Nothing in there on what the involvement was, so not at all useful. Drunk driver killed self or othere? Drunk domestic partner did the killing? Drunk and killed by police for acting out? Health problems? Died because caregiver was drunk? Simply had alcohol in the system at the time of death (but also perhaps meat, sugar, nicotine, etc.)?
I don't dispute that alcohol causes acute and chronic problems. But "involved" is just too vague.
If you want to get really wormy, you can claim alcohol doesn't even cause DUI crashes; those are caused by the person who decided to drink and drive. The agency lies with the drunk person, not with the substance they consumed.
But that's a meaningless distinction if you're concerned about the impact of DUI to the public. So "alcohol involved" is more accurate and gets to the meat of what we actually care about.
To be clear, my argument is that "alcohol involved" is not a weasel term. Trying to make the conversation about "cause" is a rhetorical trap which will turn the discussion into a quagmire about free will and particularly the agency of inanimate objects or substances. If you simply say "alcohol involved", then you avoid all that philosophical mess entirely.
By analogy to the gun debate which you're alluding to, saying "gun involved" deaths would neatly circumvent the "but guns don't shoot themselves" quagmire. However in the case of the gun debate, the "cause" language is used anyway despite asking for that quagmire, because it's more emotive.
Dispensing with causation is a very convenient approach indeed. In doing so I could say "higher concentrations of melanin pigmentation is involved with higher arrest rates in the US for homicide." If questioned I will be extra certain to make it clear I don't think being black makes you commit more crime, and totally didn't mean to imply anything close to that.
The first line of the article is "One out of every eight deaths in Americans ages 20 to 64 resulted from drinking too much alcohol, according to a U.S. population-based study." (emphasis mine)
They certainly still have the burden of demonstrating that somehow, but exclusively focusing on the particular near-synonym they used in the title seems uncharitable if you have read the first line of the article.
If I crash with a gun in my waistband, is it a "gun-involved" crash? I mean I'm sure someone has crashed because they were fiddling with a gun in their waistband.
I think it's a reasonable guess that they went with the vague "involved" qualifier in order to make the number as big as possible, to bolster the core message that alcohol is dangerous and bad for people.
I don't say this to detract from their message, and it's not some major deception, but I think it's noteworthy that this kind of sales and marketing treatment is given to an idea that's sufficiently well-accepted and consistent with observed reality to where it shouldn't really need the help.
Personally, when I sense someone is trying to bolster their argument by cherry picking or other deceptive practice, I immediately question their motives and their message. Maybe the overall effect is that still more people get the message when it's "spiced up"? Regardless, it's unnerving to me that the tactics employed in marketing seem to be applied by default to so much public communication. I wonder how accurate my perception of this as a growing trend is, and how it might relate to the general erosion of trust networks in modern society.
> In the younger group, alcohol-attributed deaths were most frequently "other" poisonings (28%), followed by motor vehicle crashes and homicides (24% and 20%, respectively). For those ages 35 to 49 years, the leading cause was poisonings (24%), followed by alcoholic liver disease and motor vehicle crashes (18% and 12%).
I don't understand the objection you're raising, or why the it means the information is not useful. Sure, granular data is great, but I don't see how the lack of it comes anywhere near totally invalidating the significance or usefulness of the figure for alcohol-causative deaths.
It's not in the article but the study of course better defines what they looked at. They looked at deaths due to liver disease, cancer, car crashes, etc.
It's also a statistical trick because so few people die before 64 (even more so for e.g. 49). This table [1] shows that someone who makes it to 20 only has a 2% chance of dying before 64. This means eliminating that 1/8 of deaths due to alcohol probably only results in something like 0.1 QALY.
The alcohol result is a corollary of the fact that people who die between ages 20-50 usually die in graphic accidents versus "natural causes" like heart attack, stroke, that are actually the unconditional largest causes of death.
The magnitude is interesting as well, tis true. However, I wouldn't say it's a statistical "trick" because that implies the ratio is not useful information.
Usually they're considered sorta "past" the adult stage since they're eligible to retire. Most studies are interested in people living their prime years - aka their working years.
That's not to say "adult" doesn't ALSO encompass what a senior citizen is, it's just not the common usage.
If you are being above board you can split the “adult” population into elderly or senior, but without that stated up front I would expect adult to mean everyone 18+. And especially since most people under 64 don’t just up and die, it’s misleading to state that ratio without that qualification.
Without drawing any conclusions, I cannot help but notice a deeper than usual skepticism in HN threads about articles that report on the negative effects of alcohol.
Pretty much the same skepticism you'll see outside of HN too.
It's a difficult subject to touch without one side soundy too preachy/judgy and the other side getting defensive and irrational.
The way I see it is this -- our brave new world is tough, and many people need their happy juice to cope with the burden of it. Maybe better work/life balance and better mental/emotional health resources would improve this, but unfortunately both those things get in the way of the rich becoming richer so don't expect much.
People get defensive when they feel like they’re being attacked. Many people really enjoy alcohol and don’t like to think about it as a dangerous drug (which, of course, it is).
I think the skepticism is on any article that has a single answer to health related problems.
For me, I find that a lot of people blame alcohol for other negative behavior in ways that doesn't make sense. It is fair to say alcohol gets too free of a pass, at large, while also thinking it is too quickly blamed for things, too.
Drinking is incredibly common, so everyone has some experience with it, and very few experience loss due to it. Same reason the flu vaccine has perpetually low uptake.
Prohibition is also taught in American schools as THE failure of government policy. The barest suggestion that alcohol regulation might be necessary to prevent some problem is going to be immediately viewed through that lens.
Sometimes the effects of a lifetime of alcohol consumption, even moderate consumption, don't catch up with you until you're much older. Ask me how I know...
I see a lot of defensiveness in the comments here. Speaking for myself, and myself only, I'm a four years sober alcoholic, and knowing my behavior at the height of my addiction, I could have easily harmed myself or someone else while intoxicated.
I would suspect alcohol consumption to be a symptom of some underlying issue but still, it's shocking. And even more shocking that we've known for decades how destructive alcohol consumption is yet society and policymakers do very little about it depending on where you are.
Policymakers tried to do something about it in the United States - alcohol was made illegal by a constitutional amendment (the 18th), which means that 2/3 of the legislative body had to vote for it.
Predictably, people continued to consume alcohol in less safe ways, illegal "speakeasy" bars flourished, and moonshining became a very popular occupation. NASCAR was born when bootleggers started racing the cars that they had modified to outrun the police.
Eventually, the 21st amendment was passed to repeal the 18th.
That was 100 years ago. Since then many countries have successfully reduced the usage of other harmful substances, for instance tobacco which was done by prohibiting advertising. It doesn't need a ban to change the public's behavior.
> yet society and policymakers do very little about it depending on where you are.
I think your focus is misplaced. It is not policy issue, it is the general public itself that is the problem.
Policymakers tried, via prohibition, would you mark this as a success?
I dont drink, and never have so i am on the outside looking in. It is astonishing how "alcohol" is front and center in many things.
Hard day at work and you want to go out with coworkers.. Where do you almost always end up?
Want to celebrate something? Head over to the bar?
The root issues with alcohol are the same with other drugs, smoking, etc. Peer pressure, societal norms, etc.
Policymakers hands are basically tied.
On one hand they LOVE the revenue. Here (Canada) we have "sin taxes" and alcohol is heavily taxed. No government will want to forfeit this revenue.
Manufacturing alcohol provides jobs, inspecting it provides jobs...
If it is not legal, bootlegging will return.
I would also like to see a decline in Alcohol consumption, much as we saw with smoking.. but you need to take the successful aspects of the "quit smoking" program and apply them to alcohol.
I wouldn't be so sure. There seems with most substances to be a cultural hedonism-puritanism cycle. Alcohol and tobacco have both been through many of these.
I personally don't drink, nor do i advocate those i meet not to drink because that isn't my job. Flip side when i go out with a group, they often advocate that i drink?
I've had a few people tell me i am odd for not drinking, getting drunk is "fun" and i should try it sometime, etc.
This is just cultural norms at work. I guess you can see this as "alcoholics normalizing their behavior" if you think everyone who drinks is an alcoholic. I get similar comments when I say I don't like chocolate. My son gets flak (including from me!) because he doesn't eat pizza.
If you lived in a teetotaler culture, you would experience exactly the opposite (strange looks/comments for drinking a beer), or possibly worse (since many teetotaler cultures see drinking as a punishable offense).
Fellow teetotal Canadian here. Glad to know that I'm not the only outsider.
I grew up in a small northern town, so had early first-hand exposure to the devastating effects that rampant alcohol abuse can have on families and communities.
I'm genuinely curious what can/should be done. If we ban it, people will still make it illegally, there will be violence, and we are in the same place that cannabis is now.
I think many countries were successful in reducing the popularity of smoking cigarettes and if I'm not mistaken a big part of that was to ban advertising. As with cigarettes, we do know that alcohol is addictive and destructive. An advertising ban might be a good first step.
You could erase one of the mechanisms by making America a place where you can walk to a party or a bar, instead of driving there and then killing yourself with your car afterwards.
Also possible benefits from making America be a place where fewer want to commit suicides.
They're constrained. There aren't terribly many policy levers to pull! At the extreme, we outright tried banning it in North America once; that didn't work very well. Taxes and minimum pricing do work to reduce consumption, but they're quite unpopular with the public. A political party in my part of the world recently won an election by promising to expand retail availability of alcohol and to lower the price.
I'd note that the majority of the cost of alcohol is already taxes. The untaxed cost of alcohol is kind of frightening and is enough to make me reconsider my more libertarian inclinations with drugs. Pure grain alcohol of the kind used to make cheap spirits or for industrial purposes is literally around $1 a litre to make. Sells for $30 a litre here -- swill vodka has a 3000% markup imposed due to tax policies designed to curb consumption. Cranking it up higher has negative consequences too. I know that with tobacco, among the most dedicated cigarette smokers, increases in prices have little impact on consumption; the addicts we'd want to incentivize the most to quit with price signalling are the most resistant to price signalling due to their addiction -- they just get poorer. It becomes a dichotomy/trade-off. How how hard do we kick the homeless alcoholic when he's down vs. how much we stop college kids from taking up binge-drinking? Booze is also pretty easy to make at home so there's the consideration of prices being high enough to push people to the grey/black market, too.
I would like to see our governments go after alcohol advertising; it's basically a free-for-all in many jurisdictions. It's interesting to compare the new regulations in Canada on cannabis advertising (essentially banned in all forms) vs. the regulations on alcohol advertising (what regulations?) Yet which is the more addictive and compulsive drug?
> It's interesting to compare the new regulations in Canada on cannabis advertising (essentially banned in all forms) vs. the regulations on alcohol advertising (what regulations?) Yet which is the more addictive and compulsive drug?
I'm Canadian as well.
You know why cannabis was deregulated? Tax revenue and to kill off the illegal sales. They knew there was a demand for the product and finally caved in and opened up legal sales so they could get in on that action.
As you rightly point out, it is already taxed to death and yet the demand continues? Outright prohibition wont work.. what are the options available?
We saw what happens with Cigarettes and taxes, black market.
Canada did a study and counted butts outside a courthouse - a very high percentage were contraband.
Both my parents smoked a lot (my dad smoked two packs a day). I dont know anyone who smokes.
"In 2017, the overall prevalence of smoking in Canada was 15.1%, equivalent to approximately 4.6 million Canadians. This represents a significant increase from the 2015 estimate of 13.0%."
here's a nice chart showing the gradual decline before a spike in usage??
A moral high horse is great, but if you're stuck in the cycle where you learn destructive habits from your parents that are hard to overcome in adulthood, how do you break that cycle with out a nudge from society and policy makers?
According to the article, only 12-24% of the deaths are vehicle crashes, depending on the age group. It also includes things like alcohol poisoning and liver disease.
I find this hard to believe, unless we are stretching the bounds of "involved" to mean that /any/ participant in /any/ event where-in they had /any/ alcohol detectable in their bloodstream is "alcohol involved". I don't see how alcohol could be the causative factor in this significant a number of fatalities, as someone who regularly consumes alcohol in safe ways. Maybe I'm simply not as reckless as most other people (other parts of my life would seem to indicate this may be true), but this is a huge statement that seems to be largely unsubstantiated in the article.
This study seems to conclude that moderate drinking has minimal negative impact. Having a glass of wine with dinner or a cocktail on the weekend trends towards negative but mild long-term effects, but nothing disastrous.
Pretty much what you’d expect, hence my puzzlement.
If you look to figure 5 you will see that moderate drinking has very low impact on relative risk, and figure 4 shows some moderate benefit with respect to ischemic heart disease and diabetes. IF you buy into this kind of high level analysis, drinking 1-3 drinks a day may lower your risk for these diseases ~10-20%.
At the end of the day, the conclusions are much the same as people would intuit. moderate drinking has little impact, may help some conidiations and exacerbate others and will depend on the individual. for the average person, the effect will be slightly negative.
What I find most shocking is that you have to get to 5-6 drinks before relative risk hits 1.5X. 30-40 drinks/week is a lot for non-alcoholics.
> At the end of the day, the conclusions are much the same as people would intuit. moderate drinking has little impact, may help some conidiations and exacerbate others and will depend on the individual. for the average person, the effect will be slightly negative.
You are of course free to interpret facts as you wish. However, the study from 195 countries and over 26 years, literally, and I copy word for word from its conclusion, says :
"Our results show that the safest level of drinking is none."
And in the paragraph where that phrase is, anyone interested can find what they say about the supposed and non-existent benefits of moderate drinking.
Advertising of alcohol needs to be banned in all channels including but not limited to internet, billboards, radio and tv. Banning consumption of alcohol in general or banning scenes involving alcohol in The media are futile but advertising needs to be done imo.
France did this successfully with the loi Evin in 1991. Since then, consumption has gone down, but it's not clear how much the law helped. Overall, most people would agree it's a good thing.
Within the gun community, popular media is often credited with teaching gun enthusiasm to younger generations. Particularly video games and internet videos. But these aren't traditional advertising, gun manufacturers (mostly, not always) don't pay for these things, and a law banning people from producing such media with their own funds would surely be unconstitutional.
Also I don't think the public is up for another round of geriatric politicians trying to ban violent video games.
People are quick to point out vehicle crashes where evidence of alcohol is found in the body of the driver, but are there any studies that show how much driving time is avoided due to alcohol consumption?
I know drinking and driving is bad (and so do many others), so for many of us I would wager it keeps us away from driving and many other dangerous activities. Sober me with too much free times starts thinking "lets go walking into back alleys in Mexico or riding motorcycles through the twisties." That's not to say one is healthier that way, though.
It's actually riding in a car time as opposed to driving time, so not as much as you're thinking. Taking it as given that you're going to a bar for the social venue, abstaining and then driving yourself home would have a similar risk profile to taking a cab or carpooling with a designated driver.
To have the effect you're pondering, the actual transportation mode needs to change. Like being in a city and perhaps driving to meet up would be the most convenient, but you take public transportation (even though it takes twice as long) so that you can drink.
It may keep you away from driving but does it keep you away from travelling by car? Riding in an uber because you drank is just as dangerous as driving yourself sober.
The commenter was saying drinking is an alternative to dangerous activities, but according to the article, that same drinking can end up killing them anyways (possibly in a delayed manner vs the dangerous activity), no driving required.
Maybe to you this is all plain as day but it wasn't so long ago that people thought one glass of wine per day was good for the heart. Now we know that alcohol is always toxic with no safe minimum. I bet that hearing just how many preventable deaths are linked to this one thing is a big surprise to many.
Headline:
> One in Eight U.S. Adult Deaths Involved Too Much Alcohol
First line:
> One out of every eight deaths in Americans ages 20 to 64 resulted from drinking too much alcohol, according to a U.S. population-based study
This is _disgracefully_ misleading headlining; not sure I've ever seen one this bad.
People aged 20-64 don't die all that much, and generally die of different things than the population at large, who on average do their dying later, so, this is perhaps true, but not at all what the headline claims.
I don't dispute that alcohol causes acute and chronic problems. But "involved" is just too vague.