back or stop smoking. In 2003, for instance, the branding of cigarettes as “light” was banned in the UK. That same year, EU legislation brought in health warnings on products, and in March 2006 Scotland became the first country in the UK to introduce a smoke-free law. This was followed in 2007 by legislation banning smoking in workplaces and enclosed public spaces in England (Wales and Northern Ireland also legislated against smoking that year).
The result was immediate: fag breaks at work were suddenly more frowned upon; the huddle of people outside the pub failing to light a cigarette in the driving rain came to seem pitiful. All the incremental changes – the health warnings, legislation, the images of diseased lungs on fag packets, the association with impotence – led to a genuine cultural shift. If you wanted to keep smoking, you had to be really committed (addicted, maybe?). Social and fairweather smokers dropped away.
Could the same trend be under way with our attitude to alcohol? Some experts believe so. It will be a huge shift, because drinking in the UK has a spirited history, stretching back thousands of years – jugs for fermenting alcohol go back to the stone age, past Hogarth’s Beer Street and Gin Lane in the 1700s through to the peak modern drinking period of the 90s and early 00s. This was the Britpop era: a wasted Jarvis Cocker mooning at Michael Jackson at the Brit awards in 1996 and the hideous proliferation of garish alcopops with brand names with no vowels. That period also saw a breakdown in the social taboos around women’s drinking that led to an explosion of alcohol being marketed to them. Witness the birth of the ladette and girlfriends drinking boyfriends under the table. Witness a massive overall rise in consumption.
As a society, we have always thought of drinking as a bit naughty. The language we use is telling. A “cheeky pint” after work; a “swift half”; “OK, but just one glass of merlot”. Everyone has feigned resistance at one time or another – but we don’t try very hard. And in recent decades, anyone who didn’t want to drink was considered an anomaly. You driving? You sick? You on antibiotics? You pregnant? You, you know … (whisper it) in recovery? An answer of none of the above would elicit raised eyebrows, a puzzled expression or, more likely, mirth. Possibly even anger or dislike. In years past, people who have chosen sobriety, or rarely had a drink, have been subject to intense peer pressure. Non-drinkers became isolated – not out of preference, but because British social life has been entirely organised around alcohol. Booze sat at the head of the table at dinner parties, dominated the dancefloor and landed deals at lunch meetings.
But over the past decade, that culture has shifted. It has certainly been difficult to avoid the news that alcohol isn’t good for you. The most recent reminder came last week, care of a Lancet paper, reporting that every glass of wine or pint of beer over the daily recommended limit will cut half an hour from the expected lifespan of a 40-year-old. And that recommended upper safe limit is lower than you might expect. The paper suggested five 175ml glasses of wine or five pints a week – about 12.5 units in total. Overdo it, and you are at greater risk of stroke, fatal aneurysm, heart failure and early death.
Then there’s the cancer risk. There was consternation in 2016 when Prof Dame Sally Davies, the government’s chief medical officer, told MPs just one glass of wine could increase the risk of breast cancer. This came just a few weeks after the recommended upper safe limit for men was revised down from 21 to 14 units a week, the same as for women.
The quality newspapers interview health experts and sociologists about the problems with alcohol; the popular press shames indulgent punters (usually northern, often women) on dark high streets, hitting the chip shops at 3am. That picture of the woman lying on her back on a bench, sozzled, gets wheeled out. And there have been all sorts of schemes and campaigns designed to curb our enthusiasm for drinking. There’s the Department of Transport’s road-safety Think! campaign, for instance, much of which has focused on drink driving. In 2012, Andrew Lansley and the Department for Health rolled out the Change4Life campaign, while Challenge 25, introduced in 2005 by the British Beer and Pub Association, encourages people who may look under 25 to carry ID when attempting to purchase alcohol, and encourages retailers to ask for it. This has made it harder for groups of teenagers to bulk buy supermarket-own tinnies. (Attempting to enter licensed premises to buy alcohol using a fake ID is a criminal offence, carrying a maximum £5,000 fine and up to 10 years imprisonment.)
All of this legislation, campaigning and awareness raising has had an impact, just as they did on tobacco consumption. In particular, millennials (those born between 1981 and 1996) and the later Generation Z (those born after 1996), are surprisingly sober.
“Alcohol is a strange concept,” says Ben Gartside, 19, a politics student at Hull University who is originally from Manchester. “Here’s a liquid you can drink and it can lead to you not remembering the night before and making bad decisions.” Ben is typical of many young people I speak to, in that he prefers to spend his money on food and travel rather than pub sessions.
Another young person I speak to says his family are heavy drinkers and he wanted to avoid falling into that pattern. In a broader sense, says Dr James Nicholls, director of research and policy development at Alcohol Research UK, this is quite common among young people; they are rebelling against older generations’ chosen methods of rebellion. According to a 2017 ONS study, more than a quarter of 16- to 24-year-olds are teetotal, a four-fold increase on the rest of the population, with just one in 10 seeing drinking as “cool”. Nicholls says that drinking among young people has been declining for a decade.
DRINKERS are being duped into believing low-carbohydrate beers are healthy, and need protection from questionable marketing, the Cancer Council Victoria claims.
Despite advertising it’s better for you, an analysis of so-called low-carb beer shows it is no better at preventing a beer gut than a normal brew. Research by the Cancer Council Victoria’s Live Lighter campaign also shows the marketing is working, with more than a third of male and almost a quarter of female drinkers believing low-carb beer is healthier.
Because the carbohydrate content of beer is already low — accounting for only 1-3 per cent of the total kilojoules in most beers — cutting its content has a negligible impact on the healthiness of the drink, Live Lighter campaign manager Alison McAleese said.
Instead, it is the actual alcohol content of a beer that accounts for more than 80 per cent of its kilojoules.
Ms McAleese said the only effective way to cut beer’s impact on your waistline is to drink lower alcohol brews. “Carbohydrates really makes a very tiny difference — the best thing you can do is pick a lower alcohol or light beer,” Ms McAleese said. “The marketing around certain beers definitely contributes to the misconception.”
Drinking more than six glasses of wine or cans of beer a week reduces your life expectancy, according to the one of the largest-ever studies on global alcohol consumption. The more you drink, the higher your risk, the study says. Heavy drinkers shave years off their lifespan. New findings in The Lancet show that drinking more than six glasses of wine a week reduces your life expectancy, that’s down from nine glasses of wine currently recommended as the maximum under Australia's health guidelines. Australian health guidelines say 14 standard drinks a week – that’s about seven pints of beer, or about nine glasses of wine – is safe. But the new findings, published on Friday in The Lancet, significantly undermine that claim
While I was aware of the fact that I drank an above average amount of alcohol for a dude in his mid-30’s, I never viewed it as a “problem”. It was more like an asset. Furthermore, it was an integral part of my persona: the hard partying, good time guy who also gets shit done! What would I be without it? Boring as hell?
The scariest thing about folks like us — the so-called “high functioning” types — is that we are so good at holding it together and hiding our disease that nobody ever really notices — until it is typically too late. I am extremely thankful for the fact that I quit when I did. Major disaster was inevitable.
Please take it from me, you do not have to wait for divorce or getting fired or getting thrown in the slammer or having a heart attack to occur in order for you to justify quitting.
I can assure you that quitting because you knew something horrible was about to happen is going to feel way better than quitting because something horrible did happen!
Prevention in Oncology is guest edited by Jennifer Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber Cancer Institute.
Each Prevention in Oncology column will address one of five areas in cancer prevention— alcohol use, obesity, tobacco use, vaccines to prevent cancer-causing infections, and germline genetics—with the goal of providing strategies to reduce the risk of cancer, as well as preventing cancer recurrence and second malignancy during cancer survivorship.
Among the many surprising findings in ASCO’s National Cancer Opinion Survey, published this past October, is that 30% of the more than 4,000 Americans polled identified alcohol as a risk factor for cancer, and just 38% of respondents said they limit alcohol consumption to prevent cancer.1 The survey results were published a month before ASCO issued its statement on the role alcohol plays in the development of cancer and its recommendations to reduce cancer risk through evidence-based strategies to prevent the excessive use of alcohol and modify behavior.2
The connection between heavy, prolonged alcohol use and the increased risk for certain cancers—mainly those of the upper aerodigestive tract (e.g., oropharyngeal, laryngeal, and esophageal cancers), as well as colon, liver, and female breast cancers—has been well known for at least 3 decades, given the International Agency for Research on Cancer’s determination in 1987 that alcoholic beverages were carcinogenic to humans.3 In fact, it is estimated that 5.5% of all new cancer occurrences and 5.8% of all cancer deaths worldwide4—and 3.5% of all cancer deaths in the United States5—are attributable to alcohol consumption.