A comparison of population cancer risks between alcohol and tobacco | Hacker News Reader

A comparison of population cancer risks between alcohol and tobacco

bmcpublichealth.biomedcentral.com

I'll patiently wait until I see more physician consensus around this issue

https://www.acsh.org/news/2018/08/24/john-ioannidis-aims-his...

Given the recent 180 degree turn on "eat fat => heart attack", I think some seriously well designed studies are needed for all studies that make a strong statement about what dietary choices one should make, especially for dietary choices made by humans since forever.

Well. What exactly are you expecting in this case? It seems quite unlikely that any study will conclude that alcohol = good. The glass of wine a day myth has not really been supported by science, and everything seems to indicate that alcohol is bad for you.

It's just a matter of how much damage is done, and a bottle of wine per week is a lot.

A bottle of wine has 8 standard units of alcohol, and the British NHS recommends keeping the intake to < 14 units per week, so a bottle of wine per week should be well within the perfectly fine area.

Not true, the relative increased risk is abysmal even for 2 glasses of wine per day. Yeah the j-curve does not exist but it's not as nearly as dangerous as some other stuff we do.

A bottle a week would (depending on glass and bottle sizes) be about a glass a day.

> "...eating 12 hazelnuts daily (1 oz) would prolong life by 12 years (ie, 1 year per hazelnut), drinking 3 cups of coffee daily would achieve a similar gain of 12 extra years, and eating a single mandarin orange daily (80 g) would add 5 years of life. Conversely, consuming 1 egg daily would reduce life expectancy by 6 years, and eating 2 slices of bacon (30 g) daily would shorten life by a decade, an effect worse than smoking. Could these results possibly be true?"

Why would the author expect all research to be useful and life changing? There is a lot of noise but there is noise in every aspect of life (investing, programming, etc). Do Charlie Munger and Warren Buffett complain about the news and say it's useless because there are a few bad articles?

I think the point was that these studies aim to make a serious statement about serious topics, but they rarely get to be properly reproduced and tested. And when they're not challenged they can creep into our official medical guidelines, where they become doctrine, and it can take decades to convince people that not all fat is bad for you or that children with mild allergies should be exposed to allergens, and that a coffee per day will not cause high blood pressure.

The scientific process as it stands at present is greatly overestimated in its ability to reach firm conclusions. It comes down to trust. Do you trust the studies that say fat and salt and alcohol have no deleterious effects? Do you trust meta-analysis because “more must better”? These issues are coming to a head and I think we’re in a transition right now but I don’t know what’s next. Some want to abandon significance testing, some think frequentist approaches should be discarded in favor of Bayesian. Meanwhile people cling to the dogma of scientific rigor because without that, what do we have. Whether the flaws in our current efforts are endemic or the result of economic factors is unclear. Publication bias is clearly an economic problem, but the problems I worry most about are things like measurement error and clerical mistakes like this https://www.bloomberg.com/news/articles/2013-04-18/faq-reinh...

Results:

One bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women). The overall absolute increase in cancer risk for one bottle of wine per week equals that of five (men) or ten cigarettes per week (women).

I.e., not very much and could well be explained by other factors, including other lifestyle patterns, data inaccuracies (much of the data was from the UK Government's Health Survey for England which involves an interview of about 8000 people), etc.

At this point at least DNA epigenetic age should be tested for any claim of long term aging effects. For heavy drinking there was a research last year, but I guess for 1 wine bottle per week it would be insignificant.

https://www.nature.com/articles/s41398-018-0233-4

One bottle of wine a week for your entire life? For 10 years? For 1 year?

> "This allowed us to calculate the lifetime risk of cancer in alcohol-abstaining never smokers"

Does this mean they create a bias in their methodology if this population subset has a healthier lifestyle? (interested scientist, not an expert)

On average people abstaining from alcohol do not have healthier lifestyles. They include ex-alcoholics, people on various medications etc. That has explained why people who drink moderately would be healthier than non-drinkers, because the non-drinker group includes people who cannot drink.

I always assumed it was because teatotallers replaced alcohol with sugary drinks.

My understanding is that the major carcinogen from drinking is acetylaldehyde, a metabolic product of alcohol consumption, not alcohol itself. Funnily enough the body also gets acetylaldehyde from cigarette smoke. A way of reducing build-up of this toxic compound, responsible for the sweet-smelling breath of the heavily inebriated, is to supplement with N-acetylcysteine (NAC) at least half an hour before drinking. This helps the liver to keep up with the metabolic load. B vitamins also help.

However, it seems to me that (I'm not a doctor so don't take this as medical fact or advice; I'd be grateful to be proved wrong) all forms of visceral pleasure act to dampen the immune system, at least slightly, at least temporarily. Which would reduce the body's ability to destroy existing precancerous cells. Not much the committed hedonist can do about that...

Note that it MUST be taken prior to consumption:

"Pretreatment with NAC significantly protected against acute ethanol-induced liver damage in a dose-independent manner. Correspondingly, pretreatment with NAC significantly attenuated acute ethanol-induced lipid peroxidation and GSH depletion and inhibited hepatic TNF-alpha mRNA expression. By contrast, post-treatment with NAC aggravated ethanol-induced hepatic lipid peroxidation and worsened acute ethanol-induced liver damage in a dose-dependent manner. Taken together, NAC has a dual effect on acute ethanol-induced liver damage. Pretreatment with NAC prevent from acute ethanol-induced liver damage via counteracting ethanol-induced oxidative stress. When administered after ethanol, NAC might behave as a pro-oxidant and aggravate acute ethanol-induced liver damage."

https://www.ncbi.nlm.nih.gov/pubmed/16439183

I’m pretty convinced that everything gives you cancer at this point.

It does. It's not that cancer or cancerous substances are "new", we've just eliminated / managed the causes of death which used to kill us.

we're living longer. Something will eventually get us.

Jeff died 92 years old. What did he die from? In reality it's old age, but might been an infection or heart problems.

While it’s worth taking this seriously if true, 5-10 cigarettes a week is relatively little. A pack is 20 cigarettes and a heavy smoker might smoke a pack a day (sometimes more).

You can see that in the actual reported increase in cancer risk: 1-1.5% total increase. Definitely meaningful, but not what we associate with smoking.

>>While it’s worth taking this seriously if true, 5-10 cigarettes a week is relatively little. A pack is 20 cigarettes and a heavy smoker might smoke a pack a day (sometimes more).

What if these 5-10 cigs a week are enough to screw a lot of things up? So after the first x cigs the damage doesn't increase according to amount smoked?

Probably not true for cancer risk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2223525/

> One bottle of wine per week is associated with an increased absolute lifetime cancer risk for non-smokers of 1.0% (men) and 1.4% (women)

Is that 1% on top of whatever double digit percentage everyone is at risk of cancer anyway?

I'll take the wine!

5 cigarettes per week? If you can get it that low why would you smoke at all? I don't know anyone who smokes, but smokes less than several cigarettes per day, most in the half-pack to pack range (10-20 per day).

When I quit smoking, I transitioned from a pack a day to a pack a week. I smoked a pack a week for five years. It was a reasonable way to get some nicotine and enjoy the social benefits of smoking (at the time, you met girls outside the bar over a cigarette) without severe health effects.

I finally Quit after growing a beard and disliking the lingering smell of stale smoke.

I do not understand what absolute lifetime risk increase of 1% means. How many more people die compared to what?

AFAIK it means that if the average person had 10% probably to die because of cancer, by drinking the probability will be 10.1 (1 percent more).

Btw that would be a relative increase. They actually say absolute...

If alcohol was a pill manufactured by a Pharma corporation there would be no studies on its adverse affects and doctors would revere it as a miracle drug.

15 years ago the AMA made it a Public Health Initiative to shut down alcohol consumption.

This is already a description of “how much more bad is drinking” because the control group is largely drinking the same water and breathing the same air. This is a pretty basic scientific concept.

As for boogeymanning scientists as a whole body, L.O.L. Clearly there wasn’t some big scientific huddle where everyone bought into the idea of creating a drug epidemic. It’s endlessly amusing to me the amount of tin foil people are willing to apply to others.

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