Paul Chase, director & head of UK Compliance, at CPL Training: Professor Sir Ian Gilmore gave evidence this week to the Commons Select Committee on Health. He made a number of claims, all of which are worthy of challenge, but here I just want to comment on two of them. He stated that: Alcohol costs 15,000 deaths a year and is the leading cause of death amongst 16 to 24 year-old males in England, with some 27% of deaths amongst this group being caused by alcohol. These two statements are classic examples of how quoting numbers selectively and out of context can mislead and alarm both the public and politicians. Take the first claim: 15,000 deaths a year are caused by alcohol: this figure comes from a report by Professor Mark Bellis and colleagues at the North West Public Health Observatory. It estimates that there were 14,982 deaths related to alcohol in England in 2005. Now, “related to alcohol” isn’t the same thing as “caused by alcohol” and here’s where it gets a bit tricky. A death caused by alcohol can only mean exactly that; but an alcohol-related death means one that either was caused by alcohol, or one where alcohol may, or may not have played a part. We’re back to our old statistical friend ‘alcohol-attributable fractions’. The alcohol-attributable conditions that may have played a part in these deaths include 11 that are fully attributable to alcohol, and 42 conditions where alcohol is believed to have been a contributory factor. If I die by being run over by a truck, and I or the truck driver had been drinking vodka, it can be claimed that alcohol was a contributory factor in my death – let’s just forget about the truck, mentioning that just distracts attention away from the attempt to demonise alcohol! Moreover, these mortality figures imply that conditions such as adult-onset diabetes, epilepsy, hypertensive diseases, ischaemic heart disease, cardiac arrhythmias, unspecified liver disease and pancreatitis may be associated with alcohol. This implication is drawn even though most recent studies clearly show that moderate alcohol intake is associated with a considerable reduction in the mortality risks associated with diabetes and ischaemic heart disease. Then there was the claim that alcohol is the leading cause of deaths amongst 16 to 24 year-olds in England, with 27% of all deaths in this group attributable to alcohol. Well, 27 is a high percentage isn’t it? But 27% of what? Well, in 2005 1,851 men in this age group died in England from all causes. 27% of 1,851 is 500. Again, we’re not told how many of these were deaths were caused by alcohol as opposed to alcohol being a “contributory factor.” I don’t want to dismiss the significance of 500 young men a year dying, but the implication is that they all drank themselves to death and that clearly isn’t the case. According to an analysis of Bellis’s report by Professor R. Curtiss Ellison of Boston University School of Medicine, these 500 deaths were “estimated to be attributable, in some degree to alcohol consumption.” So did alcohol kill them, and if so how many of them? We don’t actually know. And finally, precisely how can Professor Gilmore claim that the way to reduce these 500 alleged deaths a year is to reduce the level of alcohol consumption across the whole population – all 25 million of us who drink alcohol at least once a week?

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