^{8.0 The Health Benefits of "Moderate" Consumption}

8.1 Not unexpectedly, the drinks industry is enthusiastic about the possibility that in some populations alcohol is associated with a reduced risk of coronary heart disease (CHD). Internationally, the industry has made attempts to promote alcohol as a kind of health food on this basis. The claim is that because of the alleged protective effect in relation to heart disease, policies to reduce overall alcohol consumption are unacceptable as moderate drinkers would put their health and even their lives at risk by drinking less. ⁶

8.2 This claim is no more than a particularly implausible form of special pleading. In recent years, France and Italy have substantially reduced national alcohol consumption, in both countries this being accompanied by significant reductions in alcohol-related harm. There is no evidence that there has been any adverse effect of reduced consumption in relation to coronary heart disease. Indeed, in France deaths from CHD have continued to decline as alcohol consumption has declined. ¹⁹

8.3. The reason for this lack of adverse effect is that while there may be an element of truth in the claim of health benefits from alcohol, it is limited in scope and needs to be seen in relation to the risk of adverse effects. The scientific consensus is that:

There may be a reduced risk of death from coronary heart disease from alcohol consumption in the middle aged and elderly, but it is not certain that this results in longer life expectancy. ²⁰

 At a population level, the possibly protective effects of alcohol in relation to CHD "are essentially cancelled by increases in other causes of death". This is exemplified by France, where a particularly low death rate from CHD does not result in a similarly low overall death rate.19 At an individual level, some studies suggest that any net health benefit from alcohol is obtainable only from very low consumption levels - less than one drink per day on average - and that above this level any reduced risk of heart attack is offset by an increased risk of other diseases including cancer. ²¹

Moreover, all European Union countries are already consuming greatly more alcohol than is required to obtain any beneficial effects, assuming they are real and not merely artefactual. 22

There is no evidence of reduced mortality in younger populations: indeed, in them mortality risk appears to rise in line with consumption. ²³

In the middle aged and elderly, any reduced risk is small compared with other risk factors and obtainable from small quantities or alcohol or by other means such as giving up smoking, taking more exercise and eating a low fat diet. ¹⁷

There is no good evidence to suggest that alcohol is necessary for health and that total abstinence is unhealthy. Studies of known lifetime abstainers show that they have a longer than average life expectancy. ^24,25

8.4 Claims regarding the medical benefits of alcohol consumption should be seen in the context of known adverse consequences. The World Bank estimates that globally there are around 2 million alcohol-related deaths per annum, 5 per cent of total deaths, and that alcohol-related disease affects 5 - 10 per cent of the world's population, 3 per cent of the global burden of disease. 26

8.5 These estimates are of course higher for high consumption regions such as Western countries. In these it is estimated that up to 10 per cent of deaths are alcohol-related. In France it was estimated that in 1985 over 40 per cent of deaths were alcohol-related in men aged 45 - 64. 27

8.6 In view of these considerations, the principal international scientific review concludes:

"Any attempt to put about a message which encourages drinking on the basis of hoped-for gains in coronary heart disease prevention, would be likely to result in more harm to the population than benefit."17