Alcohol’s evaporating health benefits

Given the harms attributed to alcohol use, it is not surprising that reports1 2 showing possible mortality benefits for low level users attracted enthusiasm among consumers, the media, and the alcohol industry, along with those who welcomed this as a positive response to accusations that calls for action were based on moral fervour. These apparent benefits are now evaporating, helped along by an important contribution in this week’s issue (doi:10.1136/bmj.h384).3 Through analyses based on the Health Survey for England, particularly designed to identify whether any reductions in mortality risk were greatest in older populations, Knott and colleagues show that if there is any beneficial dose-response relation, it is limited to women aged 65 or more—and even that association is at best modest and likely to be explained by selection bias.3

From the early days, headlines such as “a few drinks may help curb heart attacks”4 promoted messages around alcohol’s cardioprotective properties; many doctors felt comfortable advising patients that alcohol consumption could be beneficial and politicians used evidence on possible benefits to justify their failure to act on reducing harms.5

Alcohol companies …