US Media Refuse to Cover Alcohol Policy

By vernacula 08/29/18
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Last Thursday, leading medical journal The Lancet published a global study on alcohol and health. The study was massive, its conclusions grim: worldwide, alcohol caused much greater damage than earlier studies had reported. It killed 2.8 million people in 2016 and was the leading risk factor for death among people 15 to 49. Considering that only a third of human beings drink alcohol, that’s saying something.

Based on their data, the study’s authors made a tentative recommendation: that we might need to consider some policy changes, including taxation, tighter controls, restrictions on advertising, and revisions to official guidelines for alcohol consumption. If implemented, those guidelines should probably reflect what the science demonstrates: that the safest level of consumption is no consumption.

A few days ago, I posted a response that pulled its punches, gently tweaking the media coverage of the study. I have now had a better look at that coverage–or lack of coverage–and a bit more time to reflect, and I now think the coverage was shameful. To me, it proved that the US media are incapable of reporting on alcohol policy. They wring their hands about alcohol abuse but never examine the laws, the business practices, and the institutions that foster it. Ever and always, they treat it as a private problem, an individual susceptibility that has nothing to do with social conditions, laws, marketing, or anything happening in the public realm. In short, the media willfully promote ignorance.

The best way to promote ignorance is to ignore an important story, and many major news outlets did just that. For example, The New York Times, arguably the newspaper of record in the US, gave it a miss. In deciding whether that matters, consider the magnitude of the story the newspaper passed up: a massive study demonstrated that a global health crisis is worse than everybody thought. When smoking (another global health crisis) turned out to be worse than everybody thought in 2015, The Times was all over that story. In addition to the magnitude of the story, consider the source. The Times runs a story a week from a major medical journal in the US or the UK. The Lancet, being one of the most respected British journals, shows up regularly in the pages of The Times, even when it’s only reporting that a malaria drug turns urine blue.

Most of the news outlets that reported on the story found a pundit to contradict it–though not an actual scientist–and gave that pundit the last word on the subject. Yes, this is partly the lazy “balance” that substitutes for research and critical thinking in the mainstream media. Why do investigative reporting on an issue when you can just snag a quotation from a lobbyist on the opposing side? But, in the case of the Lancet story, the mainstream media did more than cut corners: they narrowed the focus of the study to one, relatively minor, issue, an issue with an outsized place in public discussion of alcohol policy. That issue is the health value of light drinking.

Attention to the health value of light drinking is constant among people who are supposed to be concerned with alcohol use disorders. Right now, the National Institute on Alcohol Abuse and Alcoholism is conducting a $100 million 6-year study designed to prove that light drinking is healthier than not drinking. Are the health effects of light drinking relevant to alcohol abuse? Of course they are. Those effects–and publicity about them–may influence whether people with a genetic, developmental, or social vulnerability to alcohol addiction start drinking in the first place. But they’re not nearly important enough to deserve a $100 million NIAAA study or to become the go-to topic every time the topic of alcohol policy is raised.

Compare a topic constantly in the news now: the “opioid epidemic.” Almost every day, we hear or read a story filled with grim statistics of addiction, disability, and death. The “alcohol epidemic” is larger, by the way, but let’s stick with opioids for a minute. Coverage of opioid addiction tends to be very serious. The reporter cites the latest overdose statistics then somberly intones that we Americans have a major problem on our hands. What the reporter does not do is shift the focus from opioid abuse to the question of whether light use of opioids is healthier than avoiding opioids entirely, even though that actually is an open question. But asking it in an article on the devastation caused by opioids would be breathtakingly callous.

It’s the move most reporters made with the Lancet study, though. And before we look at their response, let me remind you of one thing: the study’s authors were very tentative with their recommendations. They said we should maybe reconsider our alcohol policies so as to reduce overall consumption. They said, if we’re issuing guidelines about drinking, they should maybe reflect what the science shows: that the safest level of consumption is zero. They absolutely did not say people shouldn’t drink moderately.

The pundit quoted in most of the articles was David Spiegelhalter, Winton professor for the public understanding of risk at the University of Cambridge. I’m quoting him from the BBC, but the same quotations appeared in dozens of other papers.

“Given the pleasure presumably associated with moderate drinking, claiming there is no ‘safe’ level does not seem an argument for abstention,” he said, ignoring the fact that the Lancet authors never made an “argument for abstention.” Undeterred, he plunged on with a strained analogy.

“There is no safe level of driving, but governments do not recommend that people avoid driving.” Yes, and governments also do not recommend that people drive short distances regularly. Nor do they announce that driving a mile or two every day is safer than not driving at all if the data show otherwise. Wow, if that’s the Winton professor for the public understanding of risk at the University of Cambridge, remind me not to study the public understanding of risk at the University of Cambridge. But still Professor Spiegelhalter continued.

“Come to think of it, there is no safe level of living, but nobody would recommend abstention.” Okay, I know this quip was supposed to be droll, and standards for drollery have slipped since Mark Twain’s heyday, but we’re talking about a public health crisis here. Large numbers of people are suffering and dying, and one reason is that nearly every time someone raises the issue of alcohol policy, the discussion morphs into an argument about light drinking. Policy remains the same–or quietly moves toward less regulation, as is happening in the US now.

The exception was the Atlanta Journal-Constitution, which kept the discussion focused on policy. But, for an expert response to the work of the Lancet scientists, reporter Fiza Pirani inexplicably turned to an alcohol industry lobbying group, the Distilled Spirits Council. In an email statement, the council misrepresented the Lancet study, repeated claims refuted by the study, and manufactured its own health crisis: that regulation would unleash a tidal wave of poisonous illegal alcohol. Ms. Pirani seems not to have noticed the chopped logic, though, because she gave the industry group the last word.

“The council referenced recent evidence from the American Heart Association that found moderate alcohol consumption may help lengthen life and has also been associated with lower risk of all-cause mortality and heart disease deaths than individuals who did not drink.”

Aargh! Did she even read the Lancet study?

Other media outlets did other kinds of shoddy journalism. NPR quoted an old “All Things Considered” interview out of context so that a doctor who was originally saying “drink as little as possible” seemed to be saying “sure, drink a little!” The point is that no article in the mainstream media engaged thoughtfully with the Lancet study and its policy recommendations–at least not one I’ve seen.

As the Lancet study made clear, the US needs a serious discussion of alcohol policy. We need to think about how we manage a drug that does such damage to a tenth of our population, think about how to keep it available to those who can enjoy it safely but mitigate its harms to those who can’t. We’re a long way from being able to do that, and the reasons why were on lurid display in last weekend’s news stories.

vernacula blogs at thesoberheretic.com

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