No amount of alcohol is good for the heart, says World Heart Federation | Hacker News Reader

No amount of alcohol is good for the heart, says World Heart Federation

bloomberg.com

451 pointscaaqil949 comments

I am fine with abstinence as a general recommendation, but critical thinking pointed out two issues with the WHF Policy Brief, which I suppose I have read in sufficient depth:

1. There is no citation on the sentence, "Recent evidence has found that no level of alcohol consumption is safe for health." This is really the only line we are interested in.

2. There is no comparison on the effects of alcohol on the body by dosage (and frequency), which is, again, what is required from the brief to make that claim.

Again, while I don't necessarily disagree with what's in the report, and that it is already established that drinking too much is not good for the heart, considering many otherwise toxic substances have a hormetic zone, it is critical that a study like this rules out the its existence for ethanol.

As I recall, for this particular bit of research that I read a couple of months ago, more precisely it states there is no clear discernible level of consumption that could be deemed "safe". That's not really a surprise if you look at the data because it's such a mess. You also can't pin a point at which consumption is a high risk. What does that tell us?

You can however surmise that low / moderate consumption is not associated with high risk of mortality. There is "risk" insofar as it is non-null, anything above zero is unsafe. So what? That doesn't mean it's significant.

edit: this appears to criticize the paper - https://jamanetwork.com/journals/jamainternalmedicine/articl...

Exactly. I find the claim "no level of alcohol consumption is safe" hyperbolic. You could claim with far more justification that "no amount of driving is safe" since you could be killed pulling out of your driveway but I think most people who drive on a daily basis would find this claim odd. "safety" is a relative, not an absolute condition, since in some sense being alive is unsafe.

That is a weird comparison. No one is forcing you to drink alcohol, but you might be forced to drive to the office. One is avoidable, the other one is not. Or if you want to be even more precise: One is easily avoidable and the other might cost you your job.

How is that relevant? If you want change it to "no amount of driving to the bowling alley is safe".

I have seen many people use such comparisions, which do not match up, to justify unhealthy behavior for themselves, shutting themselves out from proper reasoning. That is how it is relevant. I am saying: Do not fool yourself using such arguments.

Also the comparison you now brought up is again not a good argument: It doesn't matter, whether there are unnecessary rides. The argument is, that there are mandatory ones for people, while there is no mandatory thing that forces you to drink alcohol. Or at least there should not be and in reality there are probably very few.

Sure there are mandatory rides, but the argument doesn't hinge on those..you can consider only nonessential rides, and drinking. Both are totally optional, what is your issue with that comparison?

I have no issue with the comparison of nonessential rides. I want to note though, that the original argument was plainly about "pulling out of your driveway".

So if one does nonessential rides only, then yes, the comparison might work. I think that is quite a special case of a situation though, which I cannot simply interpret into what the original argument said. I mean, I am not here to interpret a working version into something, that in its generality does not work as a comparison. I rather read things as they are written and try not to add things.

We could speculate about how many people use a car mostly to be able to get to the location of work or how many people use a car for essential reasons. We are getting further away from the actual matter of discussion though, which is drinking alcohol and that not being requried at all.

> So if one does nonessential rides only, then yes, the comparison might work.

I disagree. Just like alcohol can be eliminated from your diet, nonessential rides can be eliminated without eliminated essential ones. It doesn't matter what you mostly use a car for, it's totally irrelevant.

No one is forcing you to drive to work either. Many people in don't even have a license, yet make it to work each day. You even said it, "might be forced" meaning there are possibilities in which you aren't.

If you live outside the city, you basically are. In my home town, transportation is limited, eg a bus in the morning and one in the afternoon, both which can be late, and the stops are kilometers apart and the sidewalks are shitty. So when I'm there, I take my car everywhere, as does everyone else.

But when I lived in a big city, the opposite happened: parking was expensive and the traffic sucked, so I always took the bus and subway.

Let's not make blank statements about transportation, as it differs so much from one place from another.

Still aren't forced to drive. Walk, bike, catch an earlier bus etc.

No one is forcing you to work either

Cue we get into the weeds bickering over the analogy for the rest of the thread.

Driving is absolutely avoidable. Being willing to drive might help you get a better job - but so might being willing to drink.

(Far more importantly, drinking is actually enjoyable, whereas commute-style driving is a chore. Considering a job to be somehow more important than a social occasion is putting the cart before the horse)

This is a pretty odd comparison.

Some amount of food/caloric intake is healthy or required. Too much is bad. Some amount of water intake is healthy or required. Too much is bad.

No amount of arsenic intake is healthy or required. Any is bad. No amount of alcohol intake is healthy or required. Any is bad.

Too much of many things is bad. Any amount of some things is bad.

Safe may be an odd term for it but alcohols impact on ones health is always a negative. If we define bad as a negative effect on ones health it may be a better term than safe here.

Arsenic is in all kinds of foods, if you made the claim "no amount of arsenic consumption is safe", you would be arguing that basically everyone's diet is unsafe. What does that even mean?

To take the claim "no amount of alcohol consumption is safe" seriously would mean you shouldn't eat bread, which contains a small amount of alcohol.

What about: 'No amount of smoke inhalation is safe for the lungs'?

Obviously, if you live in a city, you're going to find yourself inhaling smoke from time to time, but it's still the case that it should be avoided. It's not extreme to think of alcohol as 'always negative' but also to accept it's a common and basically unavoidable toxin.

That's a hard argument to make. "2nd hand smoke" is (for now) unavoidable (though has decreased dramatically over the last decade or two). "2nd hand alcohol" is not really a thing at all. We choose to drink it, or we choose not to (ignoring heinous acts of coerced drinking).

Having a fireplace, barbecue, outdoor fire pit, or going camping with a campfire, are all situations where people intentionally choose to engage in activities that cause them to inhale smoke. Those activities might contribute to a healthy lifestyle in the whole. Similarly, social activities that include alcohol consumption can be analyzed as a whole, without the pretense that they can always be made 'dry'. There is no 'dry' wine tasting.

Tobacco smoke and fire smoke are generally entirely unrelated from a health perspective.

Going to a wine tasting is a decision to drink wine (though if it occured at someone's house rather than a public or commercial facility, I could imagine that the hosts might accomodate a non-drinking partner or something like that).

>Tobacco smoke and fire smoke are generally entirely unrelated from a health perspective.

But not from a scientific perspective.

Indeed, and cyanide as well for instance. Neither are "necessary" either. I don't think necessity has any bearing on the discussion. Ultimately the question is whether moderate alcohol consumption poses a significant health risk, and "no safe amount" avoids answering this.

> To take the claim "no amount of alcohol consumption is safe" seriously would mean you shouldn't eat bread, which contains a small amount of alcohol.

No, it doesn't mean this. What they mean is that any amount of alcohol consumption causes some amount of harm. From the research I have seen it seems to be more or less linear. Minuscule consumption means minimal harm.

The implication isn't that you or anyone else should necessarily reduce your consumption to zero. It's that it should not be assumed that there some level of consumption that causes no harm or is beneficial (as previously believed). That is what the phrase "no amount is safe" commonly means in medicine. It is a purely medical recommendation.

This is totally separate from a dietary guideline, which would weigh the risks of alcohol against the social reality of it's consumption. That is the way that you seem to be interpreting it.

Also I'm not the person you responded to originally, but interestingly it seems like arsenic, in tiny quantities, is actually essential to our biology.

> any amount of alcohol consumption causes some amount of harm

There is no guarantee that you will suffer harm from a single drink. What it really means is that any amount of alcohol consumption carries some (possibly minute) risk of harm. This is not, IMO, equivalent to "unsafe", which generally means something well outside the bounds of normal risks that most people already take on in their everyday lives.

If we accepted that "some risk of harm" = unsafe, we would have to describe using the stairs as unsafe, taking a shower as unsafe, putting up Christmas lights as unsafe, etc.

And medically those are unsafe. The crucial part, though, is that that's not at all to say you shouldn't do them. You are simply using a different understanding of the word safe than they are. This is a medical brief aimed at experts who should have no trouble understanding what claims are and are not being made.

This is not a lifestyle or dietary recommendation. This is not a cost benefit analysis. This is a medical brief that states that no amount of consumption is safe. The takeaway categorically should not be that we should all reduce our intake to zero, which seems to be how folks are interpreting this.

For what it's worth, I say all this as a regular drinker who has no intention of ceasing drinking.

I would argue that if those things are unsafe, the term unsafe has no useful meaning, i.e. life is unsafe.

It's a policy brief, not a medical brief, it is pro-abstinence and recommends a variety of alcohol control policies, short of actual prohibition:

"- Call for strict regulation of alcohol products

- Advocate for minimum pricing of alcohol products

- Build capacity internally and among peers to promote cessation of alcohol use and abstinence from alcohol

...

- Prioritise alcohol control in national agendas for health and support policy coherence between health and other sectors"

etc.

At least death is safe. As in, dying will not increase your risk of death.

If time word “unsafe” means “carries more than zero risk” then it isn’t very useful to me to know whether a doctor considers something unsafe.

Yes, but it's useful to them. That's the point.

I’m guessing I’m not alone in saying that some of the most enjoyable, memorable, and positively impactful nights of my life were because of alcohol.

To call ingesting it in any amount “bad” is way too reductive.

Which is why I defined bad. Meth addicts experience utter bliss and euphoria while high. I've had lots of great experiences drunk or while drinking. I've also thoroughly enjoyed utterly gorging myself on unhealthy or excessive amounts of food. I've driven too fast, stayed up too late, and generally done lots of things that are bad for me because they felt good or lead to some type of, at least in that moment, good experience.

It doenst mean those things were not bad for me. It's about being able to admit that those things were bad for my health regardless of if I decided the benefit outweighed the cost. Many people thing the cost of consuming alcohol is lower than it is and that the benefits are far greater than they are. I've had plenty of incredible experiences without booze too. In hindsight there were plenty of things I would have enjoyed just as much, if not more, if I didnt think I needed alcohol to make the experiences better in some way.

It's because for years there was a claim that low levels of consumption was beneficial, not just safe. They're working to undo that conventional wisdom.

I don't recall there ever being a time when people espoused short drives as being beneficial for one's health.

To quibble, something can be "unsafe" i.e. harm you in certain ways, and also carry health benefits, since "health benefits" does not merely translate to "life expectancy". In fact for the study in question, compare impact on different organs; for some there is a harm, for others a marginal benefit (if I remember correctly).

This is the problem with pop sci headlines, they don't give you context. If one study finds that some compound has potential benefits in one specific physiological region, the news will read "x is good for your health", and vise versa.

Looking at just mortality, we can more accurately say, for those touting this study, "there is no evidence alcohol consumption improves mortality", and also "low alcohol consumption may weakly worsen mortality rates".

A lot of studies on alcohol and mortality show a J curve where mortality actually drops, and then starts rising until it's back at baseline at 4 drinks / day. Now, I am not saying that it's safe to drink 4 drinks per day. That's a lot. What I am saying is that is the point where cardiovascular benefits seem to be outweighed by the increased cancer risks. Many studies have called the J curve into question due to the 'sick quitter' effect, but you have to realize that by trying to correct for that effect they are often just adding a fudge factor to the numbers. Alcohol is a very hard subject to study because it's always self reported, and thus almost always under reported.

Correlation doesn't equate to causation. Perhaps the people that sit down with a glass of wine at night are the ones simply taking a slower pace in life and have less stress as a result.

However be that as it may I'm not giving up alcohol lol. I only drink occasionally and I enjoy it and I simply don't care if it's bad for me. Lots of things are bad for us.

Plus driving to buy food definitely makes you live longer.

It's not exaggerated. Your claim of "no amount of driving is safe" is also not hyperbolic, it's real. You drive, you're at risk.

What's going on here is that the previous conclusion was not "no level of alcohol consumption is safe." The previous conclusion was "some alcohol is good for your heart." All this new conclusion says is that this is no longer the case.

Nobody lives their life off the mantra "no amount of driving is safe"... That would be crazy but it would be entirely wrong to say that, "some amount of driving improves your life expectancy" when this is clearly not the case.

Hence the need for the WHF to take an official stance on this. It's a data driven conclusion, but you of course need to be the judge about what you need to do with that conclusion.

> What's going on here is that the previous conclusion was not "no level of alcohol consumption is safe." The previous conclusion was "some alcohol is good for your heart."

Something can be deemed "unsafe" and good for your heart. There's more than one internal organ. The word "unsafe" doesn't provide context.

Here's a better way to put it. Alcohol never was good for your heart. IN fact it's bad for your heart and does nothing good for your body. That is what the WHF means when you ignore all the semantic pedantry.

That’s a rubbish comparison.

Of course no amount of driving is safe—that’s commonsensical. You always have a chance of getting harmed when you decide to drive a car. But driving a car has a clear utility which is non-optional in a lot of cases. The utility of recreational alcohol use is, on the other hand, more akin to joyriding—so similar to a completely optional subset of car driving.

It's impossible to eat many foods without ingesting ethanol, including bread. The advice that "no amount" of ethanol is safe is ludicrous, including from a biological perspective, as the human body is well equipped to safely handle ingestion of ethanol in moderate amounts.

That’s an illuminating argument and not at all just a technicality that disproves nothing. Consider me enlightened.

> […] So what? That doesn't mean it's significant.

It is the question, how significant it is. Then there is the question, what level of significance will make a person reconsider their consumption.

However, the statement that no amount is truly safe, if it is correct, means, that in general alcohol is an unnecessary risk. There is no need to drink it and no good for ones heart comes of it in terms of biology. What society does with this info is up to all of us.

This is only true if you assume or demonstrate that alcohol has no benefits to individuals that outweigh the downside risk to health. As the downside appears to be relatively small, this seems like a fairly difficult bar to clear.

No, their statement is correct regardless of the benefits. This brief isn't a cost benefit analysis. It's not a dietary guideline. It's a statement of medical fact (based on current research, anyway): that no amount of alcohol is safe for cardiovascular health.

There may well be benefits to alcohol consumption, but those are entirely irrelevant here.

To point 1. In the brief I find at the red download link [1] contains the line “ Based on recent evidence, it has been concluded that there is “no safe level of alcohol consumption”(5).”

The reference points to an article from The Lancet [2]

[1] https://world-heart-federation.org/wp-content/uploads/WHF-Po...

[2] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Another article from The Lancet from around the same time reported a whopping... 6 months of life expectancy reduction when consuming 100-200g of alcohol a week versus 0-100g of alcohol a week. [1, Figure 4] A drink is 14 grams of alcohol, so that means that your risk from consuming 150 grams, or over 10 drinks a week, is still relatively low in terms of all-cause mortality. Figure 1 also shows that consumption of 0-100g per week has virtually no consequence on all-cause mortality.

[1] https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736...

so Japanese people would live even longer than everyone else than they already do if they didn't drink so much

Japanese people don't drink a lot. They're 17th out of the 17 "high income countries" shown by default here:

https://ourworldindata.org/alcohol-consumption

They do smoke like chimneys though, which makes for some pretty surprising stats vis-a-vis lung cancer (lower rates than the US) and life expectancy (significantly higher).

For comparaison, smoking is ~10 years of life expectancy reduction https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal....

Surprisingly obesity seems to only replace some of your last years with years with diabetes, without decreasing your longevity https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4951120/. I think I didn't read that study correctly, or didn't find a good one.

Air pollution might be around 1 to 3 years: https://dynomight.net/air/

A reduction of 6 months is also more than what you can expect to gain by taking statins: https://dynomight.net/statins/.

> obesity seems to only replace some of your last years with years with diabetes, without decreasing your longevity

That's probably only because we can generally manage diabetes pretty well, though it does impose a lot of cost on society to do so.

> we can generally manage diabetes pretty well

We can but it requires the patient to manage their blood sugar very, very carefully and a lot of them can't do it 100% of the time. Whenever they don't, the damage happens and it accrues. I see a guy in the 'hood who's had much of his foot amputated as a result of diabetes.

Or so I've heard. I'm not diabetic myself.

"Nevertheless, men with obesity aged 55 y and older lived 2.8 (95% CI −6.1 to −0.1) fewer y without diabetes than normal weight individuals, whereas, for women, the difference between obese and normal weight counterparts was 4.7 (95% CI −9.0 to −0.6) y. Men and women with obesity lived 2.8 (95% CI 0.6 to 6.2) and 5.3 (95% CI 1.6 to 9.3) y longer with diabetes, respectively, compared to their normal weight counterparts."

Is this study suggesting that obese people with diabetes lived longer than obese people without diabetes? I suppose that diabetes as a condition is not harmful in and of itself and perhaps leads to a healthier lifestyle?

My (uninformed) guess would be that people with diabetes are followed more closely than people without. Your point about healthier lifestyle is a good one too.

Diabetes is extremely harmful unless perfectly controlled which it almost never is. The damage accumulates very slowly.

Severe obesity significantly decreases longevity.

https://jamanetwork.com/journals/jama/fullarticle/195748

That effect has been magnified by the current COVID-19 pandemic. Obesity directly causes more severe symptoms in infected patients.

https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...

https://cardiologyres.org/index.php/Cardiologyres/article/vi...

https://reason.com/2022/01/03/cdc-covid-19-children-hospital...

So severe obesity would be indeed "almost as bad as smoking" according to your article, which is more in line with what I've heard before. Thanks for the sources.

> Surprisingly obesity seems to only replace some of your last years with years with diabetes

That can't possibly be right. Obesity is a negative prognostic factor in almost every disease.

I'd say quality of life is a way better measure - but its so subjective it makes it difficult.

I'm a sociable person, and in my(western) experience there are more good times when alcohol is involved, even with people who does not drink often. I get that it may have an adverse effect on health and longevity. But in the end, we are all going to die - to grow old just to be old doesn't sit right either.

There's a metric know an "Disability-adjusted life year", or DALY, that tries to quantify this: https://en.wikipedia.org/wiki/Disability-adjusted_life_year.

And your point about social alcohol is well taken. I have the luck of being a lightweight with drinking, so usually a glass of cider is enough for me, and with the right people it's always a good time. On the other hand, lots of people my age (young adults) tends to drink multiple pints of beer multiple times a week. They should at least be aware of the tradeoff they're making.

Queue the Winston Churchill quote "I've taken more out of alcohol than alcohol has taken out of me". I believe he died at age 91. Although it seems crazy that we could have ever believed alcohol is healthy in any way.

Anecdotal accounts could be one offs. We need data for a full picture and even than the data could be biased.

It may very well be Churchill could have survived longer were it not for alcohol.

This recent post seems to imply that they now have more accurate and more unbiased data leading them to this new conclusion. I think a lot of people at the WHF drink some amount of alcohol as do most people in the world. However, despite this, their conclusions and announcements must be based off data which is exactly the right thing to do and exactly what they are doing here.

There's some data on scholar, for instance a suggested health difference between wine vs beers or spirits, based on ~28k participants monitored over 2-19 years[0].

From my understanding the narrative of moderate alcohol consumption (specifically wine, via resveritrol) being beneficial comes from epidemiological studies of people living in the Mediterranean, an area with relatively long median life spans[1]

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC31093/

[1] https://www.ingentaconnect.com/content/ben/emiddt/2014/00000...

Other than this being an anecdote and doesn't mean everyone who drinks heavily will leave to their 90s, the quality of those 90 years matters too!

Though he became Prime Minister for the last time at the young age of 76 in 1951, he was plagued by health problems. He suffered many minor strokes and at least one that left him partially paralyzed for some time. He only stayed on as PM as long as he did because his successor was sick as well (Anthony Eden).

Don't know about you, but I would rather live a healthy 70 years than live 90 years but where the last 20 years are plagued with illness and thus lower quality. In that light, I try to minimize the bad habits that may result in poorer health and thus lower quality life in my later years. Not saying I'm a saint, but I don't need to drink every day or even every week. Currently I'm mostly dry. Saves a lot of money too!

It is absolutely acceptable to knowingly exchange damage to body for healing to mind, and vice versa as well. But I still appreciate that science is gradually making clear that alcohol is not perfectly harmless, and that a large-scale health foundation is finally admitting that.

The mind is part of the body

Also contrary to popular belief, alcohol does not heal or help the mind unless perhaps you have methanol poisoning or are in the middle of a panic attack

> The mind is part of the body

is it...?

Yes, the mind is an emergent property of the networks of the brain.

Or maybe you have a soul.

The soul is an emergent property of the mind and body interacting with the world.

Citation needed. Please don't invoke magic

How could it possibly not be?

if the mind is a state of consciousness, and damage to the brain damages said consciousness, the mind must be part of the body.

going further, alcohol is interesting in that, in appropriate amounts, it can improve the state of consciousness through a better quality of social interactions, and at the same time, can damage the state of consciousness through poisoning

Absolutely, and not only in a strictly physical sense (i.e. it's contained within it). Mental acuity into old age is strengthened by continued exercise and fitness - damaging the body so that it is less able to physically operate damages the potential of the mind.

Even if you want to step into the realm of the philosophy of mind[1] - there still are rather clear portions of the mind that are physically linked and a pretty wide consensus on the feedback of bodily strength to a healthy mind. Modern dualism accepts that a lot of mental functions are either enabled or assisted by our physical brain goop and classical dualism still assumed the definition of some crossover point where the metaphysical abstract expression of thought was translated into physical signals that triggered actions in the body - the existence of pain reactions necessitates a fair amount of our mental processing having the direct involvement of physical systems.

1. https://en.wikipedia.org/wiki/Philosophy_of_mind

> alcohol does not heal or help the mind

Is it not possible that some people find alcohol in reasonable doses to be a net positive mentally and mood-wise?

What people experience as positive does not need to be that. Using alcohol to not/postpone/avoid solving an underlying problem for unhappiness would be an example.

It's been basically 2 years since I've had a drink.

Before then, I drank socially-- a couple times per year I'd get buzzed with friends. Not all my social outings were buzzed.

But those hazy memories of being buzzed withe friends are little treasures that bring me smiles even long removed from them. My life is richer, and my mental health better, by virtue of hanging out with people this way and I miss it (this is a casualty of COVID).

Many memories of sober moments with friends bring joy, too. But they're qualitatively different things. I want both.

Preface: I say this as someone who has been sober from alcohol for almost 5 years.

Something can be a "net positive mentally and mood-wise" without also being something that is "not/[postponing]/[avoiding] solving an underlying problem for unhappiness".

The sibling posts make the right point: lots of things are objectively bad for your body, but your emotions are part of it, too. If alcohol or whatever makes you happier, then it's "good for you." Until you have so much that it's not good for you anymore.

It's the same for sweet desserts: why TF should you deprive yourself of all of them? Just keep it in moderation.

We could imagine a very different society with much less consumption of alcohol but people still being equally happy. If someone is made to feel unhappy when they don't drink because everyone around them is doing so, the fact that then consuming alcohol makes them happier shouldn't be pointed to as evidence the person is making a good trade off between bodily harm and happiness.

This post is kind of involved.

No, you shouldn't be made to feel unhappy; or rather, you should push back harder against anyone who tries to effectuate that. Being sorta Stoic here: no one can "make" you feel anything.

It's none of their business, after all.

People are notoriously bad at observing/examining their own behavior and mental states, although it is possible. But those people would probably be better served with a pharmacological anxiety treatment or therapy

Alcohol can be part of having a fun time, and having a fun time occasionally is good for your mental health (as opposed to the physical health of your brain, which appears to be what you're talking about).

This is certainly an opinion, but I think there are plenty of alternatives out there that can do a better job at enabling fun having without causing nearly as much bodily damage or functional impairment. We have a variety of choices in both the natural and pharmaceutical realms.

Okay, fine. It’s acceptable to damage the body to heal the body.

For example, exercise, where you damaging muscle fibers to heal, maintain, and/or improve the body.

Also for example, intoxication, by virtually every vector known to exist, often damaging the body in order to maintain the body.

Being alive is about tradeoffs, not about minmaxing. You can max out any statistic, but only at the cost of the others — sanity included. Alternately, being alive is about the exquisite joy of minmaxing, being able to hyper focus on one specific body goal at the cost of everything else in your life, including sanity (if you’re not careful).

“I’m sane without intoxicants”: so no nature, no music, no games, no social joy, then.

For example, this is either a description of an acid trip or of someone listening to orchestral music on the radio:

“It was so amazing. I’ve never felt so alive. It was, like, there was a train running through the mountains, and my room was one of the train cars, and I could see it right there, and I just stared at the wall for like half an hour and enjoyed the ride.”

I find it simpler to discuss mind and body in separate terms since people have trouble seeing transcendent experiences as intoxicants, but I hope this use of your terms helps clarify my viewpoint.

This is a dangerous statement! Alcohol is not good for the mind, even in small amounts. I feel like a cloud has been lifted since I stopped drinking.

I strongly recommend everyone read Allen Carr's Stop Drinking Now (https://www.amazon.co.uk/Stop-Drinking-Now-Allen-Carrs/dp/18...) - a fantastic book in which the author logically argues why every perceived positive of drinking is actually a negative.

This is an interesting study, and I'm not 100% sure it supports their conclusion. For example on Figure 1 the hazard ratio for all cause morality isn't much higher than 1 until you get into the 200g+ groups, and the hazard ratio for cardiovascular disease is less than 1 until you get over 200g. This would seem to support studies that find a benefit for moderate drinking on heart health. Most of this benefit seems to come from lowering the incidence of MI based on Figure 2.

This also seems to support my initial hypothesis from reading your comment which is I wonder how much of the difference in all cause mortality is due to the effects of binge drinking or drunk driving. The fact that the hazard ratio on all cause mortality isn't really above one until you get over 200g would seem to support the idea that that is where most of the increased mortality comes from.

When I read stats like that I also think about quality of life. These results don't rule out people living pretty much the same length of time, but with an assortment of ailments caused by the alcohol that make life pretty miserable, as another comment in this thread says about obesity and diabetes.

I wish we'd stop using shallow metrics life longevity over quality - it causes the layperson (who hasn't developed their critical thinking enough yet, or perhaps not capable to) to skim over that "lifespan" doesn't take into account all kinds of qualitative variables - including alcohol being a depressant, literally you're depressing how sharp your nervous system can be; yes, which people often self-medicate with because they have energies they haven't yet figured out how to regulate and are too intense, so the alcohol becomes an escape. I'm not against alcohol, I'm just for informed consent - understanding the full scope of what you're doing.

Maybe you have a different point in mind, but I am skeptical that there are any consumers of alcohol that are not aware that it is partially a depressant. This is both obvious to any consumer of it, and taught in every school that does any sort of substance (ab)use education.

Do you know if they teach that it causes cancer too?

You've uncovered the fundamental issue with numerous public health studies: the effect size is irrelevant.

You don't get attention for being modest.

Yes but "The Lancet"

“Based on recent evidence, it has been concluded that there is “no safe level of alcohol consumption”(5)

Which definitely takes artistic license with what the cited article actually said, which was:

   Our results show that the safest level of drinking is none.

Which is exactly like saying "The safest level of poppy seed consumption is none". Which of course completely dodges the question you'd really want to ask which is: "How many poppy seeds can you eat per day with either no or negligible negative health effects?" And in any case nowhere near equivalent to saying:

   It has been concluded that "there is no save level of poppy seed consumption".

Moral of the story being -- the byline quote at the top of the article:

"The evidence is clear: any level of alcohol consumption can lead to loss of healthy life"

Is not only supported by the research it cites -- but irresponsibly alarmist.

I don't think that misstates the lancet article, and i also think this information in the lancet article is useful.

There is a long belief that e.g. red wine is good for the heart, or in many places there are some herb liquors that old people drink thinking it will bring them benefits. Here the lancet unequivocally states that to our best evidence no alcohol is best. You're from now on not drinking red wine for your heart but for pleasure.

Here the lancet unequivocally states that to our best evidence no alcohol is best.

The thing is this proscription is essentially useless. It's like saying "to our best evidence no sugar is best".

So should you eat that piece of chocolate cake or should you not?

You're from now on not drinking red wine for your heart but for pleasure.

We knew that already. But it still doesn't tell us whether drinking, say, 3 or fewer glasses of wine per week has a significant negative health impact or not. For any actual measure of "significant".

Maybe figure 4 from the Lancet article [1] mentioned above is helpful here. It is titled “Relative risk curves for selected conditions by number of standard drinks consumed daily.”

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Interesting graphs.

What's interesting in particular is that for several categories (such as ischemic heart disease) the relative risk does seem to go down rather decisively for up to 6(!) standard drinks per day (which they note is "offset" by the increased risk in other categories -- including cancer).

So going by their own combined/weighted risk in Figure 5 - we see a curve that is essentially flat in the region between 0 and 1 - that is, showing negligible risk (asymptotically zero) at 1 drink per day, rising to more concerning levels starting at 2 or 3 per day.

And that's the decisive issue here: "Is having an average of 1 drink per day really any more risky than 0 per day?" The only take-way I can get from the article is that there's essentially no difference in risk level in this interval.

Would any non-trivial substance be deemed "safe" under these criteria?

There's a very small chance you'll choke to death every time you eat something.

Another score for fasting!

BRB, gonna fast the rest of my life.

That's definitely an achievable goal with sufficient dedication.

A lot is riding on the unspecific usage of "safe" here.

I've noticed that most health recommendations like these do not have any evidence associated with them, or a description of the actual risks. It seems that the doctors and health officials who write them have the evidence, but don't believe that the public needs to see it and rather should just go with whatever they say.

That’s because you’re reading a mass media report on the recommendation. It takes less than a minute of earnest effort to find the actual studies or briefs and scroll down to the sources.

https://world-heart-federation.org/wp-content/uploads/WHF-Po...

Hmm... looks like fake receipts.

For the claim "Alcohol consumption increases the risk of CVD", they cite the following paper, which actually shows statistically significant reductions in CVD from 75 to 150 g/wk.

https://pubmed.ncbi.nlm.nih.gov/29676281/#&gid=article-figur...

Having recently become pregnant, a lot of the guidance for expectant mothers echos these blanket recommendations (sushi, deli meats, hot baths etc).

On the topic of alcohol, FASD is a massive concern, but it's known that it's correlated to how much you drink and how frequently you drink (enjoying a glass of wine once a month is very different than binge drinking multiple times throughout your pregnancy).

The thing is, researchers aren't getting pregnant women different levels of hammered, and then assessing how their babies turn out (unethical much), so they're left to infer based on reported behaviors. Hence the unreliability of the data, and the "no amount is proven safe" mantra. Maybe it's the same with this recommendation?

The other thing not factored into inferred results is other associated behaviors. I'd bet that statistically, women that are binge drinking through pregnancy are more likely to also be taking hard drugs than their non-binge drinking counterparts. So is alcohol fully to blame here?

I'm not here advocating for pregnant women and drinking. But it'd be nice to have the data and evidence behind these risks, so that people can be empowered to make their own decisions.

I've seen so many women on forums stressing over a glass of wine they had at christmas, or the time they ate a cold cut without realizing. Needless stress that could be minimized if pregnant people weren't advised as if they're children.

The "no amount proven safe" mantra is refuted by epidemiological studies on the subject. There's no evidence that modern drinking is something to worry about.

It's well known that pregnant women become more risk avarse, and humans being bad at risk assessment in general they tend to channel those worries in relatively unproductive ways.

E.g. worry about obscure food safety issues, as opposed to something like traffic risk, or just focusing on staying generally healthy and anxiety free.

> The "no amount proven safe" mantra is refuted by epidemiological studies on the subject.

Is there a source?

Emily Oster's book Expecting Better talks about this, I don't have a copy on hand but you could check her sources.

Probably numerous sources, but for what it's worth my own recollection on this subject is based on this article:

https://www.independent.co.uk/news/health/pregnancy-drinking...

Epidemiological studies might not be very strong evidence though, since moderate alcohol consumption is likely correlated with class. And inversely correlated with the use of more dangerous drugs.

Congratulations!

Lacking clear research (in this case, we lack intoxicated pregnant people to study, as you say), I tend to rely more on expert judgment to sort out the facts, bringing to bear their knowledge of physiology, anatomy, chemistry, and disease; their long experience with many thousands of actual people, etc. I have none of that. If I break my arm, that's my only experience with it.

If you want to feel some dissonance about this, you might note that this is the exact language the CDC uses for things like secondhand smoke -- "There is no risk-free level of exposure to secondhand smoke" -- which everybody nods along to and accepts without much scrutiny.

Source: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/seco...

Meanwhile, when it's something like, say, cosmic radiation exposure from commercial air travel, suddenly the CDC is very interested in levels of exposure and has language that provides context intended to downplay the risks.

Source: https://www.cdc.gov/nceh/radiation/air_travel.html

Why these statements bother us when they're about one thing and not another -- or, indeed, why our health agencies would choose language like this for some kinds of risks and not others -- is left as an exercise for the reader.

The CDC has been unfortunately hopelessly politicized. It happened long before the pandemic.

OTOH, I would make the differentiating point that air travel has positive benefits to society and costs and one has to weigh those against each other. You can’t make the blanket statement “earth would be better off if air travel went away completely.”

It’s hard to find any benefit to smoking, first hand or second, so it’s easy enough to just shit on it. The ROI on whatever ills aviation may have is a topic of discussion, there’s 0 ROI on smoking.

>> It's hard to find any benefit to smoking...

Ritualistically, as an exercise in getting out of one's 'normal' consciousness, it can present useful information for self study. In habitual form, it is of course very destructive.

So the "getting out of consciousness" that is the relaxation experience many "habitual" smokers have is worthless, while changing your state for ritualistic purposes is helpful?

Both are very tiny self-reported effects that are close to non-observable for outsiders. Why would one outweigh the other, if you allow self-reported epsilon effects at all?

>> getting out of consciousness

You mean sleep (as in, night time bed activity)? I'm not talking about sleep. I am discussing getting out of normative modes of being but not going to sleep.

>> that is the relaxation experience

This is not the only experience resulting from tobacco use. There are more subtle effects as well.

>> worthless

I haven't declared a value judgment against the habit. I am saying it is destructive to the body. Do you believe that to not be a fact?

>> helpful

Again, I'm not presenting value judgments here. I am saying it can present useful information. It sounds to me like you have taken offense somewhere for some reason. I am not putting weight on one or the other.

*edit: clarity

This isn't politics, it's safety. I accept the argument that the CDC has become overly innumerate in how to live a healthy life, but it's not a liberal or conservative idea to be cautious.

There is such a thing as being unnecessarily and overly cautious, however. This sure seems like a good example of that.

Exactly. Precaution comes at a price. The question is whether the benefits of the precaution outweigh the costs. And that is an answer science cannot, and should not, answer. These days, it seems, many scientists are desperate to cloak their policy preferences in "science." That is precisely why there is presently so much distrust of scientists.

I never understood distrust, because scientists base their work on research that is extensively cited. Making conclusions that are not supported by evidence, e.g. "desperately cloaking" policy preferences, could jeopardize one's scientific career.

Many people seem to unrealistically demand scientific recommendations to be "guarantees." However, scientific conclusions are very precisely made best guesses, built on humanity's knowledge.

> I never understood distrust, because scientists base their work on research that is extensively cited.

It's good that the supply chain of science is traceable, but it doesn't guarantee truth by any means. Their are many non-scientific human endeavors that have traceability, take software development for instance.

I think the distrust comes from many fields having fairly obvious political trends, in particular social sciences. Another source of distrust is overextrapolation of science by authorities. For instance, science might say that certain drugs are harmful if abused, and politicians may use that to claim the war on drugs is based on science, which obviously is not true. Lastly, some fields struggle producing consistent and falsifiable results, such as economics and psychology.

The replication rate of Economics as a field is higher than replication rates for psychology, cancer research, pharmaceutical research, and many other fields. When was the last time you opened an econ journal?

0.1% of studies in the econ field are replication studies.

58% (quite high, higher than a lot of biology related field) are positive replications.

But! some of those use the same datasets, with different time bases, and most are narrow replication of high impact studies.

Also, economics now is not a singular field, and I'd bet gp was talking about macroeconomics. You could be more charitable.

Choosing the level of safety we enforce in society is inherently political.

There was a comment I saw the other day along the lines of "Science will tell you what the numbers are, but doesn't make a judgement of how big that number should be."

You can get a pretty good estimate of how many lives would be saved if we smoked less, or drank less, or did any number of other things, but ultimately that's an input into a public policy decision making system that doesn't have a provably right answer unless everyone involved agrees on what the desired outcome is.

Nobody is enforcing anything, either in the parent or the OP, so don't panic. Your comment seems inflammatory and irrelevant in this context, but I'm sure that's not your intent. You'll be ok, don't worry.

Safety becomes politics once acting in "unsafe" ways becomes illegal.

As we've seen in the past 2 years, there's no real positive benefit to society to frequent business flying (at pre-pandemic levels).

Like smoking, we don't need to completely ban air travel. The equivalent would be severely limiting it (for example, prohibiting business flying).

> The equivalent would be severely limiting it (for example, prohibiting business flying).

People fly to go on holiday and experience cultures other than their own which is something we should be encouraging rather than discouraging. I strongly agree with reducing needless business travel but if doing so also limited vacation travel I think it'd be a net negative.

We should be discouraging all air travel. All of it.

No, we shouldn’t. Instead, we should work on ensuring that as many people are able to enjoy new opportunities it provides if they do desire as possible. Everyone should be able to enjoy life.

Climate impact is significant. That's going to interfere with generations enjoying their lives.

We should then work on enabling people to fly with no climate impact. For example, using zero emissions energy to synthesize jet fuel. The goal should be to enable people, not to block them.

Sure, but not high on the list of priorities. How about enabling people to get healthcare, go to college, or to survive by addressing global warming.

"Stop everything above this line on Maslow's pyramid because some people fall below the line" is not a solution to any of the problems faces by people below the line. It's like demanding that an astrophysicist cure AIDS at once before ever using another telescope.

You don't help people climb a ladder by chopping off the top and declaring the ladder climbed.

flying isn't a step on maslow's heirarchy of needs.

> You don't help people climb a ladder by chopping off the top and declaring the ladder climbed.

Sounds like public schooling in the USA for the last 25 years :(

If someone said those crazy, extreme things, that would be a relevant comment.

You don't even have to be zero emissions. You just need net zero. If you're putting carbon into the air, you need to sink an equivalent amount of it. If you use biofuels for instance, so long as you replant/regrow the same biomass as you convert to fuel, you're closing the loop.

Zero emissions technologies are great where they're practical. Aircraft are one of those places where the energy density and overall density of your fuel source is very, very important.

If you care about climate, get cryptocurrency banned. Air travel has all sorts of bad consequences, but also has economic and social benefits. Crypto on the other hand is an endless black hole of energy that even when used for its intended purpose creates economic and social harm.

Talking about taking away things that people like, like airplanes and red meat and gas stoves just get people up in arms. Start with the low-hanging fruit: crypto has no value except to speculators and criminals and tax evaders. Concrete is like 10% of our energy use, and we use way too much of it for temporary structures. No one likes leaf blowers, just ban the gas-powered ones.

> Talking about taking away things that people like, like airplanes and red meat and gas stoves just get people up in arms. Start with the low-hanging fruit: crypto has no value except to speculators and criminals and tax evaders.

What distinction are you drawing here? Both flying and crypto have a handful of rabid fans who use them a lot (and seem to enjoy it) while most regular people barely think about them at all, except to get vaguely irritated when they hear them passing by.

(I'm in favour of punitively high taxes on both, FWIW)

The main distinction is that airlines generate economic activity via tourism, shipping, and cultural exchange. Cryptocoins generate mostly black market activity; corruption is generally considered bad. If airlines disappeared today, people would still travel, with more time but only one order of magnitude more energy efficiency. If BTC disappeared tomorrow, people would would make most of the same transactions with more time efficiency, and six orders of magnitude less energy.

5-10% of people take a flight every year. For the US and Australia, it’s roughly half of all people. [1] is from a climate interest group.

Supposedly 3.9% of people worldwide own cryptocoins. Thought that stays would support my argument more but I suspect lots of hodling and not much trading.

[1]: https://static1.squarespace.com/static/5d30896202a18c0001b49...

> Talking about taking away things that people like, like airplanes and red meat and gas stoves just get people up in arms.

Certain people will get up in arms regardless, partly due to certain people making up threats like 'someone is going to take away your ...!' But nobody here said that.

My favorite thing about air travel is the opportunities it takes away. Destroying the planet is so important to the future of humanity

In no way is air travel necessary for anyone to find enjoyment in their life or to seek new opportunities, even overseas.

there's no real positive benefit to society to frequent business flying

I'm seeing a lot of communication and alignment issues because people can't get into one room and hash things out.

I've seen this firsthand many times, too. Having a meeting over beers and longstanding disagreements just melt away.

> there's no real positive benefit to society to frequent business flying (at pre-pandemic levels).

I'm sorry but I don't buy that. Business flying has obvious benefits including, perhaps obviously, enabling businesses to be run efficiently.

I started a new job after the start of COVID, and it has been really hard to build the personal relationships to become fully effective (our offices are spread out globally). My manager has said that pre-COVID days, I would have had the chance to meet many of my colleagues face-to-face and have a few beers with them, which would have greased the wheel to creating some personal connections. It's always easier to request help from someone who has a good impression of you.

Similarly with clients. It's much easier for people to go on attack-mode when they are displeased when it's only through email or a video conference where people have their cameras off. Unhappy clients can be placated and turned towards working together to a solution much more easily in person, and happy clients can be turned into long term partners more easily over dinner and friendly chats. This is especially true of customers in Asia.

Nicotine (especially when consumed via smoking) has some negative side effects, but is also a neurotrophic and can be quite beneficial.

Addiction and blood pressure are really the only downsides if you were to consume it in the form of, say, gum (and boy does the addiction suck).

The addiction is one of the most difficult to quit. With repeated use the nice feelings stop as well. There's no benefit to it, you're hijacking some neural circuitry until it hijacks your life

Regular consumption of nicotine also reduces Alzheimer's risk (and probably Parkinson's). This has been known for a long time. Few things are absolute.

1991: https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC1670208/

> The risk of Alzheimer's disease decreased with increasing daily number of cigarettes smoked before onset of disease (relative risk 0.3 in those smoking greater than 21/day v 1 in non-smokers). In six families in which the disease was apparently inherited as an autosomal dominant disorder, the mean age of onset was 4.17 years later in smoking patients than in non-smoking patients from the same family (p = 0.03).

There is also ongoing research on this topic funded by the US government.

https://www.alzheimers.gov/clinical-trials/memory-improvemen...

Nit: that study is cigarettes. There is more to tobacco than nicotine, such as harmala alkaloids and miscellaneous MAOIs.

Either way, that's super interesting.

> It’s hard to find any benefit to smoking, first hand or second.

The same is true about recreational travel. People expose themselves to high levels of radiation and travel risk purely for recreational purposes. Smokers inhale carcinogenic substances for recreational purposes.

Is the risk for the two even remotely in the same ballpark?

No, but the problem is that a scientifically informed (evidence based) public health site communicating risks should be consistent and shouldn't use inconsistent absolutist language.

Well, it depends on how much you smoke and how much you travel. Thing is if I smoke even one cigarette like as a digestive after a big dinner once every four months I have to pay 600 dollars of extra health insurance per year because of how all this bullshit messaging about how nicotine works. And of course it's to protect something like only 35% of the human population that will get addicted to it.

I stopped smoking for months or years many times and I never ever had any side effect except maybe I'm a bit tired the first days. I don't even put up extra weight or anything like that. I feel like an adult baby being treated like I need financial punishment to help me be a healthy person.

> Thing is if I smoke even one cigarette like as a digestive after a big dinner once every four months I have to pay 600 dollars of extra health insurance per year because of how all this bullshit messaging about how nicotine works.

Really? Where do you live? Because I'm not aware of any country that does this (other than with sin taxes on tobacco).

Health insurance in various places goes up if you consume tobacco products, and doesn't take the amount consumed into account:

https://www.kff.org/faqs/faqs-health-insurance-marketplace-a...

That's what I figured he was referring to, but you (and he, if that's what he meant) are just wrong. Your source points out that the amount consumed is taken into account:

https://www.kff.org/faqs/faqs-health-insurance-marketplace-a...

Now, it is binary. But US federal law puts "an afterdinner cigarette once every four months" very much in the "nonsmoker" category.

Where does it say that the amount consumed is taken into account? That guideline is referring to the number of consumption occurrences per-week, not the amount used.

Which is the tobacco equivalent of classifying someone as a heavy drinker because they're using red wine as a trace ingredient in cooking several times a week, and considering that the same as consuming 4 vodka bottles over a span of 4 evenings every week.

Or, to bring this back to the example that started this thread, and which you seem to be thoroughly missing, to regulate numbers of radiation exposures per week. Without taking into account whether that's from standing outside in the sun for 10 minutes, eating a banana, or standing next to an unshielded nuclear reactor.

It's not some pedantic theoretical concern. There's an astronomical difference in the health risks between smoking a pack of cigarettes 4 times a week, using E-cigarettes 4 times a week, or applying a nicotine patch 4 times a week.

I live in the US and the 600 extra are binary, the question is "have you used any tobacco products in the past three months?" and a yes means an extra 600 per year. It's not that unusual if you get health insurance through your employer because it drives the cost down for everyone else, and of course scamming money off smokers even if they just casually do it a couple of times every three months is socially accepted.

Also except executives no one is above 60, which is where one would argue that if you are a smoker you may actually needing to tap heavy into health insurance money for smoking related conditions. There's even research that if you quit before 40 your smoking related cancer risks go down 90% https://www.healio.com/news/hematology-oncology/20211228/qui...

Of course I can drink a bottle of wine per day, not exercise, eat processed meat and not consume a gram of fiber and I don't have to pay extra health insurance. It doesn't make any sense.

I thought you were in the US.

By federal law, you cannot be charged more for smoking a cigarette every four months. You can be charged more for smoking with more regularity. There is a binary cutoff, but the level isn't zero (feds have a minimum level, but states can impose higher ones.). You may want to consult a lawyer if this is something that is really happening and concerns you. Plus, you certainly should consult a lawyer before you change your answer on a the form, in case you are in a grandfathered plan or some other special case.

> Well, it depends on how much you smoke and how much you travel.

I find it hard to believe that smoking could be less dangerous than flying even for people who work as airline pilots or flight attendants.

Smoking every day? Sure it's more dangerous. Vaping at a party once per month? I don't think so.

If you say vaping now, then maybe. But actually smoking once a month I still doubt.

benefit of smoking is the buzz and social enhancement. it is not useless.

> The CDC has been unfortunately hopelessly politicized.

These accusations are a common way to tear down democratic institutions, handing power to corporations and powerful individuals. Do you have evidence of it? I've seen none, other than some things attempted by political appointees during the Trump administration.

The CDC (formally Centers for Disease Control and Prevention) has long tried to enter the gun control debate. That has nothing to do with their mission of communicable disease prevention. Congress has repeatedly voted to block them.

The wider medical community has been vocal about gun control, because guns are a leading cause of injury and death. The fact that it's not a virus or bacteria is arguably a pointless technicality, incidental to saving people's lives. The people who catch the 'bullet' disease are treated at hospitals by doctors.

You may not think it's appropriate, but many doctors disagree. There's nothing in that indicating it's politicized; people may want to politicize gun control, Coronavirus, and lots of other health issues, but that doesn't make the health institutions political for dealing with it. (They also want to politicize the CDC and every other democratic institution (the Post Office, etc.).)

Should CDC also be involved in traffic laws too?

They are not involved in writing traffic laws, but they most certainly are involved in researching traffic caused injuries. It makes sense, because they are a leading cause of death

"Involved in laws" doesn't really describe the CDC exactly, but whatever.

One example of many:

https://www.cdc.gov/sleep/about_sleep/drowsy_driving.html

The CDC is still the Centers for Disease Control and Prevention. It's mission includes but is not limited to infectious disease. Congress has mandated they cover, in addition to infectious disease, research on food borne pathogens, environmental effects on health, occupational safety, injury prevention and how best to promote health. They do research on, for example, obesity and diabetes which are noncommunicable. They also are tasked with education to improve the health of US citizens (or residents, it's unclear). They specifically and explicitly replaced the National Communicable Disease Center, as their mission grew.

Meanwhile, all they've tried to do is research gun violence, not "enter a debate".

Yes. If you want a really good explanation of how it happened and the effects it’s practically the subject of The Premonition by Michael Lewis

While I somewhat agree with your overall point, level of control is important here. I can choose whether to get on a plane or take a drink. I can't control if someone farts standing next to me, or if they exhale smoke in my face.

Did you look at any of the references at the bottom of the page? There are many, many dozens of studies in the report by the surgeon general. On page 421 when they analyze lung cancer risk, they have studies with volume and frequency of second hand smoke based on the volume and frequency of the smoking habits of the one spouse being a smoker and the other being a non smoker.

This would be a very meaningful comparison if people were regularly forcing a diner-full of people to hop on a plane with them several times per year.

Obviously the analogy to getting on the plane is walking in the diner.

I think we can all agree there are stronger arguments for air travel than habitual smoking of cigarettes.

Do you live somewhere that forces you inside of diners several times per year? I'm interested in where that is.

Have you actually done research differentiating between the risks of tobacco exposure and radiation exposure?

There's no scientific evidence to suggest that small doses of radiation (< 0.1 mSv) is harmful to you, at all. In fact, there's even scientific evidence to suggest the opposite, it's called radiation hormesis.

I can choose to take a flight or consume alcohol, but I can’t choose to not breathe while you smoke next to me. There is no need to look for conspiracy theories as homework.

In case you missed it, the claim has nothing to do with choice -- it has to do with making a blanket, absolute statement for one thing and a more nuanced statement for another.

I guess you're exactly the person these types of statements were meant to placate.

As a public statement, mathematical existence of risk may, if small enough, can very well be said to be non-existing. For all practical purposes, is a 1e-10 risk contain any sort of information for the average people? Is it lying to call it risk-free? I really don’t think so, human language is not exact - in the real world nothing would be risk-free otherwise, essentially we would loose that word.

Good points. If I can take a crack at the exercise for the reader, I think the inconsistency has fairly straight forward reasons, even if they're frustrating: humans are terrible at reasoned risk analysis (if they even see the value); people prefer absolutes and easy heuristics to "it depends"; most people have first-hand experience with the extremes of smoking and drinking and it's thus easy to vilify; the best defense of vice is pleasure, which isn't much of a defense in the eyes of many, whereas exposure to pollution and cosmic rays is impossible to prevent without giving up near-universally valued things (transportation, energy).

We see similar patterns with nuclear power, climate change, and pandemics...

I think the difference is that there is something to be gained in exchange for the risk posed by cosmic rays during air travel, so people are more interested in taking a nuanced approach to it. Meanwhile second hand smoke is a nuisance at best and a legitimate health concern at worse. Most people (myself included) are happy to ban smoking on airplanes or in restaurants even if the health benefits are negligible at best.

I do agree though, studies like this should always include useful context rather than just making absolutist statements. Perhaps alcohol and tobacco smoke need something similar to the banana equivalent dose used when talking about radiation exposure.

> Nobody gains anything from an activity that fundamentally requires exposure to tobacco smoke.

Except smokers, of course.

Smoking isn't just addictive and deadly, like alcohol, it has its own appeal to users.

We’re not talking smoking though

We’re talking second hand smoke

Who exactly is looking to get some second hand smoke in their face while avoiding actually smoking?

I seem to be in a small minority, but I always liked the smell of second hand smoke despite never smoking. I've smelled some cigarettes up close and I think I'd really like them, but I don't want to start for health reasons.

The difference is that you consent to someone else's drugs entering your body.

Me too. I liked the smell. And the bars used to be less 'clear' due to the smoke. They had more atmosphere.

I did hate the way my clothes smelled afterwards but anyway that's what a washing machine is for.

I don't go in for cigarette smoke, but cigars, oh my.

Secondhand smoke is the cost of being in a bar outside of the US. Good luck making friends with European expats without some secondhand smoke.

I can't stand the smell of cigarettes, many of them make me feel nauseous. This may be because I'm young enough that public smoking has been banned for most of my life, so I never ever got used to the smell.

Europe is the exception here, not the US.

In general European countries have bans on smoking in public places much stricter than the US.

https://en.wikipedia.org/wiki/List_of_smoking_bans#Smoking_b...

I wasn’t aware of Europe’s laws but I meant outside of Europe too with European expats. Living in Asia currently and second hand smoke is a big part of my social life.

I don't know what the laws are, but the amount of smoking centimeters away from the entrances of buildings in Europe was staggering to me as an American. Both from patrons and employees. I was breathing in smoke plumes pretty much everywhere.

Used to be that bars were the place you went in the US to smoke and drink. Since you can't smoke in bars (Note: "pubs" for UK readers) anymore, there's less of a reason to go to them, and it incentivizes drinking at home. Which has led to a lot of bars closing and fewer of them than ever.

I don't think we're trying to solve for maximizing the number of bars

All the bars where I live seam busy as ever. I don't think smoking bans are hurting them at all.

You don't need bars or luck to make friends with European expats.

Isn't smoking a terrible deal, even for smokers? If its just about the nicotine there are lots of ways to get it without ruining your lungs or arteries (inflammation is the easiest way to get heart disease).

As a former smoker: It's not just the nicotine, it's also about the ritual, the habit and the social component. Although the latter might have changed these days as smoking has become a lot less popular since then.

If you want to feel some dissonance about this dissonance, you might note that a meta-analysis was done on the evidence that using a parachute is effective at saving your life when jumping from an aircraft. It's a real, but satirical approach to worshiping randomized controlled trials for things that should effectively be obvious. There are obvious limits to empiricism, and we shouldn't proudly flaunt lack of evidence ≠ evidence of absence in cases where it's perfectly reasonable to expect results. I mean, we could be wrong about theses things, but it would be a shift in thinking akin to newtonian -> einsteinian physics.

Paper: Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial

Conclusions: Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention. However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials might selectively enroll individuals with a lower perceived likelihood of benefit, thus diminishing the applicability of the results to clinical practice.

>https://www.bmj.com/content/363/bmj.k5094

As the paper's title says, it's a randomized controlled trial, not a meta-analysis. A meta-analysis would likely exclude the RCT due to poor experimental design.

You are correct, but a meta-analysis would still suggest that there is no evidence that parachutes protect people jumping out of airplanes, because we don’t have evidence because we can’t have evidence.

Actually meta-analyses are not limited to RCTs - in my experience they can be quite subjective.

So for example, a meta-analysis might say that there's a fair amount of evidence that people not wearing parachutes die after falling from airplanes (e.g. https://www.washingtonpost.com/world/2021/08/26/story-an-afg...), and plenty of evidence that people can land successfully with a parachute (skydiving videos, too many to count). The conclusion would be a strong correlation between parachute use and not dying. The only thing there isn't is an RCT, to prove that the correlation is causal. The purpose of the parachute RCT paper seems to be to prove that the design of an RCT is just as fallible as any other reasoning that attempts to prove causality, so in fact RCTs are not the "gold standard" and other forms of reasoning may be just as valid. (e.g. basic physics in the case of the parachute)

>basic physics

I totally agree, the point that organizations like the World Heart Federation are using. We are taking basic physics as a truism, but it's the result of experimentation, which creates a framework. The same is done for the way the body functions. That framework can be used to make sweeping statements about alcohol / ionizing radiation, etc.

I've been totally blown away recently listing to This Week in Virology, as the panel of experts regularly discuss their concerns about how many people are discussing the viral/vaccine mechanics as though the framework we have of disease is perfect. It's always fascinating to hear what absurdly qualified people have concerns about when discussing their area of expertise.

To be clear, the problem here is in equating “evidence” with randomized controlled trials. We have plenty of evidence that parachutes work, just not in the form of RCTs.

David Gorski of sciencebasedmedicine.org calls it “methodolatry”:

https://twitter.com/gorskon/status/1484220420295376900

https://twitter.com/gorskon/status/1479900075602194445

https://twitter.com/gorskon/status/1483268592674217986

I think the reason one bothers us and another doesn't (in the case off smoking) relates to the level of non-contradiction evidence. It's been decades since the pseudo-research propaganda from the tobacco industry was taken seriously, and lots of legitimate research to go along with that.

Alcohol on the other hand seems to produce a fair number of contradictory studies on a regular basis. There are pretty clear negative effects of excessive use, but at the low-to-moderate levels it's a lot murkier. It's especially hard to know from some studies whether or not the proposed negative impact was caused by alcohol or whether alcohol use was a type of proxy variable for general health and lifestyle.

It seems the reason they've gone for the "no amount of alcohol is good for" precisely because of the existence and popular influence of contradictory claims. They're taking the position that it's the negative effects that have the plausible mechanisms and the associations of low-to-moderate use with sometimes better outcomes than abstinent cohorts that are most likely proxy variables for general health and [former] lifestyle.

(c.f. absolutely no pop-science reporting on supposed therapeutic benefits of cosmic radiation from frequent flying, so the average person hearing about it is likely to overestimate its negative effects rather than wonder if they should be booking a flight with every meal!)

There is no dissonance here, this is FUD. The language is wildly different because the actual risks are wildly different. One kills a lot of people and the other doesn’t.

How many people are actually dying from air travel radiation? The numbers are low enough that they’re hard to find evidence for. Here’s a study, for example, that attempted to answer the question for pilots, who obviously fly frequently. They weren’t even able to detect higher death rates at all. https://pubmed.ncbi.nlm.nih.gov/14648170/ “Neither external and internal comparisons nor nested case-control analyses showed any substantially increased risks for cancer mortality due to ionizing radiation.” (Edit: of course there are some studies that demonstrate small amounts of increased cancer risk, and increased risk of pregnancy complications for airline crews. The numbers are small.)

On the other hand, “Tobacco is the leading preventable cause of death in the United States” https://www.cdc.gov/tobacco/data_statistics/fact_sheets/heal...

Even if you are skeptical of the CDC’s estimates for mortality rates by things like second hand smoke, there are pretty clear reasons to take smoking a lot more seriously as a risk than radiation exposure from air travel, the direct risk to smokers is orders of magnitude higher than the risk of air travel radiation.

The fact that the CDC’s language reflects the actual risks is a good reason to put more trust in what they say, not less. They’re not trying to hide something from you, they’re trying to help you understand the actual relative differences in risk, which are much, much higher for smoking.

Edit2: BTW, the WHO agrees with the CDC about there being no safe levels of smoke, and is backed by significant amounts of research and outcome statistics worldwide. https://www.who.int/news-room/fact-sheets/detail/ambient-(ou...

First of all, this is a good and fair pushback.

But I’d respond that I chose secondhand smoke for a reason. I similarly doubt there’s any measurable impact of being around a smoker every once in a while, but the language around secondhand smoke got more and more hysterical leading up to the widespread implementation of smoking bans, to the point that it’s not uncommon today to hear people complain that walking near a smoker on a sidewalk outside is a risk to their health.

That’s basically absurd.

But the “no safe level of exposure” language has been used to justify such claims.

Finally, to be clear, even if you think this language is good and useful, there’s still utility in thinking about why that’s true, especially if hearing similar language about alcohol bothers you for some reason.

> to hear people complain that walking near a smoker on a sidewalk outside is a risk to their health

Doesn't have to be the smoke itself that's harmful. Presumably, if you can smell someone's second-hand smoke, you're also inhaling the bacterial spray contained in their breath, no? Something I think about if I'm walking outside without a mask on and end up stuck walking for a while behind a smoker. I tend to put my mask back on.

The bacterial spray isn't unique to smokers.

That's what our immune system is for.

Covid is a problem at the moment but bacteria really aren't. Your chance to die from a bacterial infection randomly caught from someone in the street is minimal, and exposure boosts your immunity. And they are everywhere anyway.

You might get a cold for a few days but that's life.

With over a billion smokers on the planet, or ~20% of the population, it’s not that absurd to worry about urban smoke outdoors contributing to urban pollution. Nor wood burning house & backyard fires either, nor cars, but that’s a different debate… We aren’t around smokers once in a while, we’re around them constantly. Even urban outdoor second hand smoke really is a higher risk than air travel radiation.

Yes I want the language to be specific about the levels of risk. I would agree that “no safe levels” is vague and less helpful than one or two percentile data points. That said, I completely agree with the CDC’s stance and language on both second hand smoke and air travel radiation.

> Even urban outdoor second hand smoke really is a higher risk than air travel radiation.

Isn't this exactly what's in dispute? What's the evidence that this is true?

Not really. The actual topic of conversation underneath the smoke is the political neutrality of the CDC, and public mistrust of science and government funded sources of information.

If you are really curious about the evidence, follow the thread up and click the links. I already posted links that have some stats and links to studies on the harms of second-hand smoke, and so did @dionidium too. :)

I didn't see anything in your links that addressed second-hand smoke specifically? I think there's a broad consensus that a) tobacco is a significant cause of premature death b) low outdoor air quality (e.g. high PM25) is a significant cause of premature death. But given that tobacco smoke does not show up in your link's list of major contributors to low outdoor air quality, that does not add up to a statement that second-hand smoke is significantly dangerous.

You’re talking about the WHO link specifically? You’re right, that link doesn’t mention secondhand smoke because it doesn’t have a list of major contributors (doesn’t mention cars or factories either). I’d agree it’s probably not a great example of what you’re asking about. I really only posted the WHO link because the WHO uses similar language to the CDC saying things like ‘there are no safe levels of exposure to pollution.’ Might not answer your question, but I think the WHO pollution guidelines published a few months are good reading (https://apps.who.int/iris/handle/10665/345329).

To clarify what I was talking about above, I’m saying the close exposure to smokers is high in urban areas -- in proximity, frequency, and density. There’s also broad consensus that the risks and harms of secondhand smoke are greater in proportion to proximity of the smokers, and that downtown urban areas where people congregate have higher concentrations of cigarette smoke than other places. I’m not personally claiming that average Pm2.5 air quality over time sees a measurable impact from cigarettes. (Even if true, I would expect cigarettes are dwarfed by cars --- but 6 trillion cigarettes a year isn’t nothing, right?) I’m really primarily claiming that being in an urban area like a downtown city center is high exposure to secondhand smoke, being very close to smokers is often a many times per hour occurrence in busy urban areas, walking and entering/exiting buildings.

The CDC link does reference the Surgeon General’s report, which links to a whole pile of primary sources on secondhand smoke. You can also Google around for primary sources for links between smoking and general air pollution. I just tried and found a handful of papers studying outdoor smoke exposure levels, e.g., https://erj.ersjournals.com/content/48/3/918. The main consensus that I see is that for a range of small distances like 10-20 feet, outdoor exposure is plenty high enough to be very concerned about the risks, and that high traffic areas can collect smoke and increase exposure.

> Even if true, I would expect cigarettes are dwarfed by cars --- but 6 trillion cigarettes a year isn’t nothing, right?

I don't really understand this reasoning - the way I see it any effect that's dwarfed by cars might as well be nothing, there's no sense worrying about a splinter in a broken leg.

> The CDC link does reference the Surgeon General’s report, which links to a whole pile of primary sources on secondhand smoke. You can also Google around for primary sources for links between smoking and general air pollution. I just tried and found a handful of papers studying outdoor smoke exposure levels, e.g., https://erj.ersjournals.com/content/48/3/918. The main consensus that I see is that for a range of small distances like 10-20 feet, outdoor exposure is plenty high enough to be very concerned about the risks, and that high traffic areas can collect smoke and increase exposure.

Hmm, sounds like there's a measurable impact which is honestly more than I expected. Still, it seems like a rather cherry-picked measurement; they compare levels in the evening when the traffic street is presumably mostly empty, and note that the traffic street had worse air quality after midnight. They notably don't compare levels in the morning or afternoon when traffic would actually be present and the traffic street presumably had overwhelmingly worse levels of pollution. And they jump straight to recommending a ban on smoking. To my mind to put that on any kind of rational basis you'd have to first set a safe level of PM25 and then propose banning the biggest contributors to PM25 on streets that exceeded it - but reading between the lines of that paper, I assume that once you measure PM25 over a full 24 hours that would mean banning cars long before banning smoking.

> Any effect that’s dwarfed by cars might as well be nothing, there’s no sense worrying about a splinter in a broken leg.

Now we’re conflating several different things. The overall contribution to AQI metrics might be dwarfed by cars, but the overall mortality is not - estimated rates of mortality from smoking related causes is higher than the estimated rates of mortality from pollution.

There might be no sense in looking at cigarette smoking to reduce AQI metrics, but there’s every reason to look at smoking to reduce premature death & hundreds of billions in unnecessary health care expenditure, right?

I don’t want to play armchair researcher and defend that paper, it just happened to be a primary source that I found online. If you want to pick apart the methodology, it’d be better to find a different primary source that empirically demonstrates that proximal secondhand smoke is not harmful.

I take responsibility for sending a slightly wrong impression, I didn’t mean to suggest that smoking is a huge contributor to pollution per-se, I see my comments implied that, but I was only trying to say that outdoor smoke in urban areas is a real risk factor to non-smokers, that exposure to secondhand smoke downtown is a very common occurrence, and it seems to be supported by some research. The point I was making is that secondhand smoke can and does affect people outdoors even if it doesn’t push the AQI, and the reason is proximity - smokers are on average hanging around much closer to non-smokers than cars are. The bulk of cars are far away on the freeway, while the bulk of smokers during the day are working near me, pre-pandemic anyway.

> Now we’re conflating several different things. The overall contribution to AQI metrics might be dwarfed by cars, but the overall mortality is not - estimated rates of mortality from smoking related causes is higher than the estimated rates of mortality from pollution.

But "smoking related causes" is conflating two very different things. If you want to ban smoking because it's harmful to smokers, that's a very different argument from banning smoking because it's harmful to others. It would be very convenient for people who want (out of what is - to them - legitimate concern, but is coming from a very different cultural background to that of most smokers) to ban smoking if secondhand smoking were clearly harmful, but frankly if this kind of paper is the best they have then I strongly suspect that it actually isn't.

> If you want to pick apart the methodology, it’d be better to find a different primary source that empirically demonstrates that proximal secondhand smoke is not harmful.

It's hard to publish a negative result and hard to get funding for work that goes against the narrative. And fundamentally the onus is on the people claiming an effect to demonstrate that it's real.

> The point I was making is that secondhand smoke can and does affect people outdoors even if it doesn’t push the AQI, and the reason is proximity - smokers are on average hanging around much closer to non-smokers than cars are.

Again that's something that I think would need to be scientifically shown rather than just assumed.

To be clear, secondhand smoke has absolutely been scientifically proven to kill people. We’ve been discussing the margins of outdoor secondhand smoke, which is, I admit, harder to demonstrate conclusively with simple stats. Outdoor conditions vary wildly, and proximity certainly matters.

I agree that it’s hard to publish a negative result, but the fact is that I gave you a primary research source that was trivial to find and claims to show only a moderate effect, and you’re still rationalizing your discounting of it and rationalizing why you don’t have any primary sources to support the view that outdoor secondhand smoke isn’t harmful.

It would be silly to claim that secondhand smoke is not harmful outdoors, because we already know for a fact that exposure to secondhand smoke is harmful, and being outdoors just reduces the exposure depending on conditions - wind, dissipation, distance, partial enclosure, etc. There’s no question about whether it’s harmful, the only question is how much.

People aren’t banning smoking because it’s sometimes risky. People are banning smoking because it’s always risky, and non-smokers don’t always have control over their exposure levels. The outdoor exposure levels might be considerably lower than indoor exposure, but why should you tolerate any exposure at all? If you can smell it, you’re breathing additional pollution and toxins. You haven’t given any reasons at all that we should accept and tolerate lower-than-indoor levels of risk and damage just because they’re lower. Some people prefer none, and isn’t that a right they should have in public places? Why should people even tolerate the smell if they don’t like it? Would you tolerate a small amount of tastable but moderately low risk poop from your neighbors in your drinking water, given a choice?

> To be clear, secondhand smoke has absolutely been scientifically proven to kill people.

News to me. If that's true, why do conversations about secondhand smoke involve so much rhetoric and so little science?

> People aren’t banning smoking because it’s sometimes risky. People are banning smoking because it’s always risky, and non-smokers don’t always have control over their exposure levels. The outdoor exposure levels might be considerably lower than indoor exposure, but why should you tolerate any exposure at all? If you can smell it, you’re breathing additional pollution and toxins. You haven’t given any reasons at all that we should accept and tolerate lower-than-indoor levels of risk and damage just because they’re lower. Some people prefer none, and isn’t that a right they should have in public places?

If they should have that kind of right, they should have that right in respect to other sources of air pollution like cars or wood fires too. If it's about risk, we should set a safe level and ban the biggest contributors to it. If it's about cost/benefit, we should do an honest assessment of how much benefit is required to justify how much pollution, and set a corresponding tax level on all sources of air pollution, or a cost/benefit level for which kind of sources we'll allow and which we'll ban. Maybe the missing reason here is that we're quietly putting a higher value on the pleasures of cars (i.e. of upper/middle class people) than the pleasures of smoking (i.e. of lower-class people)?

> Would you tolerate a small amount of tastable but moderately low risk poop from your neighbors in your drinking water, given a choice?

I think the fact that you go for a disgust-based argument is pretty telling: this isn't about the health risks of secondhand smoke, it's about a cultural disgust of smoking and smokers.

I hate smoking and smokers as much as anyone, but this thread has really made me think about public officials' eagerness to ban it.

> News to me. If that’s true, why do conversations about secondhand smoke involve so much rhetoric and so little science?

If the fact that second hand smoking has been proven risky is news you to, even indoors, it means you haven’t even googled the question, and that you didn’t click any of the links at the top of this thread. The CDC page has a literal pile of primary source research and data. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/seco...

Do you really want to know the answer to the question you asked? You can find the answers without talking to me. I fully encourage not reading the rest of my reply and just answering the questions you asked yourself with an open mind. Or is this about debating me with logic alone until I stop responding? Logic doesn’t compete with history. It’s irrelevant whether rhetoric is involved, but for the record the reasons rhetoric gets used sometimes is precisely demonstrated by your response to primary research: you didn’t believe it. Okay, if you discount the science, then maybe reason or emotion can work. If you discount reason and emotion too, then maybe you’ve decided and are closed to hearing any input on this topic?

> If they should have that kind of right, they should have that right in respect to other sources of air pollution like cars or wood fires too. If it’s about risk…

I agree with you, we should all have rights about clean air. But you’re now intentionally ignoring the reasons we already discussed. It’s was never about risk alone, it’s about risk vs benefit. Do you need to jump to strawman arguments after we’ve already covered this? Cars have high value in addition to their risks. Cigarettes have no value. It’s weakening your argument and leading me to believe you’ve simply decided that safety is not a valid concern and that you’re choosing to ignore facts. I’m giving you more credit than this, I know you know that cars have real utility and that cigarettes don’t. Your class distinction is a bit cringey and broadly speaking mostly false, I think you already know that too.

> I think the fact that you go for a disgust-based argument is pretty telling

I think the fact that you’re the one using spin framing and rhetoric here while accusing others of doing what you’re doing is telling. I didn’t go for a disgust based argument, I went for a safety argument. Poop is not safe to drink in any amount, my “moderately low risk” was a cheeky parallel to the smoking safety argument. Poop is gross, so I see why you’re trying to use that against me, but secondhand smoke is also gross.

> this thread has really made me think about public officials’ eagerness to ban it.

Why? Are you confusing what I’m saying with what the CDC says? Are you using my rhetoric to justify claiming that public officials are using rhetoric? Isn’t that jumping to conclusions? You still haven’t yet given a single reason why smoking should not be banned, despite the fact that it’s harmful to human health and harmful to the economy, and has no redeeming values. You’ve only expressed fear, doubt, and uncertainty as a response to both reason and primary source research, with only rhetoric of your own in response.

> The CDC page has a literal pile of primary source research and data. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/seco...

There's certainly some interesting stuff there, but it's very clearly written with a heavy bias and very clearly not a primary source (indeed they state explicitly that their second-hand smoke estimates are based on unpublished data, which seems like a huge red flag).

> Do you really want to know the answer to the question you asked? You can find the answers without talking to me.

I am genuinely interested, just common-sense sceptical. Even heavy smoking is not that deadly (especially compared to something like cars - just looking at the impact on people I've known personally). The idea that there would be this huge mortality impact from the much smaller level of smoke exposure that second-hand smokers get just doesn't pass the sniff test. If I take the report you linked at face value, I'm supposed to believe that second-hand smoke kills fully 1/10th as many people as actual smoking - but most of the risks of smoke exposure are linear, and there's just no way that people are breathing in 1/10th as much tobacco as second-hand smoke as actual smokers do. So something stinks.

> Cars have high value in addition to their risks. Cigarettes have no value.

This is your fundamental assumption that's been going unspoken until now, and it's the part I'm taking issue with. Cars don't have a lot of value, IMO. And you're simply ignoring the fact that many people enjoy smoking, or you've decided it somehow doesn't count. It has a lot of value to them, that's why they do it.

Of course if you start by assuming that the value of smoking is zero then you'll reach the conclusion that the cost/benefit isn't worth it. But you could justify banning anything that way (I'm sure there's not a single thing in existence that has absolutely zero health risks associated with it). And I'm pretty sure the decisions about what things are zero value are being made mainly by classism (probably not intentionally, but just because the people who contribute to this kind of public health report come almost exclusively from a particular class).

To be clear, I don't think the CDC is full of political operatives intent on fighting a culture war. What I think is that almost nobody at the CDC smokes, that they don't know many smokers, that they (correctly, more or less) perceive smoking to be a lower-class-coded activity, that there is probably near-universal agreement within the CDC that smoking is an undesirable (maybe even "gross") activity (associated with low levels of educational attainment).

On the other hand, they all fly in airplanes. They attach little or no moral weight to flying. Everybody they know flies on airplanes. Etc, etc.

I think it's unlikely that this isn't influencing their language. The risk of smoking, in their view, isn't something to be managed or weighed or compared; rather, smoking is an abhorrent activity that should be stamped out of existence.

How could that possibly not influence how they write about it?

That’s extremely heavy and unfounded speculation on your part. How do you know who flies, or what their morals are, or who they know?? You’re now attempting to move the goal posts to a different playing field entirely. Your beef was over radiation, which has extremely low levels of risk compared to air pollution, not the morals of flying. The questions about the environmental impacts of flying is certainly getting enormous amounts of exposure currently, why do you think people at the CDC are any different from the rest of us in that respect?

You’re still trying to paint a picture of hypocrisy where none exists. The CDC is presenting facts on risks, not moral judgements. The fact is that the risks of smoking are large, it kills many times more people than all causes of flying related mortality combined, and that is the reason there is a lot of information decided to educating people about those risks. Smoking is also one of the easiest things to change, it’s a choice, and it’s a luxury, not necessary for anyone to do. Why not try to reduce it? They’re not judging people who smoke as low class, they’re pointing out correctly that smoking is something that statistically harms people of low SES disproportionately, not just health wise, but financially. The whole idea is to try to help those people escape. It seems strange to me to spend any energy complaining about the CDC’s language of smoking, while ignoring the vast amounts of social damage left in the wake of Big Tobacco.

I don't care about the morality of flying and I'm not suggesting they should, either. That's the whole point. Of course they use stronger language wrt activities they look down upon than for activities they don't.

And maybe that's as it should be! Again, I am asking people to notice when this happens.

The CDC hasn’t been “politicized,” in other words; their project is intrinsically political.

> their project is intrinsically political

I don’t think that case has been made here, you’re failing to demonstrate it. I disagree that intrinsic politics has anything whatsoever to do with the safety of smoking vs radiation exposure of air travel.

There are times when other people politicize what the CDC says. Your comments here explicitly and repeatedly attempted to politicize the secondhand smoke recommendations. Covid is also one of them, and it seems like you might be dancing around and hoping to implicate Covid politics while trying not to talk about it directly. The CDC has been actively trying to stay out of the politics and simply help people understand the risks and statistics, and what choices they can make to reduce their risks.

> of course they use stronger language wrt activities they look down upon

They don’t look down on any activities. They report safety stats and safety guidelines. The language is stronger when the mortality rates are higher, period.

You're not the only one here who has suggested I might be trying to make some kind of clandestine point about COVID. I've been on this difference in how the CDC treats these two topics since long before COVID existed and COVID couldn't be further from my mind.

Then I’m sorry. Truly. I was speculating wildly and incorrectly. My apologies.

It's not a proof but I really enjoyed Zizek's thoughts on how fight against smoking is an ideology :) https://www.youtube.com/watch?v=r238kp3ar_A

Hehe, I don’t know who this is, but it was fun to watch. “I’m a kind of Stalinist fascist ... if I take drugs, then I become passive, and enemies can attack!” LOL!

So, the argument he didn’t even attempt to address in his comparison of smoking to other drugs is that smoking hurts other people directly, while other drugs don’t. The primary reason we have rules against smoking in public is it’s effects on people nearby who are not choosing to smoke. This entire thread was about secondhand smoke, and Zizek didn’t address it.

Similarly, the reasons we have some regulations on smoking in private, and the entire reason we have regulations on drugs is because of the direct damage it does, statistically, to the users, and to the indirect damage it does to other people. For the minority of bad cases, hospital visits for overdoses and car accidents, social services for addicts or their children, rehab, and loss of jobs are real issues. For the larger majority there are still measurable effects on drug users’ lifespans and on the economy.

We are a collective and have no choice about that. We have some shared resources that we need to agree on. If you want to enjoy freedoms, you have to respect other people’s freedoms. Where’s my freedom to breathe clean air if you smoke near me? (I happen to have some athsma, the risks to me of secondhand smoke are greater than mild exposure to carcinogens.)

So yeah, not only is it not a proof, it’s not even a reason to buy the argument that anti-smoking sentiment is ideological. To prove that it’s ideology, you need to demonstrate that smoking is safe.

I wish it were acceptable to complain about stinky purfumes and body sprays. They fill the air with volatile organic compounds. Plenty of people are happy to chuck on something smelly while hypocritically complaining about other types of smells. Some cause allergies (hayfever) in me to the point I have to leave an enclosed space or suffer consequences. I know friends that get headaches from them.

Hear, hear! Some are worse than others, some don't bother much, but lots of perfumes give me headaches.

Right. And where is the "no safe level of exposure to perfume" PSA?

It's entirely rational to suspect the motives and veracity of statements like this.

The harder you make it to engage a behavior, the more likely it is to become extinguished or reduce. These are nusges. It's basically how you influence people incrementally toward a desired outcome.

I too, am bothered by some of the history of tobacco-related data. I am ok with the government using indirect methods to reduce tobacco deaths.

Wearing perfume doesn't makebthe too of preventable deaths. Perfume smell may be as annoying as cigarette smoke to some people. There's a clear reason why there's societal pressure to address and regulate one I dustry as opposed to another.

Whether a given government is using shit science and where it draws its concerns in regards to societal pressure valves to release, has a lot to do with who the leaders of the administration are. This is why politics needs to be a leading concern for any researcher or citizen that prefers effective methods of dispersing evidence-based knowledge.

I once encountered a smoker who smoked something seriously insane that smelled like burning shit. I could barely believe it's happening.

It's not absurd to worry about it, it is absurd to say there is no safe exposure level and leave it at that. Especially because so many people smoke it is important to be informed about the actual risks of second hand smoke.

If I'm walking down the street do I need to cross the street if I see someone approach with a cigarette? If I'm at a bar and smell smoke coming in should I leave?

No safe level means one person a mile away is a problem.

I bet they would say that's absurd, with a straight face.

A wise man I knew used to say

"Dilution is the solution to pollution".

In fact, once you think about it, that's also the only solution.

I hear your point, and agreed already that more detail would be nice.

To be fair, the CDC does not ‘leave it at that’. Their page that @dionidium linked to does not either start with or stop with the statement “there is no risk-free level of exposure to secondhand smoke.” It’s one statement among many that include actual statistics, and so incredulity over a line of summary taken out of context might be slightly misplaced.

The CDC is in the business of setting guidelines, so the context of their statement that it’s not risk free is a suggestion that regardless of your situation, it would be better to not expose yourself to smoke. This happens to be in complete agreement with the message and recently updated guidelines by the World Health Organization, and with statements by the American Medical Association.

Reasonable people are free to make reasonable choices. A little smoking and drinking isn’t going to kill anyone, and we all know that. So we don’t need to get upset when someone says a little is a little bit bad. That said, for someone with athsma, they might reasonably choose to cross the street, since smoke is a trigger and meeting someone on the street who smokes is a very common occurrence if you walk around in urban areas. If they go to a bar, then they’re probably asking for it. :P

“ it’s not that absurd to worry about urban smoke outdoors contributing to urban pollution”

Where do you live that second hand smoke is a significant urban level pollutant?

Take a pack of cigarettes, 25g, divide it by 3 (your 30% of people are smokers) = 8.3 g per capita and burn it.

Now consider all the diesel per capita that is burned in this dystopian city of smokers.

No, we don't get to pretend these trucks have diesel particulate filters. Not if the city has 30% smokers. [1]

Anyway, at 8g/person, pollution controls wont save the argument - smoking is a negligible urban level pollutant.

[1] or propose a city with lots of smokers that has strict and enforced diesel rules. Tel Aviv? Israelis used to love to smoke.

Note the change from secondhand smoke to outdoor secondhand smoke, once you responded rationally. This poster may be a bot.

Reminds me of a discussion at a students' senate meeting on campus a few years back, when they were discussing banning tobacco smoke everywhere including in the parks away from buildings. People who noted that PM2.5/PM10 emissions from construction sites (ubiquitous at the time), or even BBQs, where much greater than cigarettes, even if all people on campus were chain smoking (we maybe had 5% smokers), were ostracized. The times we live in lol.

There are other large source of particulate emissions, larger than cigarettes, there is no doubt about that. Why would that mean we shouldn’t have rules about smoking in public places? Is it okay to try to address multiple issues at the same time, and do something about the ones we actually have control over, even if it only partially addresses the problem?

It’d probably be ideal to eliminate the other sources of particulates too, it’s not necessarily a competition, though we all like buildings and BBQ. But out of curiosity - were the people noting that one BBQ is a bigger source of particulates than one cigarette also being fair about the averages, like the fact that there are generally many fewer BBQs running at far lower density and far less often than cigarettes? Are you sure they weren’t argued down because the point might be both somewhat misleading and also somewhat irrelevant? (I’m not certain about that, just suggesting it’s possible. It’s also a fact that there are people who like to ride on high horses and get uppity about their beliefs. I might be one of them sometimes.)

Exactly, you mention beliefs, while the point was (is?) one of science. By the way, have you ever heard of banning coal BBQs? I'm not sure at all that the exposure is less severe. Say you are at a party, there's a BBQ 20ft away, and some annoying guy lights a cig 10ft away. I'd bet you money that the BBQ harms you more, or at least emits more than 4 times (you need to scale by the square, diffusion of a fluid) PM2.5 than the cigarette.

Yes, I mentioned beliefs and was admitting that some of the behavior you saw might be based more on human beliefs than science. It wouldn’t be the first time it ever happened, right? ;)

I have heard of banning coal BBQs. I’m sure you’re absolutely right that the instantaneous exposure per second can be worse if you’re close and downwind from one than a cigarette from the same distance. But how often do you go to a party? Is it dozens of times per day, every day? Because that’s how often I bump into smokers when walking around downtown. Part of the CDC’s point is that the damage is cumulative, and you need to integrate over time and space. Exposure to one big source for a short time can be a little bit bad, while exposure to many small sources for a long period of time can be much worse.

I was referring to a specific situation (a university campus) that already banned smoking from all indoor areas, and all outdoor areas within 100ft from buildings (could have been 200, I don't remember). The question was whether to ban it everywhere. That scene I used of the party was very accurate, you'd have about 1 in 20 people who smoked. You'd not bump into smokers in any other settings, basically. (You'd maybe see a random smoker smoking on their own far away from buildings.) This was early 2010s at a west coast university.

Also, you don't need to be downwind from the BBQ. It's a point emission of fluid (particulate). It diffuses. The intensity scales with the square of the distance. (Same exact process as the cigarette smoke.)

To bring it to the relevant topic of the day, I don't believe I will ever see the CDC issue a statement that "no level of exposure to the COVID-19 virus is safe", and recommend China level of quarantine.

Walking near a smoker on a sidewalk outside IS a risk to my health and the health of my children. I have asthma as do my children. Both my children and I have had asthma attacks due to second hand smoke, even limited quantities. As a smoker you may not notice this but the smell from even a whiff of second hand smoke persists for a long time and it's awful. Our family gives smokers on the sidewalk a very wide berth.

Nobody gets to create a hazard to others walking on a sidewalk. If a business wanted to dispose of an equivalently toxic substance out in the open, they would be heavily fined and shut down. Why should smokers have a special right to do this and, incidentally, litter cigarette butts all over the place?

I'm extremely grateful to live in NYC where there is a (frequently violated but still) ban on smoking inside all public parks. I would absolutely support a sidewalk smoking ban and better enforcement of the ban on smoking in parks and within 25 feet of building entrances in NYC and limit smoking to private property with the smoker responsible for ensuring second hand smoke does not affect adjoining private property.

The primary difference between smoking and alcohol is that with alcohol, there is no equivalent to second hand smoke. When someone who drinks alcohol creates a negative externality for those around, they are ticketed or arrested depending on what they did, everything from drunk driving laws to drunken disorderly laws. I'd love to see a laws on the books similar to drunk driving laws that addressed the issue of smoking around minors.

Now if the CDC said there was no safe level of exposure to nicotine and so we should ban all nicotine gum, that would be absurd.

Well at least now nobody can claim I made up this objection.

Along the lines of second hand smoke, are there any levels of safe exposure to air pollution (considering recent studies saying that chronic exposure is equivalent to losing one year of education)? In that case, internal combustion engine exhaust might be a larger source of health risk than outdoor second hand smoke, depending on where you live.

The research and statistics are trending toward the conclusion that there are no safe levels of exposure to pollution, car/ICE or otherwise. The 2021 WHO report is pretty good/interesting stuff https://apps.who.int/iris/bitstream/handle/10665/345329/9789...

Personally, I’m pretty certain that cars are a bigger contributor to overall air pollution than cigarettes. I would guess much bigger, however Googling this question will return studies that claim to show cigarette pollution is worse per gram of smoke or whatever.

I don’t know what it means to lose a year of education, that sounds like it could be a little hyperbolic, and hyperbolic stuff does get said unfortunately.

Anyway, we can and should work on both problems, cars and cigarettes, we don’t need to limit ourselves to which one is worse, they’re both bad. Smoking alone really does contribute significantly to early mortality globally, so it really is a problem to solve.

Cigarettes are also, unlike cars, a completely optional choice. Unlike the reasons to drive, the reasons to smoke are not backed by any economic needs or economic benefits aside from income to the tobacco companies. There is no socially redeeming value to smoking, where there is a lot for cars (jobs, food distribution, transportation & travel, etc). So, it will be far easier to stop people from smoking, and reduce overall death, than it will be to stop people from driving.

Great comment. Way too much of HN is invested in "nanny state bad and corrupt" justified with FUD-like narratives. There's always this low-simmering culture war here. And really, air travel radiation is the hill these types of people want to die on?

The problem with conservative forums like HN is eventually you get on this treadmill of "and so and so isn't so bad" be it alcohol, smoking, Hitler, etc that's a mix of ignorant and purposely dishonest to push agendas. This takes people down some strange and often ignorant and hateful roads, which then helps craft their personalities and core beliefs into something very negative.

The reality is, alcohol is pretty toxic and a health organization really shouldn't recommend a daily allowance of it. I think the cognitive dissonance with people who want to be "right with the science" but also want to drink needs to come out somehow and it often comes out, at least with health issues, with these overly-broad and just weird attacks on groups like the CDC or WHO or whatever. Instead, these people could just admit that "Yes, I do this very unhealthy thing for pleasure and its as unhealthy as the experts say it is." Instead, they'd rather nitpick at random things and reach an irrational conclusion than accept the truth of it all.

On the healthcare end it works the other way like "Here's some unwarranted nitpicking about vaccines," that terminates to a crazed anti-vaxxer position. Its the same kind of dishonesty and leads to the same types of irrational conclusions.

For a lot of people, not only is this how they often think, its the default mode of how they think. They sling mud, project, and attack at any perceived slight against their personal beliefs and the culture war they're always fighting. Its a sign of an emotionally immature mind and these people are everywhere and they build powerful echo chambers. When we see them die of covid as they post facebook memes denying its existence, we then know the fruits of this kind of mental labor. Its dishonestly all the way down.

> The problem with conservative forums like HN

Not terribly on topic, but I've been lurking here for more than a decade, and today I learned that it's a conservative forum. And on top of that, it has the same problems inherent to conservative forums (fora?). Weird.

While i wouldn't agree that HN is a conservative forum, there is certainly a lot more conservative-leaning material posted here than similar tech-focused forums.

See any thread about California, Texas, diversity & affirmative action, COVID, etc.

The pattern only overlaps with conservative on the topics of regulation, maybe taxes, definitely affirmative action.

Everything you said but it's not about conservatism in general or most of the rest of the current conservative platform.

It's just anything that annoys a tech bro who never had a problem in life except that it's a crime that his copycat app was taken down and some girl got a job he thought the world owed him, or he succeeded and believes he did it all himself and doesn't owe anyone else anything.

I mean, it is a large overlap. You could describe both this and the coservative platform as "whatever rationalization works to justify being selfish"

But for instance, I bet almost none of these "conservatives" have a moral or religious objection to sex outside of marriage, sex outside of their race/ethnicity/religion, definitely aren't down at the soup kitchen every wednesday to feed the hungry, never turned the other cheek in their lives, will happily ridicule "preppers" even while researching about data islands...

I think I'm not really articulating my point all that well but hopefully you do still get what I mean despite my weak examples.

This thread was diverted from questioning alcohol as a poison in "any amount " to culture war. This is the borderline astroturfing that destroys communities. Turn every discussion into a political one. I no longer read Slashdot knowing I'll find commenters with more insight than the OP, because they're buried in fragile outrage. Sorry I'm making it worse, just this thread, which should be a few references on each point, became panic and FUD disorientingly fast.

> Not terribly on topic, but I've been lurking here for more than a decade, and today I learned that it's a conservative forum

Me too.

I understand that the commentary on HN can sometimes be frustrating, but many topics are nuanced and worthy of discussion. If you are looking for a forum which converges on one version of the truth and does nothing but repeat that version of the truth to itself, well, maybe try another discussion forum. If you are not interested in participating in those discussions, it's fine to just keep scrolling or collapse the thread entirely.

It may not be deadly, but female flight attendants become infertile earlier than women working on the ground.

Just speculating here, but doesn't it have something to do with accumulation in the body? Your body obviously can't accumulate radiations. It also does process and eliminate the like of ethanol and many other substances. That's not the case, I believe, for heavy metals like mercury, lead or arsenic, that are eliminated much more slowly (if at all?).

That's why you can enjoy lychees by eating a few everyday if you fancy it, and will only poison yourself if you eat a lot at once. But you can poison someone by exposing them to a little bit of arsenic everyday (at least in the movies, not sure how true it is...)

I think tar from smoke accumulates, and there is a lot of it in second-hand smoke.

Obviously not a doctor, so I'm probably completely wrong...

The damage from smoking is accumulative. I have noticed it in the skin of young female smokers after a few years of heavy smoking. You can see it's affects on some other parts of the body over longer periods.

Drinking a lot of alcohol has a similar effects as tobacco on your health, and on the skin. If you know a heavy drinker then they quit for six months and then you see their face, there is noticeable rejuvenation. There are patterns of looks to older people that drink at pubs frequently.

You might enjoy this excerpt from E. T. Jaynes’ book “Probability Theory: The Logic of Science”:

https://bayes.wustl.edu/etj/prob/book.pdf#page=16 (the section that starts with “What is ‘safe’?”)

yes but these three (radiation, smoke, alcohol) are very different hazards with quite different modes of harm

There is robust data that the risk of first-hand smoke is not a linear relationship between cancer (and other bad stuff) and dose--no amount of smoking is safe.

To be frank you are uninformed on basic statistics as well as medicine.

You are doing the standard thing that many educated people do when they think they are smarter and more informed than they are. You dress up a bad take as if you found some secret (CDC's hypocritical language) and assume that a mathematical relationship exists ("obviously exposure to bad stuff carries linear risk"), when it is actually more complex than that (if we can call a binary relationship more complex than linear lol).

> bad stuff carries linear risk

This is a straw man. I believe that a lot of stuff carries continuous risk going up from zero and increasing with dosage. If a substance does not start with zero risk at zero dose, it is most likely not a toxin but an essential (i.e. vitamin A).

Very few substances are so rare that the discreteness might matter for practical purposes.

To portray the risk as binary, centered at zero is certainly wrong. You also would have a very hard time to find study subjects who have never been exposed to a few particles of smoke.

That doesn’t mean it’s not linear to some degree; surely 24 cigarettes a day is worse than 1 a week.

Smoking by a person may or may not create benefits for the person smoking. However, secondhand smoke creates no positives and significant net negatives (the smell, the accumulation of black deposits on clothes of things around you) for anyone who encounters it even if you ignore the health effects.

It can also create pretty serious immediate issues beyond just the long term problems for people with breathing issues like asthma or certain allergies. If smoking and second hand smoke were everywhere, like it was in 80s and early 90s in the US, and you were one of the fairly large percentage of the population with these issues, you basically couldn't go anywhere without risking your health.

If the second hand inhaler were a child, it's an even more serious problem. Nicotine is highly addictive and does a real number on your brain. It makes addicted smokers justify things to themselves due to the sheer physical need and you end up with parents smoking around young kids etc.

Even if you are a libertarian, you should support restrictions on smoking consistent with the principle that each of us has freedom but your freedom to swing your fist only extends as far as my nose.

Alcohol is a bit different. Unless the drinker starts behaving badly after drinking, or there are long term issues like alcoholism that affect the whole family, they are really only hurting themselves.

What the studies have found is that drinking in moderation (at or below the 1–2 standard drinks a day limit) does not have cause a very large impact on life expectancy. This raises sharply after exceeding the limit.

https://www.health.harvard.edu/blog/sorting-out-the-health-e...

Personally unsure whether a reduced year or two of life is really that significant.

That article seems to back up the idea that no level of alcohol is safe, given that low / moderate alcohol consumption is still associated with a small decrease in life expectancy.

(Though there are always potential confounding factors in such studies)

It does lose you time, yes, but there's lots of other factors in a person's life like level of stress, air pollution, etc. that have similar or worse impact. Alcohol intake is at least somewhat more controllable than those factors, so it can be up to you whether that lost expectency matters.

How alcoholism can be triggered in some one is also not known. That is also an additional risk factor in every single drink consumed, perhaps?

Here's a paper that combined a 30 year study on intake with MRI data and came to similar conclusions (no safe level of consumption and no observed benefit from low-dosage consumption).

https://www.bmj.com/content/357/bmj.j2353

One thing to keep in mind when reading these papers is that a "unit" of alcohol in these studies is often equivalent to about half a standard drink in the US. So when they talk about 7 units a week, it's not 7 drinks, it's usually 3.5 drinks.

Chris Masterjohn theorizes that alcohol can have a beneficial hormetic effect by antagonizing vitamin A and the body adapting to supply more vitamin A. However, he theorizes the maximum beneficial dosage is about 2/3 of a single drink.

https://chrismasterjohnphd.com/lite-videos/2018/12/13/is-alc...

This is a great comment. I am just usually employing a rule of:

"If there is a conflict between healthy / unhealthy, then can just minimise or avoid it."

Nobody really argues about vegetables... Meat and dairy products however, thats an interesting discussion.

What's disappointing is how quickly your observation was diverted to panic and inciting outrage. I'm interested to know why the CDC now says "no amount" when the evidence for decades has been that small amounts are cardioprotective. Is there truly none?

The "small amounts is cardioprotective" is most likely false, the new recommendation simply reflects this. I recall reading about this in research more than 10 years ago. (Sorry for not citing, I'm on mobile rn)

For everyone complaining about evidence citation, this is just a press release. The actual brief which includes 41 citations is here: https://world-heart-federation.org/wp-content/uploads/WHF-Po...

(the parent comment was originally in reply to https://news.ycombinator.com/item?id=30009882, which we merged hither)

I saw this from this link: https://world-heart-federation.org/news/no-amount-of-alcohol...

In that article, it states:

"Alcohol has a greater impact on people from low socio-economic backgrounds, who are more likely to experience its adverse effects compared to people from higher socio-economic backgrounds, even when consuming similar or lower amounts."

Can someone provide some insight here? What does your wage have to do with how you body handles booze?

I'm not 100% certain about this, but my initial thoughts are that low socio-economic backgrounds will have less medical treatment (especially preventative) so issues aren't caught as quickly meaning you'll have more health issues at the same consumption rates. Other stats such as higher socio-economic backgrounds tending to eat more healthy foods, exercise more, have a greater ability to have a fruitful social life etc, will all be additional factors.

That's true across the board though, and seems strange to call it out specifically in regards to alcohol consumption.

It’s true across the board, but is relevant to things done across the board. So it is more relevant to public health than the disproportionate impact of scuba diving.

My first thought would be compounding any of the comorbidities that are already correlated with low socioeconomic status.

The two major negative effects of low social-economic status on health that I commonly see mentioned is increased stress and reduced amount of cooping mechanics that provide protection.

The human body is pretty able to withstand most injuries, viruses, bacteria and so on. The more stressed a person is the less the body is able to do that recovery. In addition, if and individual is low on the socio-economic scale they might not have available cooping mechanics like resting, taking a day of, or access to social support. A lack of cooping mechanics is also a source for stress, making the body prioritizing other things than recovery.

It cites this paper:

https://pubmed.ncbi.nlm.nih.gov/32504585/

which says in its abstract: " Individuals with low socioeconomic status (SES) experience disproportionately greater alcohol-attributable health harm than individuals with high SES from similar or lower amounts of alcohol consumption." and "Alcohol use explained up to 27% of the socioeconomic inequalities in mortality. The proportion of socioeconomic inequalities explained systematically differed by drinking pattern, with heavy episodic drinking having a potentially significant explanatory value."

This is a statistical claim. Not a causal claim. But we could make some assumptions about it. For instance low income people may be less likely to afford childcare or driver services like Uber which result in them being more likely to drive or child-care under the influence. Furthermore they may be more likely to have diabetes and heart issues, which may make them more susceptible to comorbities from alcohol toxicity.

Although I live in a place where weed is legal, I don’t use it. I enjoy the occasional glass of a nice scotch, though, and I love a good stout or porter beer. This is where it gets a little strange for me: by every metric I can think of, I’d be better off replacing alcohol with weed. There seem to be fewer negative effects, it’s not a source of empty calories, and looks like a better recreational drug in every way.

And still, growing up with “Just Say No”, I can’t quite bring myself to. In the back of my mind, a little voice asks if that’s the example I want to set for my kids, which is silly when they’ve seen me (responsibly) using alcohol for years. I just can’t imagine using a vape or popping an edible in the same way I might pour a little glass of whisky before settling down for the evening.

Personal anecdote but I disagree. I started smoking pot regularly after college and moving to a state where it was legal. It mostly displaced alcohol in my social circle. I thought it was harmless and 'superior' to drinking. I cannot have pot around anymore and was somewhat difficult to finally quit. While the consequences of pot addiction and difficulty in quitting are much lower than that of alcohol; the barrier to forming an addiction is also much lower. Pot undermined my life, mental health, social life, and motivation while using it. It's just too easy to get high, and too easy to tell yourself 'it's only pot, and it's not harmful.' Now I'll drink a couple beers after work some days, or some days I wont. But I don't think about how I want to go home and drink while I'm at work and it doesn't leave me in a groggy anti-social haze for 24 hours after using it. For me, alcohol is a much healthier drug.

I appreciate that. And again, I have little experience with pot so I can’t counter that with a personal story. I’m a little surprised, though, as it’s so easy to stumble across alcohol with it being sold in every store and restaurant. I’d have to go out of my way to acquire pot, but I could pick up a 6-pack of beer on my way to the cheese section of the grocery store.

I wonder what the relative numbers are of people who occasionally use pot vs weed and become addicted to it.

Exactly, with alcohol I know play that's my 2 drinks of the night on weekends, call it a day.

Weed : the effects can last for days, paranoia, delusion, short term memory loss, not wanting to socialize, depression.

Sample size of one, I know! Your mileage may vary .

"it’s not a source of empty calories"

Until you get the munchies...

Hah, fair point. The Jack in the Box around the corner advertises:

- Late night “munchie meals” (https://jackinthebox.fandom.com/wiki/Jack%27s_Munchie_Meal)

- Delivery until 3 AM.

That can’t be a healthy combination.

I avoid the munchies mostly by drinking a crap load of water, which I need to do anyway to keep my sensitive throat from getting sore.

Microwave popcorn is also only about 400 calories a bag!

For me as a daily weed user, this "type" of munchies only persisted for so long. Curious to hear of others experiences, but after about a year of developing the habit, I became almost repulsed by very salty/greasy/sweet foods and started to crave simpler meals comprised of more fruits and vegetables.

Healthy food tastes better too. Honestly I’ve grown sick of simple snack foods by now. I’d much rather eat a nice meal

I wish more folks realized this. I tend to eat healthier if I smoke regularly because of this.

tbf the munchy satisfying foods aren't necessarily empty calories. Alcohol is the worst of all macros and devoid of nutrition.

Sounds like you already realize the error of your reasoning.

Don't be so set in your ways. As we get older, it's harder and harder to convince ourselves to try new things. You should actively fight that to keep life fresh and full of excitement. Don't let the words that were burned into you as a kid influence your rational adult decisions.

Specific subject aside, I totally agree with you. Life’s too short and the world is too amazing to get stuck in a rut, and I’m ready to give it all a try. You’ve got a vacation planned to live with shepherds in the Alps for a couple of weeks? Save me a space in your yurt. Let’s do this.

But truthfully, the third alternative in alcohol vs weed is “none of the above”. I’m not obligated to choose a vice, and if I had to give up alcohol today, say for health reasons, it’d be a small bummer but I don’t know that I’d rush to replace it.

Well, media has been recently overwhelmed by studies showcasing the benefits of weed so that the disadvantages of using it appear to be lower or none at all, but that's not really the case.

If smoked, you're smoking tar and volatile compounds that can harm the lungs, much like a regular cigarette - although you're probably not going to smoke a pack of 20 joints in a single day like the moderate-to-heavy smoker next door do.

There's also an association between weed and schizophrenia (and depression) in adults. I'm not going to say "weed causes schizophrenia" (or depression), but the correlation exists and some will argue it implies causation here. Weed is also associated with some memory problems in adults too, although they seem to wean off if you stop using it.

There are cardiovascular risks associated with THC too, since it can cause abnormal heart rhythms and elevated heart rate. And, again, it's even worse if smoked since carbon dioxide and smoke compounds are known for affecting the heart.

So, yeah, weed has benefits, plenty of them, but I wouldn't say it's necessarily "safer". Don't get me wrong, alcohol is toxic, it's broken down in the liver into Acetaldehyde, a known carcinogenic. This stuff can't be healthy. But, for weed, we have less data on how it impacts the body - see how much time did it take to scientists finally admit alcohol is toxic? -. Similar studies on cannabis are still ongoing and we don't know yet all the risks it poses, but we already can see they do exist.

Maybe the real healthy thing is not switching from one drug to another, but cutting back on the overall consumption.

See, I'm of the opinion that problem drinking and/or weed is escapism or a form of self-harm, and unless the underlying issues are solved you'd just find an alternative.

Anecdotal, but I drink less now that I'm in a comitted relationship / living together. I still drink, but it's social. I've only been sort of hung over once in the past year.

Going to the movies is a form of escapism too. I wouldn’t connect escapism to self harm. It can help you avoid getting help, but that’s only harm by opportunity cost, which opens up all sorts of issues.

what's wrong with temporarily escaping sobriety?

Anecdotally, my partner and I enjoy sharing various intoxicants within a committed relationship.

I do not see an underlying issue to be solved.

Those are all good points. I still think evidence shows that weed is likely the less harmful option of the two. In the spirit of harm reduction, if I had to choose one of them to start with, weed appears to be the rational choice. But there’s no one telling me I have to use either of them.

Coffee is still my favorite drug, and I’ll fight for that one.

But humans aren't rational, we decide based on emotions most of the time. Alcohol and coffee have rituals you've been familiar with since childhood. Society says it's ok so you feel ok about it.

Also maybe you prefer one of the highs over the other? I don't drink alcohol before doing sports or going to work, but I might have a coffee.

Granted weed is a depressant like alcohol. But maybe the high is not as enjoyable for you. Maybe you don't find the relaxation after work that you expect from the scotch.

The schizophrenia and memory loss part seems to be for very heavy usage.

AFAIK infrequent use of edibles has no down sides.

nope there are still the cardiovascular risks

I think that the relationship between marijuana smoking and lung damange isn't so cut and dry bad as smoking nicotine is. Here's a blurb:

> Regular smoking of marijuana by itself causes visible and microscopic injury to the large airways that is consistently associated with an increased likelihood of symptoms of chronic bronchitis that subside after cessation of use. On the other hand, habitual use of marijuana alone does not appear to lead to significant abnormalities in lung function when assessed either cross-sectionally or longitudinally, except for possible increases in lung volumes and modest increases in airway resistance of unclear clinical significance. Therefore, no clear link to chronic obstructive pulmonary disease has been established. Although marijuana smoke contains a number of carcinogens and cocarcinogens, findings from a limited number of well-designed epidemiological studies do not suggest an increased risk for the development of either lung or upper airway cancer from light or moderate use, although evidence is mixed concerning possible carcinogenic risks of heavy, long-term use.

https://pubmed.ncbi.nlm.nih.gov/23802821/

Setting aside tradition/ritual, which I don't think should count for nothing, I can think of many objective metrics on which alcohol is superior:

- Flavor

- Fills the stomach (can be a disadvantage too, but is advantageous in some situations, e.g. while waiting for dinner to be served at a party)

- Doesn't consume itself (i.e you can set down a drink and come back to it 30 minutes later)

- Easy to consume a small amount without substantially altering your mental state.

- No fire/burn risk

- Doesn't generate smoke/odor, which is unpleasant for other people and gets in your clothes/furniture

How can flavor possibly considered an objective metric?

In the sense that alcohol beverages sit on your tongue and most have a designed flavor, of which there are many varieties to enjoy. But I suppose you're right, marijuana smoke does have a flavor, and you may prefer that to any alcoholic beverage.

But granting that it's not objective, it still something one could point to (and I would) as a reason for preferring alcoholic drinks.

Most people looking for flavor aren't smoking. Vape products these days are designed with specific flavor profiles. I'm not talking about the strange mango/bubblegum/etc flavors, I'm saying most weed itself has designed flavor for extracts these days. In the same way that orange juice is a design flavor (manufacturers will work with the brand to combine sugar/juice/oils/scents/pulp ratios), most dab vape concentrates are reduced to their bare components then recombined to achieve a flavor profile desired. Want it more skunky? More piney? Sharper? Softer? It's all achievable and designed.

The industry has changed drastically in the last decade. Consider smoked weed to be analogous to moonshine when comparing it with alcohol. That's not a dis towards flower, but many products are just as heavily designed as a bottled beer or scotch is these days.

There are lots of ways to consume weed that don’t have those drawbacks. There’s a dispensary around the block from me, and even though I don’t use it, I went in to look around to see what our new neighborhood shop looked like. They had a wide selection of edible candies, vape pens, and even drinks. It looks like it’d be very easy to get a consistent dose without burning anything. I know how much alcohol I can drink to get a pleasant effect without getting drunk, and I’m supposing I could do the same for weed if I wanted. (Or maybe not: it looks like the effects greatly vary based on strain, or how much CBD you take with it, etc. The “how much should I take to relax?” formula looks quite a bit more complicated.)

Fair point, I was thinking of just smoking, and not other forms of consumption.

I get it. When I think of weed, my first mental image is still of someone passing a joint or bong around. I was surprised at how many measured dose options there were, though. Want a bag of watermelon gummy candies with X mg of THC? They’ve got you covered.

I do wonder how much variance there is in those. Is that 5.0 mg += .1mg, or “eh, about 5 on average”. It’s easy to dose alcohol as you know how much alcohol is in an ounce of whisky. If you find one that’s stronger than another, your taste buds will let you know quickly.

Worth noting, for many people there is a significant difference in experience with edibles vs smoked/vaped weed.

My recommendation is to not overthink it. If you're curious at all, go spend $7 on a single pre-roll, light it up, and try it out. There's plenty of unpleasant-ness in it for a first timer, but if you like being high, then you'll probably want to do it again.

Dosing for smoking is pretty easy; take a few puffs and wait ten minutes. If you don't feel what you want, take a few more puffs. You don't need to understand your mg dose unless you become pretty habitual

This dosing suggestion is probably good for a lot of people, but for some, that initial "take a few puffs" could be way too much.

Alcohol is pretty versatile. Not every use of it is for intoxication. For example, nobody is getting a buzz from deglazing a sauce pan with red wine.

erm https://en.wikipedia.org/wiki/Hemp

I prefer edibles. Maybe it's because I don't really want the full experience, at least right now (perhaps I'll benefit from a higher level later on for medical reasons). I learned I like CBD and am glad to be in a state where I can have THC as well, at any ratio to CBD. It isn't a consistent dose, but it's easy to dial in what the top dose I might have is, and I like the randomness below the top dose.

>- Flavor

This is obviously not an objective metric of superiority.

>- Fills the stomach (can be a disadvantage too, but is advantageous in some situations, e.g. while waiting for dinner to be served at a party)

Also subjective, as you realize its inconveniences and give one positive use case. In my experience this bloat is largely uncomfortable and inconvenient.

>- Doesn't consume itself (i.e you can set down a drink and come back to it 30 minutes later)

This is only true if you leave something lit that is burning, something I doubt most would do on purpose

>- Easy to consume a small amount without substantially altering your mental state.

Sister comment addresses this well

>- No fire/burn risk

Valid concern, but there are many common ways to consume weed that don't carry that risk

>- Doesn't generate smoke/odor, which is unpleasant for other people and gets in your clothes/furniture

Same as above

Ironically I think the traditions and rituals around alcohol is the best thing it has going for it, on most "objective" measures weed is regarded superior.

> Flavor

I vape flower cannabis, flavor is a key component of this process.

> Fills the stomach

Cannabis stimulates my appetite. This is welcome and paired with a glass of wine (on an empty stomach) before dinner makes the experience amazing!

> Doesn't consume itself

My vape shuts off with inactivity - it doesn't "consume itself. Neither would a "bowl" of cannabis. Even a "joint" would stop burning if you put it down.

> Easy to consume a small amount without substantially altering your mental state.

This is one of the major advantages of consuming cannabis via the vaping/smoking vs. edibles (also alcohol). The effects are felt in seconds which allows you to eaasily regulate dosage. Edibles and alcohol can easily be overconsumed because of the delay involved in stomach/liver process.

> No fire/burn risk

My vape is electric, the risk of fire would be similar to using any of my other electronic devices with heat, such as a wax melt device etc.

> Doesn't generate smoke/odor, which is unpleasant for other people and gets in your clothes/furniture

While the vape does create an odor, it's short lived and doesn't smell like smoked cannabis.

Just get a vape pen. It’s even more convenient than a beer. Fits in your pocket. You can take a tiny puff and put it back if you wish. Barely any smell

Each of of these can be solved with a either edibles, vaping (or a number of non-fire options), or a pipe with small bowl.

Weed isn't legal where I live however its easy enough to access. A thing i really dislike about weed is in my (and most of my friends) experience its possible to just accidentally get to high and have a panic attack or freak out.

While this is possible with drinking, I find its much more difficult especially when drinking beer as I do. It has to be a much more conscious decision for me to get wasted drunk than for me to accidentally get so stoned I hide in my room.

Weed these days is so strong, smoking a full sized joint is much like drinking a glass of vodka. If you do it more often you learn your limits and dosage to get that two beers vibe consistently

A good alternative with similar results is Delta 8. Lower potency and less likely to cause any freak out moments.

You're already giving a bad example to your kids by drinking alcohol.

That's fine. They'll grow up and decide what to do. If they'll drink themselves senseless there must be a bigger problem than seeing you drink alcohol in small quantities.

I certainly am not doing all the mistakes I saw my father's doing and I hope my kids will grow up to be responsible adults which will make their own decisions.

I never lived in a place where weed was legal but for a couple of years I used it as an antidepressant and as a way to unwind. I bought a vaporiser (the healthiest, quickest and hassle-free way to absorb weed - very little smell lingering and you're not smoking paper) and vaped nearly every evening (after kids bedtime) and it was great to survive a hard period of my life. After 2 years I didn't feel the need anymore and I stopped. I can't be bothered to go to onion to buy weed anymore and just drink a beer every once and then when I want to unwind - but if weed was easy to buy I'd definitely buy it and treat it like I treat beers. I'm glad I didn't use alcohol in the same way, merely for the extra calories and for the liver damage.

Still, there is a good reason you're fine drinking a beer in front of your kids but you should avoid vaping in front of your kids - and that's merely to avoid exposing them to passive vapour.

I’m torn on the setting an example bit. My parents never drank at all, that I know of. Growing up I was led to believe that you drank either never or always, like there was no middle ground. I wish someone had told me or demonstrated that it’s OK and normal to have the occasional drink and then stop.

We’re fortunate to live in a house with a yard. If I were going to smoke or vape, it’d be on the back deck. I wouldn’t use it inside any more than I’d use tobacco smoke or vape in my living room. More likely, I’d use an edible.

The downside to doing it secretly is that I’m pretty sure my kids in high school know what a stoned person looks like. The last thing I’d want is to have them notice I was under the influence, then come to their own (and wrong) conclusions like “huh, does Dad do this every night? Has he always?”

My parents drink wine at every meal… there is never water at their table! And yet I have never seen them drink any alcohol without food… my perception when I was young was that wine was just another beverage. As an adult now I pretty much follow their example… I don’t drink if I am not dining… but unlike them I do it onto certain or twice a week.

Best example is to do neither and find something that actually is interesting or sort of fun to do at night.

Imagine being haunted by Nancy Reagan in 2022.

"You had to be there, man."

It wasn't just her, but that the US went all-out stigmatizing weed. According to the DARE program, after 2 marijuanas you might as well be shooting up heroin. (Note: this spectacularly backfired, as plenty of kids tried weed and didn't die, figured the whole thing was a lie, and then tried harder drugs that are much less forgiving.)

I don't think a thing about other people using weed. I'm sure plenty of my friends and coworkers in the Bay Area do, and they're all awesome and productive people. It still feels weird for me, though, after a lifetime of being told it was bad.

It's not just Nancy Reagan, man... Every former president and first lady since JFK, they're all out to get us. They got that Annunaki blood, long flouride fangs, and woobly mind control waves.

> I just can’t imagine using a vape or popping an edible in the same way I might pour a little glass of whisky before settling down for the evening.

Every drug has its uses, I guess. Different effects for different situations. I can't imagine a social setting smoking weed to, it has to be alcohol for me.

My parents were responsible cigarette smokers. They were not chain smokers or even pack-a-day smokers. My father quit cold turkey when the surgeon general warning came out for tobacco.

I wonder how accurate or fair a comparison my statement makes?

i'd recommend trying weed before putting too much more thought into this.

they're really not interchangeable as recreational intoxicants. i find marijuana a very different experience to alcohol, and personally i much prefer the alcohol. i had had the same thought as you, that maybe marijuana would be better for me, but ultimately i don't think it matters if it's better if i don't like it.

also, beer and whiskey are delicious and it's more about the enjoyment of consuming them for me than the effects of the alcohol. weed isn't very enjoyable - smoking is terrible, and edibles are just worse version of sugary treats.

I once fell into the trap of thinking that, this sticky green leaf was just a fun harmless substance.

It's a silent killer,compared to alcohol it's so easily abusable because you can never have too much.

What was half a roll after a long day of work became 2 or 3 rolls a day.

It makes you okay with being mediocre, and comes with a lot of sneaky short and long term mental side effects that are yet to be studied.

Lately I would rather have a scotch and 24 hour later have it out of my system, than live with a thin daily mental fog.

Yeah I stay clear of it these days

> Lately I would rather have a scotch and 24 hour later have it out of my system, than live with a thin daily mental fog.

This was absolutely my experience and resulting opinion as well. Ultimately weed is not as harsh in the short term for me, but the cumulative effects over even a week of usage start to become apparent in my cognitive ability. It's a little insidious the way it creeps up on me. For that reason I don't partake nearly as often and have fallen back to enjoying alcohol in moderation myself.

I seem to recall studies around weed and schizophrenia being correlated so not convinced it wins by all metrics. Probably just most

My favourite quote on the matter:

But claiming there is no ‘safe’ level does not seem an argument for abstention. There is no safe level of driving, but government do not recommend that people avoid driving.

Come to think of it, there is no safe level of living, but nobody would recommend abstention.

https://medium.com/wintoncentre/the-risks-of-alcohol-again-2...

I understand why they want to dispel the persistent myth that alcohol can be good for you, but do they have to do it by employing their own vacuous statements? Tell people what the extra risk of drinking a daily glass of wine is, then they can make their own mind up on whether to take that risk or not.

Such empty discourse absent of falsifiable statements is more damaging to our society than a glass of wine ever could be.

> Such empty discourse absent of falsifiable statements is more damaging to our society than a glass of wine ever could be.

Hear, hear.

    Ah, make the most of what we yet may spend,
    Before we too into the Dust Descend;
    Dust into Dust, and under Dust, to lie,
    Sans Wine, sans Song, sans Singer and—sans End!

The textbook I used when I was teaching "Economics of Regulation"[1] emphasizes the fact that trying to drive individual risks to zero (acting, in the process, as if there is never a cost to trying to reduce risk) is a fool's errand.

Viscusi's "Pricing Lives"[2] is a great work. "VSL (value of a statistical life) is the risk-reward trade-off that people make about their health when considering risky job choices." Once you understand that, you understand how one ought to reason about whether one policy is better than another. Once you understand that, you come to the realization that the actual policies implemented bear no resemblance to the policies that ought to have been implemented in light of a rational cost-benefit calculation.

[1]: https://mitpress.mit.edu/books/economics-regulation-and-anti...

[2]: https://press.princeton.edu/books/paperback/9780691208596/pr...

> But claiming there is no ‘safe’ level does not seem an argument for abstention. There is no safe level of driving, but government do not recommend that people avoid driving.

False equivalence. Drinking is not necessary for life (and it's harmful as we see here), but driving is required for many people's livelihood.

It's not unreasonable to equate the two. The necessity of driving in western cities is very much a design choice that could reasonably be considered to be a public health crisis. It's not an inherent property of the world.

Have you ever been to an asian city? I can assure you, there are (100s of millions of) people that rely on vehicles/driving for their livelihood.

To equate the necessity of drinking alcohol with that of mobility is absurd.

Actually in Japan you could argue drinking was somewhat required for their livelihood lol it’s different than driving requirements but interesting nonetheless

https://www.google.com/amp/s/ameliemarieintokyo.com/en/nommu...

They can change their culture such that they socialize over tea or something not harmful.

Yet, the government does not recommend against non-essential driving. So yes, you're technically right it's a false equivalence, but one can easily modify the scenario to make it a fair comparison.

Yet, driving has been getting safer and safer with cars that crash better, have monitoring systems, pre collision breaking, etc. This is not possible with drinking.

This quote is too simplistic to be useful.

There are certain activities that are not harmful but risky (0 harm most of the time and high level of harm rarely) e.g. driving and others that are harmful but not risky e.g. drinking or being exposed to radiation in an X-ray machine.

It is important to draw this distinction in order to not weaken the point you are trying to make.

The main point here is not that drinking is harmful but rather that the individual should decide their own tolerance for harm. The dose and length of exposure matters here since the damage is likely to be cumulative.

With an X-ray machine or flying at high altitudes, we know that the small amount of intermittent radiation that one is exposed to doesn’t outweigh the benefits.

It is up to the individual to decide if they are in a position to make that tradeoff.

With drinking, the difference between thinking low amounts are beneficial and low amounts are harmful could make a huge cumulative difference over time. It seems like a lot of commenters here are missing that essential fact.

Don't worry, in 5-10 years it will be good for you again.

I still remember being lectured in school on the food pyramid and the importance of getting your 8-10 servings of grains a day.

This clip from Woody Allen's "Sleeper":

https://youtu.be/D2fYguIX17Q

> Don't worry, in 5-10 years it will be good for you again.

I don't know about that, it it looking more like Alcohol is heading down the path of cigarettes where the more unbiased funding and studies that are done, the worse it appears. There have been several convincing reviews[1] recently that showed an increased risk of cancer at any dosage.

[1] https://pubmed.ncbi.nlm.nih.gov/32584303/ (First one I could find easily again)

Yeah, it’s really a myth that science is changing so much.

You can look at dietary recommendations from the 70s, and they’re fine. Eat your plants and don’t eat garbage. The food pyramid was more a product of lobbying than science. The doctors advice wasn't that bad, although there would be less knowledge of the dangers of refined carbs.

People want it to be true that the doctors don’t know what they’re doing, but it’s not (or these are bad examples of).

Honestly, I find it baffling when people think that doctors know what they're talking about when it comes to nutrition. Maybe things have changed in recent years, and that would be great, but in my experience and from the anecdotes of others, my conception of what doctors understand is the opposite of what you describe.

Granted, I do agree that the science actually hasn't changed that much, and that doctors who do research know ath they're talking about, but your average MD is pretty clueless about nutrition and fitness because that's really not a subject that gets priority in med school. There are even doctors today who still give advice along the lines of the Food Pyramid and My Plate. I've heard more than one account in my social circles of doctors telling people the myth that dietary fat flows freely through your blood vessels and clogs them exactly the same way that bacon grease can clog drain pipes.

> People want it to be true that the doctors don’t know what they’re doing

Also, the root of this statement is something I am surprised by. People want their doctors to not know what they're doing? In what universe is that true? Maybe that fits your experience, but this is a phenomenon I've never encountered in the slightest.

> People want their doctors to not know what they're doing?

No, you're right, people who go to a doctor certainly don't want their individual physician to be incompetent. I believe parent was talking about a less specific, somewhat "anti-establishment" point of view. Folks who feel that they've been failed by medical doctors, for example -- a chronic condition that they can't get help with. Or people who have other reasons to believe that the medical profession is ossified, or beholden to interests that don't serve patients -- critiques of that sort.

Ah ok, then I misinterpreted.

Yeah, OP is spot on. It's not really EVERYONE either, but I'd say the majority of people I know really like some version of the "doctors don't know what they're talking about" argument. Things are weird now with COVID and the politics around this stuff.

You'll probably see more of these attitudes on the right, but the idea that doctors don't know what they're talking about, and change their recommendations all the time is incredibly popular. So it's not like 100% of people, or probably not even 95%, but I think it's more than eg. 30-40%.

I've found this is one area where (far) left and (far) right overlap, actually. Maybe not in the exact specifics, but in a general mistrust of professional medicine.

Doctors often don’t have to know that much about nutrition, beyond telling you to eat your plants, and some stuff targeted at people who need specific diets.

You say they’re clueless on fitness and nutrition, but I don’t know what information they should be expected to know. Your talking about topics riddled with bullshit, when you look at public discourse.

Honestly, there’s not much to know other than to eat food that’s pretty famously healthy (plants), and avoid sugars. Now they definitely want you to limit meat, excessive fats, and refined carbs, too; but the basics are really simple.

There’s lots of studies out there, but there seems to be very little that’s clear other than those basic guidelines. You can really run around in circles with how complex this subject is, yet ignore the basics.

While the grains thing was particularly stupid advice, recommendations haven’t changed as much as you’d think. The guidelines from reputable sources as far back as the 60s and 70s were fine. They didn’t understand how deadly refined carbs were, but recommended eating fruits, vegetables while limiting desserts and too much fatty meat; now you might be eating a bit too much carbs without understanding the risks, but you should be perfectly fine with that diet.

People have been making noise about this issue for a very long time. Doctors know this stuff is poison and causes cancer. It’s always seemed silly that just the right amount of poison is good somehow. Of course, you don’t know without study, but experienced people can see areas where the data doesn’t seem to make sense.

I remember hearing about this stuff a few years ago and it was nothing new, even then. We know that early studies looked good because many “sick quitters” stop drinking due to their failing health. This makes non-drinkers look less healthy. Now this stuff is still actively studied and many of the pro-alcohol people insist it’s still healthy, but the writing has been on the wall for at least 5-10 years; no amount of alcohol is “healthy”.

> It’s always seemed silly that just the right amount of poison is good somehow

Why is it silly? A lot of things are dose dependent. A small amount of tylenol makes you head feel better. A lot of tylenol kills you. Lifting weights is very good for your health, but if you overdo it, you can get seriously hurt. A stressful day here and there is harmless, but if you're under constant, chronic, stress, your health will deteriorate. Four hours of sleep will leave you feeling terrible, 7-8 hours will leave you feeling rested, and 14 hours will likely leave you feeling terrible. I could go on, but I'd argue that dose-dependency is the rule rather than the exception.

It’s not dose dependent though, it’s a dangerous poison that causes cancer. Your other examples are completely different. Tylenol is closest, but you’re really talking about overdose. Drinking a couple of glasses of wine a day isn’t an overdose.

Yes, there may be some nasty chronic effects of tylenol too, but I think you’re trying really hard to fit a square peg in a round hole.

Is there a specific definition of poison you're working with?

You say that there's obviously no amount of poison that's good for you, but by that model of poison why do you assume that alcohol is a poison? Doesn't that become the question at hand?

I meant it more as a figure of speech. Nobody is trying to shoehorn health into random poisons. BTW there are allowable amounts to many poisons. There aren't allowable amounts of things like lead and butane.

The question is why we're trying so hard to make something healthy. The answer is obvious, because we like it. You don't see doctors trying to come up with justifications for why we should drink arsenic or cyanide, just as long as it's tiny amounts.

Alcohol causes cancer, heart disease, obesity, diabetes, anxiety, and many nasty things. It may be one thing to tell people that their glass of wine a day is OKAY, but we shouldn't be telling them it's "healthy" without good reason. The better analogy is smoking, because the harms are more similar than people think.

> I meant it more as a figure of speech.

I sort of figured, but then it wouldn't be much of an argument to claim that it can't be beneficial.

But fair enough, I misunderstood your argument. Your argument is actually that any claims of a fun "poison" being beneficial are highly suspect.

To that end - that would make sense for novel poisons or poisons that are rarely consumed. But this is one that's been consumed by many successful cultures for thousands of years. Animals get drunk on fermented fruit. That makes it seem more plausible to me that there could be something beneficial to it. Perhaps it was only beneficial in the days of unclean drinking water (unless that one is also not actually true! It's hard to believe anything anymore.).

The first time I started to wake up to government one-size-fits-all health policies was back in my 8th grade health class when we were being taught about the food pyramid, and this one kid asked the teacher why hamburgers are considered junk food when they pretty much fit into the model food pyramid. I remember the teacher being stumped and uttered out a barely comprehensible response after an awkward moment.

At first I thought that kid was a smartass, but the more I thought about it, the more I realized that he wasn't wrong. I've you've got an American hamburger with all the fixin's, although its proportions aren't exactly like the food pyramid, it's close enough that it's hard to classify it as being unhealthy unless it's laced with extra cheese and barbecue sauce and whatnot. Yeah, there's fat in the patty, but the whole fat being bad thing is pretty much one of the biggest forms of bullshit ever invented by health policy.

This isn't to say that I actually think hamburgers are health food, but that the food pyramid is kind of a farce, especially in the sense that it implies that grains are some sort of nutritional necessity that should be consumed in greater quantities than everything else.

That's because the food pyramid is owned by the USDA, which represents American farming.

> the whole fat being bad thing ... bullshit

I bet it played a big part in the growth of the $71B US diet industry.

Five top wine consumers [0] vs. (coronary disease per 100k [1]): US (79.2), France (31), Italy (51), UK (47), China (114), Russia (225), Spain (38.9)

[0] https://www.statista.com/statistics/858743/global-wine-consu...

[1] https://www.worldlifeexpectancy.com/cause-of-death/coronary-...

Wait, so grains are bad now?

They shouldn't be most of what you eat, since they have a lot of digestible carbohydrates compared to the amount of fiber, fat, and vitamins, but they are certainly not bad for you.

Your calories (unless you're a genetic outlier) should be relatively evenly split between carbs and fat. If whole grains are where most of the carbs are coming from, that's fine. Science says so.

Yep. You don't have to go that far. A decade back it was thought that red meat causes cancer, specifically intestinal cancer. Lots of health guidelines reflected that. It has all fallen apart in the last 2-3 years.

Have some place to read this? Everywhere credible I look seems to still say it. For example,

https://progressreport.cancer.gov/prevention/red_meat

https://www.theguardian.com/food/2019/sep/30/research-red-me...

https://www.nytimes.com/2019/09/30/health/red-meat-heart-can...

Good overview of the controversy.

Media reporting is the literal worst way to learn about scientific reporting and studies

What's a good way? Certainly not reading individual scientific studies yourself.

Textbooks, meta-analyses, asking researchers personally (multiples of them), and individual studies (also multiple, never rely on a single one)

You started with this

>It has all fallen apart in the last 2-3 years.

as if the scientific community has demonstrated it - it has not, and your articles do not support that claim. Your articles from 2-3 years ago are about one report, and even your articles call into question that report. So no, it has most definitely not "all fallen apart."

Interestingly, days after your NYT article, they published this one https://www.nytimes.com/2019/10/04/well/eat/scientist-who-di...

Go figure, right? He also has papers claiming the opposite of well established sugar research, which, you guessed it, was paid for by a industry trade group that tries to undermine health guidelines to make people believe doctors less and eat bad stuff....

When there are decades of papers and different groups with a similar claim, and one group publishes one counter claim, it makes news. It does not mean the counterclaim will stand further scrutiny. In this case, as looking over google scholar at research following the 2019 claim, it has not withstood more scrutiny.

Here is the paper you posted [1]. Here [2] is but one followup paper claiming your paper is basically crap. I can find none supporting the conclusions in [1].

All papers since then I can find still claim meat increases the risk of intestinal and other cancers.

Please don't believe or spread outlier results from news stories.

[1] https://www.acpjournals.org/doi/10.7326/M19-1621

[2] https://diabetesjournals.org/care/article/43/2/265/36125/Red...

“Good for you” doesn’t make sense. As an analogy for a startup “sales people considered good for the organisation”. Or “meetings shown to be bad for the organisation”. Makes as much sense as “avocado is good for you”. Although a holistic diet, exercise, toxin avoidance, danger avoidance but balancing life goals and mental health regime is probably good for you.

In this thread: a lot of people trying to justify their preexisting choice to drink or remain sober.

Sane people find arguments for stuff they do. If they don't have reasoning (scientific or emotional) for their behaviour, they either change or they aren't sane.

Also many pointing out that the notion that avoiding any consumption of alcohol is a ridiculous notion, as implied by the article, given that it's a common component of many foods.

Are you talking about trace amounts though. Or something that might add up to say a unit per week?

On reflection, I think the original study intended to say that "no amount of alcohol improves health". This is a different conclusion from "any amount of alcohol degrades health", which is how it has understood by many commentators.

It's quite possible for low alcohol consumption to have no effect on health, while also concluding it doesn't improve health.

Question one: what is the world heart federation? I have never heard of it before today.

Two:

> The evidence is clear: any level of alcohol consumption can lead to loss of healthy life.

The evidence is not clear. There are plenty of studies showing benefits. “Any level” “can” makes the statement technically true but meaningless, you could replace alcohol with anything and that would also be true. If you want to back up the statement, do a meta analysis study and publish that instead of pretending you’re the authority and giving vague statements.

This reads like somebody with a prejudged conclusion announcing that instead of actual scientific openmindedness. Plenty of people in the comments who already agreed are eating it up.

How could anybody who didn’t already agree with this be convinced, their argument boils down to “we say the studies conclude this” which is trivial to refute.

> There are plenty of studies showing benefits.

Yes. And these studies are being exposed as the product of alcohol lobby.

https://www.vox.com/science-and-health/2018/3/21/17139036/he...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055701/

I am perfectly aware of p-hackng. I still don’t believe it without actual evidence, I get strong vibes of people wanting this to be true which would take more than a little evidence to overcome.

The alcohol industry gave the government money to prove moderate drinking is safe https://www.vox.com/science-and-health/2018/3/21/17139036/he...

Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055701/

And what are the studies that show that moderate drinking is not safe?

Lazy skepticism and contrarian attitude is not helpful.

Many of these studies purporting to show a benefit from drinking included a sizable sample of people in the non-drinking group who had stopped for health reasons. In other words, they were probably told at some time in the past that they'd destroy their liver if they kept it up, indicating some level of damage to the body. In a society where some level of drinking alcohol is the norm, the non-drinking group has an overrepresentation of these people which skews the results.

It's funny hearing this, because it's so clear to me that the opposite is the case. If you were an alien and you observed alcohol use on Earth for a few years you'd have no trouble concluding that it's almost certainly harmful even in small doses.

But humans like alcohol, so they do not want this to be true.

I mean we evolved consuming alcohol and are way better at metabolizing it than some of our primate relatives, some creatures thrive on it.

Let me offer some food for thought:

How many athletes report drinking a bit before competing?

The answer is none because it negatively affects all physical ability.

So would you say it’s likely that in aggregate drinking would be healthy?

Edit: Wow, I guess people really don't like to think about this. To respond to both comments below, yes sure, sometimes it helps to relax just a bit and alcohol can help with that, but obviously you could also just drink some tea or actually train yourself to command better control over your state of relaxation. Alcohol is a shortcut that comes with some penalties, but personal ability might overcome those penalties. That doesn't mean that person couldn't have performed even better without drinking.

And regarding lists of athletes that have been known to drink, well of course a counterexample to any absolute statement can be found, I'll grant that. But in the overwhelming majority you won't find top level athletes at the bar the night before the big event and there's a reason for that.

Refuting your “none”

https://whyy.org/segments/when-a-bit-of-booze-is-just-the-bo...

> The answer is none because it negatively affects all physical ability.

Wrong. I can think of a few off the top of my mind who still have alcohol in their system while competing/training.

- Arnold Schwartzenegger - Jon Jones and various other ufc fighters - olympic athletes in the olympic village according to news sources

more here.. https://firstwefeast.com/drink/2015/08/athletes-drinking-hab...

Also note, physical ability isnt the only thing involved in high level performance. Ive had a couple beers before doing gymnastics before, and while it made me more disoriented i was less inhibited and actually performed better that day.

At some point, alcohol was listed as a performance enhancing drug in archery because a moderate amount is supposed to steady the aim. It is still banned in many competitions for that reason, and not just because drunk shooting is a bad idea.

I used to have a beer before the gym, so I could get my heart rate up faster (thinner blood), and lift more (less pain response). If I were competing with an otherwise equally matched opponent at the gym, a beer would give me an edge.

Depends on the type of athlete. I know many ultraendurance and endurance athletes who are quite happy to drink the night before an event. This includes nationally and internationally ranked people, not just back-of-the-pack participants.

Alcohol consumption was pretty common in the NBA, with some even drinking during halftime. Some of the biggest stars of the league in the past decades drank a lot of alcohol, though much less now with more stringent policies in place. There are players that led the league in scoring despite drinking well into the night all the time. Lebron James is a famous wine drinker. He drinks every day and his longetivity and conditioning is unmatched, but he may be from a different planet.

These were some random facts from an NBA fan who doesn't drink.

I used to work with one of the best athletes in the world (double Ultraman world champion), and I think he would disagree with you.

https://www.slowtwitch.com/Features/Island_To_Island_-_The_t...

"Mickey Mantle knew two things: 1. Drinking 2. Playing drunk baseball" -- Norm MacDonald (RIP)

I think you've got the politics of this backwards. There is overwhelming cultural pressure to support some level of alcohol consumption. A host of shoddy (and largely alcohol industry funded) studies tried to demonstrate that it was beneficial.

It's not. It's harmful no matter the quantity. Study after study demonstrates this now. I say this as someone who drinks regularly, by the way. I have no desire for it to be demonstrated that alcohol is harmful; it's a part of my life and has been for decades.

If you want evidence, go open the actual brief and check out the dozens of references, including multiple meta analyses.

You know what's worse than drinking alcohol? Sitting in a chair all day staring at a screen.

Why do we need studies for things we've known for centuries? Drink, eat, exercise, all in moderation. Get outside and move often as possible. It's not rocket science.

I think we need studies because there are people who believe the opposite. Growing up, a close friend of mine had a die-hard belief that everyone should have a glass of wine with every meal because it was good for your heart.

Alcohol changes your state of mind which leads to car accidents, abuse and so much more.

To compare that to sitting is stupid.

Why?

The article in question is about what's good for the heart and ultimately, living. Prolonged sitting kills far, far more people than alcohol. Anecdotally speaking, alcohol happens to be a lot more fun than sitting. Pick your poison, I suppose.

One is a poison, the other is not.

Sitting, alone doesn't kill you. The studies that mention that include unhealthy habits coupled with sitting.

Alcohol defenders like you should just embrace the poison and stop trying to compare it to anything else unless that other thing is literally another poison.

You are ridiculing yourself.

> Why do we need studies for things we've known for centuries?

Because folk wisdom is not science. For example, many people enjoy a cozy fireplace, but increases chances of heart/lung disease a significant amount due to small (PM10) particles: https://www.epa.gov/pm-pollution/how-smoke-fires-can-affect-... https://www.lung.org/clean-air/at-home/indoor-air-pollutants...

"No amount of alcohol is safe, however it's the dose that makes the poison." [1]

"for every 100,000 people who consume one drink per day, 918 will have an alcohol-related problem per year. But if the same 100,000 people drank nothing at all, 914 would still have one of those same problems. That’s only 4 more people per year (per 100,000) who will have a problem that’s attributable to alcohol—that’s tiny. But it’s also not zero." [2]

[1] https://peterattiamd.com/qualy-1-what-are-peters-thoughts-on...

[2] https://www.popsci.com/moderate-drinking-benefits-risks/#pag...

I agree with solox3 about the need to cite the evidence, not just say "studies show."

That said, my doctor asked how much I drank, and I said about four drinks a week. She said "that's too much." So now I have a pretty strict limit of two per week, and "a glass of wine with dinner" does count towards that. I think she was more in tune with ALL the evidence, not just the articles that tell everyone what they want to hear.

People really don't like to hear that two-per-week thing. The beer or glass of wine with friends is a pretty important part of society. In fact, I really think you only live once, and what's the point if you never have the things you really love? But don't delude yourself that it's healthy; it's not.

That said: I lost a brother to alcohol & cigarettes, so it's a little more personal with me.

The article seems to cherry pick official statements to support the title. "Studies have shown that even small amounts of alcohol can increase a person's risk of cardiovascular disease, including coronary disease, stroke, heart failure, hypertensive heart disease, cardiomyopathy (heart muscle disease), atrial fibrillation (irregular heartbeat), and aneurysm. "To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease." "Studies that claim otherwise are based on purely observational research, which fails to account for other factors, such as pre-existing conditions and a history of alcoholism in those considered to be 'abstinent'.

So they claim their research shows increased risk, not stating by how much - there is difference between 0.5% and 15% and 50%, across a broad range of conditions. The only counterpoint mentioned is that there is no reliable correlation between moderate (no mention of what that is) consumption and lower risk of heart disease - what about all the other conditions? Finally there is a quote dismissing other research because it fails to account for other factor but there is hardly any mention on what factors have been accounted for in the current research.

The whole thing seems poorly written and seems to preach instead of document and explain.

Consumption of any substance in sufficient quantities will cause harm - you can drown by drinking too much water in too short of a period of time but no one is going to suggest that because of that there isn't any quantity of water is safe to consume.

Yeah, maybe there's no evidence that a small amount of alcohol helps in any way, but "any level of alcohol consumption can lead to loss of healthy life" is pure alarmism. Along the same lines as "any level of fat consumption can make you fatter". Technically true but also irrelevant.

> It is important not to exaggerate the risk of moderate drinking and unduly alarm responsible consumers

Ha, yeah maybe you should have thought about more before talking to the press.

Everything is a balance though, isn't it?

If a little alcohol reduces one's stress and increases socialization, then they may be better off with the alcohol on net.

It's not obvious that alcohol reduces stress.

Alcohol consumption increases cortisol production, so I'd say the opposite is true.

I had a doctor tell me it was probably preferable to have a beer after work to unwind than try to quit. I dunno, I think it's very dose and situation dependent. There are social aspects to drinking in our culture and being social has health benefits.

It's obvious to me that it reduces my stress. No study could convince me otherwise.

Always interesting when one group reports a subjective phenomenon, and someone else refutes their experience by pointing to an X mg/dL change in some serum test.

Obviously the experience is what matters, not what the machine says. Alcohol increases cortisol levels? Ok, all I know is I feel nice and relaxed right now.

Of course if I overdo it, or do it too often, then the next day will demand the debt repaid, or my baseline will shift upward. Ok, so don't overdo it.

You can get the same benefit of relaxed by making or buying a hops tincture in MCT Oil. The hops are what make a pilsner feel really relaxing. The pulse side is you don't have the harm from the alcohol.

Alcohol removes my anxiety/stress nearly every time I consume some. Depending on how much I consume the next day my anxiety could be worse though.

awareness of stress?

Does alcohol reduce stress or just delay it?

Yes, and the takeaway from this brief should not be "reduce your alcohol consumption to zero." It is instead, "know when you consume alcohol that there is no quantity that will produce no harm." That's a big departure from the previously accepted, and now thoroughly debunked, conventional wisdom that a small quantity is harmless or even beneficial.

Increases socialization only because the culture is required to socialize over alcohol. In other societies, we socialize over tea and coffee.

That common claim has a lot of asterisks/caveats, however: stress has many bad health effects and alcohol can reduce stress, but it does so while inducing many of the same phenomena that make stress dangerous (e.g. cardiac issues).

The problem with articles like this is that they lack context on the relative risks of various activities. Is drinking a daily glass of wine more or less bad for your heart than skipping your daily aerobic exercise? Surely we can put some numbers on that.

daily, whoa there armstrong

Straight up comparisons like that are pry too simplistic when dealing with a complicated system like our bodies.

People seem to really want this kind of +1/-1 point system for health related behavior tho. Like: “I just spent 30mins at the gym so I racked up enough ‘health points’ to eat an apple pie at McDonalds”.

I think the reality is that you need to generally do a good job of following all advice all the time if you want to remain healthy. Keep very active and remember that indulgences are OK, but should be infrequent.

Why aren’t we looking into the merits of a daily or weekly cigarette? At a certain point it really looks like it’s just poison and wet should knock it off.

While smoking is harmful overall and I certainly wouldn't advise anyone to smoke, the nicotine it delivers does have some merits. So there is some nuance to the issue.

https://peterattiamd.com/ama23/

The dose makes the poison. For some poisons there is a minimum threshold dose below which there is no detectible harm. For others that threshold is zero.

> The dose makes the poison

Exactly.

The concept of dose-dependency is one of those things that earlier generations had an intuitive understanding of, but something we have an increasingly fragile grip on in the modern era.

I don't think anyone is having trouble understanding dose-dependency. There's just a separate question regarding whether some substances should have no acceptable dose, and when we should make that distinction.

Things like nicotine are thought to be pretty much not worth consuming in any situation. Things like lead have no "allowable dose". Maybe alcohol should be treated similarly to cigs. This is a totally defensible position, that's worth discussing.

Probably not going to get a chance to RTFA, but yeah, I know there's some stuff. I think it was looking like nicotine could be helpful in regulating some mood problems and similar stuff. Kinda like ADHD meds or anti-depressants. There may be some stress relieving effects, although I wouldn't be surprised if there's more stress in the long term (from constantly managing withdrawl)

Anyway, we're at the point with nicotine where virtually no one is willing to entertain the idea of recommending people consume "just a little". Maybe we should be that way with alcohol, too.

I think a good measuring stick would be the distance you'd need to drive in a car to generate the same level of risk to your life. Driving is seemingly mundane but I think one of the riskiest things we do on a daily basis in the US.

Driving risk statistics are sort of artificially inflated by deaths and injuries of motorcyclists and DUI/ DWI drivers involved in single-vehicle crashes. If you avoid putting yourself in those categories then driving is much safer than the raw statistics suggest.

There's also a huge variance in risk based on what vehicle you drive. Some larger vehicles have a statistical driver death rate close to zero.

https://www.iihs.org/ratings/driver-death-rates-by-make-and-...

Before talking about what amounts are good or bad, the cultural phenomenon of drinking has always been mysterious to me. Alcohol feels overrated. It seems like no more than symbolic association with social life, or celebration. I love socializing and celebrating, but when I want to seize the moment, I want sharp senses - not the opposite. Also, I find it not tasty honestly.

I trust people to like having me as their company even when not participating in drinking.

They're focused on heart health so they don't address the fact that alcohol is also a carcinogen. This is sort of a "The sky is falling!" kind of article, but it comes down to, as always: Be aware of the risks in some intuitive way and decide what you want to do.

I saved this article from a similar discussion a few years ago, which argues that moderate drinking (but not binge drinking) is healthy in various ways. Does anyone know if it, or the underlying data it refers to, has been refuted?

https://psmag.com/social-justice/truth-wont-admit-drinking-h...

This is a correlation fallacy.

The group of moderate drinkers is also the group of the most healthy. That doesn't necessarily mean that moderate drinking is healthy.

Because guess what else correlates with moderate drinking? Affluence.

Guess where poor people fall more in either the "never or hardly" category or the "binge drinking" category. Either you feel like you're too poor to afford to drink and thus do so only rarely. Or you've just completely given up and all your money goes to drinking.

What else correlates with affluence? Overall health outcomes. If you're poor, you also can't really afford to go to the doctor regularly.

So what the study really tells us is what we already know: having a reasonable amount of money is good for you.

Don't forget that studies looking at drinking often fail to seperate out former alcoholics who usually have long-term health problems from drinking from teetotalers

Heineken and Carlsberg paid NIH $100 million to "to show that moderate alcohol consumption is safe and lowers risk of common diseases". This and other ethical research violations created the whole "moderate amount of alcohol may be healthy" meme.

The alcohol industry gave the government money to prove moderate drinking is safe https://www.vox.com/science-and-health/2018/3/21/17139036/he...

Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055701/

I feel like alcohol consumption isn't taken as seriously since its been legalized, but its incredibly destructive. The only thing I've really seen get talked about is driving while drinking.

This hits very close to home to me because I am currently taking care of our kids while my wife had to fly across the USA to help with her Uncle's funeral. He was a high functioning alcoholic for many years until he joined AA and cleaned up. He was a very active member of AA and lead his local chapter. He had just come to visit for the holidays and passed a week and half later from a heart attack.

My mother's side of the family came from a long line of abusive alcoholics, and she was the first to break the cycle. So I made the personal choice to not even try it to keep it going. Sometime I do wonder if I'm missing out, but I don't want to take the risk of getting addicted.

> I feel like alcohol consumption isn't taken as seriously since its been legalized

alcohol was being consumed before first evidence of laws in human society. Ancient mesopotamians drank a lot of beer because it was more resistant to bacteria then other beverages.

Unless you meant legalized after prohibition?

We have been consuming alcohol long before we even became Homo - even 10 million years back we were seeking out rotting fruits on the forest floor.

Some birds and many insects specifically seek out fermented fruits and ears of corn etc. Not sure if it's known why.

I think the problem is the culture of alcohol in some countries… in Southern Europe has a culture of wine as part of a dining experience rather then as a recreational drugs and the effects are that has a lower alcoholism rates than countries where it is more seen as recreational (like Northern Europe or the US).

I live in France, we have wine served at the company’s cantine… no one is ever drunk!

https://worldpopulationreview.com/country-rankings/alcoholis...

I think most people know this on some level. Alcohol cannot be good for the body. However, society encourages and even shames people that don't drink to an extreme degree that people go with the herd on this. Its going to be impossible to beat and turn around that societal pressure and acceptance.

Who thought that Alcohol is actually good for the heart? Here is the good news: It won't either kill your healthy heart if you don't abuse it

> Who thought that Alcohol is actually good for the heart?

I remember studies in the 90s (the ones I can find specifically were done by Eric Rimm) that touted health benefits from a glass of red wine. These weren't randomized control studies, they rarely controlled for anything that might impact someone's drinking or what they drink, and they've been torn apart in the years since.

The high consumption of red wine in France is thought by some people to be the explanation of the French paradox.

https://en.wikipedia.org/wiki/French_paradox

I've completely cut my drinking down to "only on holidays where I'm expected to", and even then I don't get "drunk".

While I never got to a point of drinking where anyone would call it a "problem", I realized that any amount of alcohol probably isn't great for my depression, and I also realized that I actually didn't enjoy being drunk all that much.

I don't really miss it much, though it was a little difficult to quit cold turkey a few years ago when I did it.

You're expected to drink? For religious reasons? I've found it incredibly easy to stop drinking entirely. Nobody has ever questioned why I don't drink alcohol let alone expect me to drink. I figure there are enough people who don't do for religious/cultural reasons that it would be silly to ask and offensive to expect. Even though I probably don't look like someone who abstains for religious/cultural reasons and only do so for personal reasons.

> You're expected to drink? For religious reasons?

Nah, I won't even say "peer pressure" either, but more of a "fuck it it's New Years" attitude. Not uncommon (at least amongst my friend group) to have a shot of whisky or something at midnight on NYE.

Again though, it's on the order of 1-2 shots, and I'm a pretty tall guy, so it's certainly not enough to get me intoxicated or anything like that.

A fitbit helped me discover how terrible alcohol is for your heart. I could clearly see which days I would have a drink because my average resting heart rate would go from 63-65 to 77-80!

You easily could have done that just worrying about it.

Unlikely. A) I never worried about it, B) The effects last into my sleep.

The effect is also most pronounced in my sleep since my heart rate is usually quite consistent, it varies like 2 bpm most nights. But if I look at the last night I drank, my average heart rate is +10 from baseline and varied by 20 bpm during my sleep.

The data is crystal clear.

That high an effect? I don't think so. I also monitor my heart rate and anxiety doesn't cause nearly as big a heart rate increase as alcohol.

I wish this info was more well known. My family still labors under the old info of thinking a little of that poison is healthy. And I have watched that be incorrect.

> The Eurasian Economic Union’s technical regulation mandates provision of an ingredients list, health information, and an additional message of “recommendatory nature” to be put on all types of alcoholic beverages intended for human use.

Eurasian Economic Union?

Have I slipped down the wrong trousers of time?

Honestly. So what. Human beings have lived with alcohol during all of civilization. If it’s bad for me…so be it. Not rationalizing or endorsing just saying maybe a little recklessness is bad for the individual and good for the species.

Can anyone find any research in the citations that my glass of red wine in the evening - although it may increase atherosclerosis and have other health implications - doesn't have benefits that offset the drawbacks.

https://world-heart-federation.org/wp-content/uploads/WHF-Po...

How much do the social, relaxation, and stress relief benefit my health. In the same way that taking a walk in a polluted city has pros and cons or the enjoyment someone might get from sky diving or taking up motorcycling.

> although it may increase atherosclerosis and have other health implications - doesn't have benefits that offset the drawbacks.

You can get all the theoretical benefits by eating grapes or raisins.

How often do you get together with friends after work for a few raisins before heading home?

Alcohol is one of the worst "drugs" on a personal/societal harm scale - if we're going to tolerate this at large, we should probably consider legalizing everything else that's less harmful to at least be consistent.

While we're at it, let's de-stigmatize the abuse of substances and treat it like a real mental health issue.

> if we're going to tolerate this at large, we should probably consider legalizing everything else that's less harmful to at least be consistent.

Please do not decide policy using this kind of reasoning. Maybe we should legalise more stuff, but “worse things are legal” is not a good reason.

> A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines. — Ralph Waldo Emerson

Consistency in legal matters seems like a good and necessary thing for ensuring fairness. What is the basis for Emerson’s quote to apply here?

Suppose the law states that David Haroldson (or the Glorious Leader, or foreign diplomats) cannot be convicted of any crime. That's inconsistent, (perhaps) arbitrary, and unfair. Yet, it would be foolish to extend this conviction-immunity to everybody.

I feel like that supports what I wrote.

Or make it so glorious leader is not above the law.

Yes. Consistency is not necessarily the problem; foolish consistency is.

For the sake of consistency, wouldn’t it be desirable for the glorious leader to be subject to the same legal punishments as the masses?

That's his point.

Arguing about consistency in a system without the rule of law seems a bit foolish as well. Diplomats are a more interesting edge case. And AFAIK they can always be prosecuted and convicted in their home country.

That can be abused as well. Just frame the leader for a crime and he sits in prison until it is proved that he is innocent, then do so again for a different crime.

For the above assume the leader is actually glorious, though of course most leaders who are called glorious are awful (IMHO)

I’m generally pro-legalization, but there are many things that we hypothesize are safe but do not know the long-term effects of and, within living memory, have discovered that many things initially thought safe were not.

People were taking X-ray images of shoe fit in department stores, we used thalidomide to treat morning sickness, etc.

What society says is legal has an effect on how it is perceived and how frequently it’s accessed by minors, teens, young adults, and adults. Exercising a modicum of conservatism in approving all things that we think are safer than alcohol seems appropriate to me.

I can guarantee you the most dangerous part of using any substance is our legal system.

Legalize everything for anyone 21 or older, and while we're at it, raise the enlistment age to 21.

If you're old enough to die for this country, you should be old enough to light a j in it.

And raise the voting age to 21 too?

I don't see a problem here, politics is probably bad for brain development. 25 might actually be more appropriate.

Voting age should be low. Maybe 8? 0 is good to

I'm not kidding. Talk to any 8 year old and they're much more level headed compared to those 10x their age. But the current system is set up to crush them relying only on the good will of seniors to protect their future.

This isn't a new idea btw https://www.theguardian.com/politics/2021/nov/16/reconstruct...

Wouldn't this in effect give a parent with multiple children multiple votes.

Mail in voting means you'd just fill out the ballots for your kids.

I think voting should remain at 18. Although I have some ideas on making more concerns local. Why does most of my tax dollars go to the federal government rather than the state.

At the State level at least I have a remote chance of being heard. And if I don't like what my state is doing, I can drive 50 miles to another.

Meh decriminalize possession and consumption, sure. I don't think something like heroin should be easily available though.

You can either tax, regulate and make it safe.

Or have addicts die in the street.

Prohibition doesn't work.

Addicts are going to die in the steet if it's regulated and legal too. I'm not sure you understand what heroin addiction does to people.

Humans have consumed it for several millennia, we know all side effects of it.

That is faulty logic. We hypothesize that mRNA vaccines for COVID-19 are safe but do not know the long term effects. Why should we exercise conservatism for some drugs but not for vaccines?

To be clear, I'm just using that as an example of logical inconsistency and I recommend that everyone eligible protect themselves by getting vaccinated. I also think that all recreational drugs should be legalized (or at least decriminalized) because regardless of the potential long-term effects the failed war on (some) drugs is causing far more harm than the drugs themselves.

For what it's worth, mRNA immunotherapies for cancer have been being injected into people for almost 20 years now. Efficacy aside, we know the medium-long term outcomes of injecting ourselves with mRNA.

The relative risk reduction for potentially catching covid-19 vs actually having cancer are radically different. Long to medium term risk of adverse effects from mRNA therapies are probably not weighed heavily against imminent eventuality of short term death with cancer. Edit- that's not to say I don't disagree with you on us knowing the long-medium term risks of mRNA therapies.

I'm not getting into the relative merits of vaccination, I'm merely saying that mRNA isn't going to hurt you. Even decades from now. We know there are no medium-term risks of mRNA therapies because the otherwise healthy people who have injected themselves with mRNA are still alive and kicking.

Here is the first Phase I test of an mRNA vaccine from 2013.

https://clinicaltrials.gov/ct2/show/NCT02241135

Here's a phase I trial for mRNA therapies from 2005.

https://clinicaltrials.gov/ct2/show/NCT00204516

We make trade offs of short-term benefit and long-term risk all the time. When considering the purely recreational intake of a substance, the long-term risks are more relevant (due to the relatively small short-term gain) than for a vaccine which has unknown risks but has now-proven significant short-term benefits.

Scientifically speaking we know nothing at 100% confidence level.

While that is technically correct, mRNA is something your body makes in relatively large quantities every day. As such if it was harmful life itself wouldn't be possible.

Really the argument should be about strengthening informed consent. "Safety" is not objective; something that one individual would consider safe might not be safe for another. For example I have friends that like to go sky-diving. For them it's "safe". For me, it's not. Drugs should require a waiver similar to signing up for a credit card. e.g.,

"This drug completed a 12 month Phase 2 clinical trial with 65,917 participants in which the drug demonstrated efficacy of Y against symptomatic disease. 1.5% of participants experienced adverse effects which included runny nose. 0.01% of participants experienced a fatal allergic reaction. These drugs are still undergoing trials and our understanding of safety and efficacy can change in the future.

[ ] Check to indicate you understand and consent"

I think this should be the standard for vaccines, drugs like marijuana and alcohol and cigarettes. Do it at the point-of-sale. For things that are particularly dangerous, maybe require an interview with a physician to make sure the person is of sound mind and capable of consenting. I believe that if you treat people like adults they will naturally make the best decisions for themselves. When you treat people like children, they'll act like children.

I do agree with this argument, but most of the time legalising doesn't just make problems disappear. It needs to be paired with better access to mental health facilities, rehabilitiation, etc.

Making drugs legal doesn't mean people will start abusing them. I do not drink or take drugs, and both are easy as hell to access here in the UK.

The benefits for me of legalising drugs would be making it easier for people to seek help with less stigma attached to it, remove drug dealers out of the equation, make it safer to procur drugs if people are going to take them anyway, I believe it would also make scientific research much easier which in turn might help us to know the long term effects of these drugs.

Does legalization make things better or worse than now? If it makes things better but still not perfect, perhaps we don’t need to hold up legalization until we can provide better mental health facilities, rehab, better public transport so people can get to these facilities easier, etc.

Don’t let the perfect be the enemy of the good.

> What society says is legal has an effect on how it is perceived and how frequently it’s accessed by minors, teens, young adults, and adults. Exercising a modicum of conservatism in approving all things that we think are safer than alcohol seems appropriate to me.

Considering that we are talking about alcohol, this argument could just as well be used in favor of liberalization.

I (and at least one other poster) were talking about things thought comparatively safe to alcohol.

https://news.ycombinator.com/item?id=30010236

Sorry. I didn’t read the context correctly. :)

In that case the question becomes: has use (and in particular abuse) of substances increased after legalization? Which I will just throw out there since I’m too lazy to research it myself.

Legalization brings production and sale of recreational drugs under regulation. That will not stop all harms, but those harms are then more likely to be known. Addiction treatment is more accessible when drug use is not criminalized.

Point was foolish consistency. I see an IT diktat that a function should not be longer than 100 lines. I would even go ahead and say seems reasonable for lot of cases. But to make it absolute would be foolish consistency.

Consistency in how the law is applied is important, but not that the composite of all laws be absolutely fair relative to each other. That is "foolish consistency" because it's impossible except by very closed-minded fundamentalism. The idea that you find the "worst" thing that is legal and then repeal all laws against things which are "better" is not a viable legislative strategy.

Also the exceptions exist usually for a good reason. Trying to get rid of them without understanding it is a bad idea.

There is nothing foolish about treating things that are the same consistently. It would be foolish to grant animals citizenships to keep it consistent with humans, but just as e.g. human rights are applied consistently to people no matter where they come from or how they look like so should our policies to things be in general. Alcohol is a drug with a tremendous potential for harm, and if a society decides it wants to ban those, again there is nothing foolish in doing that consistently. But when looked at like that, it's clear there is not much rational in the way we regulate things. It's just a bunch of traditions and whims.

Statesmen saying “alcohol is legal, might as well legalize everything else that is less harmful on some dimension”. Where the alternative may be just leaving alcohol as an exception, or outlawing it (but yeah… don’t mess with Americans and their Alcohol - see prohibition and the whiskey rebellion).

Unless we have a perfect metric quantifying the “amount of harm” for every substance or practice, we will never have this kind of consistency. And then, there is the issue of harm to self versus harm to others, and how we can weight both aspects.

Consistency is in the eye of the beholder. For some people, sex is just as bad as alcohol, and they include some kind of spiritual damage as “harm to self” in their analysis. These things are necessarily subjective. Psychological damage cannot be quantified either.

So it follows that consistency is subjective, and even if a legal framework could be consistent from the point of view of a certain group of people by chance, it would not be consistent in the eyes of everyone.

No two situations are the same, and demanding consistency at an arbitrary level of reasoning means disregarding everything you would see when looking closer. For example, banning something that has been legal for a long time is difficult because of the economic aftershocks and cultural resistance. If something new was invented that was just as harmful as alcohol, it might be best to ban it and leave alcohol legal.

FWIW, I probably mostly agree with you on policy. Just wanted to chime in on why people might object to the reasoning.

Also attempting to ban things that are both desirable and very easy to make is a great way to create an enormous criminal black market like we did with prohibition in the US.

Everything was legal until a law was passed criminalizing it.

There's a difference between an offense and a crime (in most countries).

Making buying/selling/using some substances a crime is limiting freedom, and hence should only be a measure of last resort. So no "the alc lobby push for laws against weed" kind of story that ended up with the "reefer scare" tactic.

> Everything was legal until a law was passed criminalizing it.

Many things are illegal not because a law has been passed against it, but because something seemed bad, was brought before a judge, and the judge made a judgment that set a precedent. That's what is called common law.

Having a law created is a separate way that things can become illegal. That's what is called statutory law.

Not all countries have common law.

>but because something seemed bad, was brought before a judge, and the judge made a judgment that set a precedent

Like growing MJ in yr garden?, gimme a break.

Hoe can substance use ever become a crime under common law? Some penalty okay, but a crime???

This kind of reasoning is perfect. You remember when alcohol was made illegal in the US? Remember the harm that caused from gangs, uneven police crackdowns on illegal bars, and such rampant criminality that alcohol was quickly re-legalized? The drug war is 100x worse.

If we'd been consistent, we'd have dodged 50 years of a brutal drug war that has done so much damage to society, the rule of law, our democratic institutions, the role of police, basically everything, that it's hard to imagine the vacationing on the moon type of future we missed out on.

Treating drug addiction like alcohol addiction and drug dealers like liquor stores, would have been the road less taken and would have made all the difference.

Countering an Emerson quote with a Frost quote. Well done.

The argument you are making here is not that drugs should be legalized for consistency's sake. The argument you are making is that drugs should be legalized because the dangers of prohibition outweigh the benefits. That is a completely different line of reasoning

If our threshold for badness is X and we apply that to alcohol, but don't apply that to drugs, then we're being inconsistent with how we apply our threshold for badness. You just had to take your argument a step further to see the consistency argument.

That popular view of Prohibition--as an unmitigated failure that only created problems--may not be supported by historical evidence: https://www.vox.com/the-highlight/2019/6/5/18518005/prohibit...

From that article:

> Across the Hudson River, in Manhattan, the number of patients treated in Bellevue Hospital’s alcohol wards dropped from fifteen thousand a year before Prohibition to under six thousand in 1924. Nationally, cirrhosis deaths fell by more than a third between 1916 and 1929. In Detroit, arrests for drunkenness declined 90 percent during Prohibition’s first year. Domestic violence complaints fell by half.

> Maybe we should legalise more stuff, but “worse things are legal” is not a good reason.

That's not the reasoning to legalize things. That's the reasoning used to filter out what we should consider further.

> but “worse things are legal” is not a good reason.

It's a very good reason to at least change one of the two. Either make the worse thing legal, or criminalise the "better" thing. Arbitrary rules are never a good thing.

>> Arbitrary rules are never a good thing.

Any parent, ever - will be able to tell you this is a fact.

If you think arbitrary rules can stick, wait until your kid hits the 'why'/'how come' phase.

In this case, the government is the parent making an arbitrary rule and the people represent the 5-year-old kid asking why.

Parent: 'You can drink, but you can't do cocaine.'

Kid: 'Why?'

Parent: 'Because cocaine is bad for you.'

Kid: 'But why? Isn't drinking bad for you?'

Parent: 'Cocaine is worse.'

Kid: 'Why?'

Parent: 'It's addictive and it ruins lives.'

Kid: 'But doesn't alcohol do that too?'

Parent: 'Well, yes...'

Kid: 'So why is cocaine so much worse?'

Parent: 'It just is! Just stop asking questions and listen to your parent.'

This kind of shit stops a kid from respecting their parent, because they trust their parent to know what's good for them, and to have reasons behind rules and restrictions.

Similarly, when the government starts making arbitrary decisions for us, but can't provide the logic behind it - and - worse - the evidence from the medical, scientific and psychology communities state the complete opposite - we lose respect for and faith in the government.

> Parent: 'You can drink, but you can't do cocaine.'

> Kid: 'Why?'

Parent: 'Because alcohol is legal and cocaine isn't; that has several consequences.

'Governmental regulations provide some confidence that alcohol is safe and as-advertised; there is no regulation of the manufacturing quality of cocaine.

'Buying alcohol brings you into close proximity to the liquor supply chain, all of whom can settle disputes by using the court system. Buying cocaine brings you in close proximity to the cocaine supply chain, all of whom can only settle disputes using violence.

'And of course there are no legal repercussions for the possession of alcohol; there are legal repercussions for the possession of cocaine.'

This isn’t actually a reason, though, as it begs the question. Cocaine could definitely be manufactured legally if made legal.

These are what I consider to be the strongest reasons why my child shouldn't do cocaine in my country right now. If they go to a country where it's well-regulated, then the cost/benefits calculation changes quite a bit.

How does it beg the question?

Not GP, but a lot of people have trouble distinguishing "illegal" from "wrong", and the cause and effect. It's "wrong" to take cocaine because it's illegal; it's bad to legalize cocaine because it's "wrong". Cocaine is bad because of all the harms it causes to society; but a lot of the harms it causes to society (some of them listed above) come about solely because it's illegal.

But...that's just one more step of 'why', the next one after this is the one that doesn't have a good answer - so - kinda proving my point.

Reasoning about society by infantilizing adults is also a terrible way to reason about policy.

Leaders are not parents, states are not families, national budgets do not compare to your bank account, and adults are equal partners in our society.

I realize you're trying to get at psychological tendencies, but the premise is flawed and leads to applying faulty intuitions in disasterous ways.

That is one amazing quote. Thanks for making it known to me.

It’s not necessarily meant to be used as an argument as such. It could also be intended as a rhetorical device in order to force the opponent to concede on another point:

Person A: We should legalize weed in order to be consistent [see above argument]

Person B: Nonsense! Weed has harmful effects on society!

Person A: Alcohol objectively harms society more than weed [insert citations here]. So you would agree that we should regulate alcohol more, yes?

It would at least give people some options and some would choose less harmful ones.

The reasoning used to put the policies in place on those "illegal" substances was hardly reasoning in the first place.

So many countries have had great success with legalization, so what is your reasoning for so much caution? It's only continuing the legacy of pain.

> “worse things are legal” is not a good reason.

Seems pretty excellent to me. Things should be arranged on numerically indexed scale from benign to deadly. We should identify a point on that scale where illegality begins, and everything to the left is legal.

I'm fine with alcohol being the high water mark. We can fairly objectively rank the health and societal harms of various drugs. Hard to quantify, but straightforward to build an ordinal list. Caffeine, weed, basically all psychedelics, amphetamine, mdma, and tobacco all make the cut (the latter just barely). Coke, meth, heroin, unsurprisingly worse than alcohol, ought to have some distribution controls at the very least. Prescription opioids actually look surprisingly bad.

At the very least, the US drug schedule system is completely out of whack with actual risks. There's tons of sched 1 drugs which are objectively safer than alcohol.

David Nutt did important work in this area. See for example his scale of drug harmfulness here:

(Edit: see archive link below)

And

https://www.sciencedirect.com/science/article/pii/S014067361...

That pdf 403's. Here's an archive.org snapshot: https://web.archive.org/web/20201112012236/http://dobrochan....

Alcohol is one place behind street meth in Figure 1. Damn.

That's interesting, I do wish it had a few more items on the "lower" end of the harm spectrum, just to help me gauge this better. Things like Caffeine, or the other "Energy Drink" supplements.

Do you really think it's worse than the current wave of synthetic opioids? I think I could even make a good case for cigarettes being worse than alcohol.

The comment never claimed that alcohol is worse than synthetic opioids or cigarettes. The comment stated it is one of the worst drugs.

"one of the" is weasel words.

The two are actually on par with each other

Parent is most likely basing their comment on the work of David Nutt, see my other comment on this thread.

Smoking is for sure worse than alcohol consumption: https://ourworldindata.org/grapher/number-of-deaths-by-risk-...

Global yearly deaths by smoking: 7.1 million

Global yearly deaths by alcohol usage: 2.84 million

This doesn't include all of the other harmful effects from alcohol, like violence and injures. How much marital physical abuse happens due to alcohol? I'd rather have someone harm themselves from smoking then someone beat their wife while drunk.

Not to defend violent alcoholics, but people who get violent when drunk already have a problem, and would also violent when sober (they probably are). Most people who drink are not violent.

Regarding injuries: Sure, but the statistics in general doesn't include stuff that doesn't kill you but still is bad, like non-lethal lung problems from smoking.

To be clear, this data is showing correlation, not any kind of causation.

Regardless, if we accept the argument that people need to be coerced for their own good into avoiding harmful behaviors, the data linked seems to argue that we should be restricting access to sugar and high glycemic index foods (flour) much more than alcohol since "High blood sugar" at 6.5MM and "Obesity" at 4.7MM both beat alcohol by a large margin.

Yes, I agree that we should do more about unhealthy foods. Not restrict access to them (after all, smoking is also not illegal), but set in places incentives that nudge people towards healthier foods (these can be financial, educational, psychological, etc.).

The difference is that the average smoker dies at 80, and the average alcoholic dies at 35.

Source? 35 feels realllly young, but I guess it depends on what’s considered an “average” alcoholic. If someone is spending their entire day drinking string liquors everyday, I can maybe see that.

I was being approximate, but here is the more nuanced explanation:

"This study found an average of 93,296 alcohol-attributable deaths (255 deaths per day) and 2.7 million YPLL (29 years of life lost per death, on average) in the United States each year."

https://www.cdc.gov/mmwr/volumes/69/wr/mm6930a1.htm

Whereas smoking reduces life expectancy by "only" ~12 years.

80 sounds old for smoking to.

While I don't disagree with smoking being extremely harmful, most people addicted to nicotine can still function regularly. Regardless of which kills more, they both kill via proxy and that's where I see the biggest issue for both of them. Interestingly enough I've found that many people smoke when they're drinking.

The paper referenced in sibling comments purports that alcohol is worse than tobacco.

https://web.archive.org/web/20201112012236/http://dobrochan....

I wouldn't be surprised. There are studies that are beginning to link liver health to neurodegeneration, and that's just one set of potential disease states.

https://www.sciencedaily.com/releases/2021/09/210914152531.h...

I don't know, the ways in which they stack up is like apples and oranges. Cigarettes are certainly bad for you, and it's known they cause cancer but cigarettes don't have the same severity when it comes to withdrawl in my understanding. Alcohol withdrawl can cause hallucinations, seizures, even death. Also, I would say the danger is greater with alcohol because it impairs your judgement in a far greater way than cigarettes... have you ever been scared of someone who is driving while smoking?

Extrapolated out over time, I would guess that alcoholism is a cofactor in more deaths annually than cigarettes (edit: that is to say, deaths not caused directly by drinking, including drink driving, but conditions such as diabetes and heart disease which are greatly exacerbated by drinking for example... I wonder if someone who dies of cirrhosis gets chalked up as a death by alcohol?)

the parent said "one of the worst" not the worst.

also, at least for now, cigarettes are legal, which just bolsters the point above.

While we're at it, let's de-stigmatize the abuse of substances and treat it like a real mental health issue.

Literally everyone involved in the treatment and support of substance abuse does that, whether it's treatment facilities or social groups like AA and Al-Anon. As they should. Every family I know has been affected in one way or another by drug or alcohol addiction and has firsthand knowledge that substance abuse must be treated like an illness and to forgive (but not forget) the damage it causes. So I'm not exactly sure your statement reflects reality.

It's not treated that way by society at large.

Treat here not in the "provide medical care for" sense but in the "interpretation" sense, as in, "I know it's a polka, but I'm going to treat it like a waltz."

Once again, I think that's a fun thing to see because it's always nice to dunk on the broader culture, but that's genuinely not been my experience. People are generally very understanding and considerate of substance abuse situations and the carnage that surrounds it.

And it should be noted that while substance abuse is an illness and should be treated as such, it's not leukemia or muscular dystrophy. It requires an active participant to make a concerted effort to obtain and abuse an addictive, destructive substance. So it's no surprise that substance abuse might not be given the same level of sympathy.

"Literally everyone involved in the treatment and support of substance abuse" is a small percentage of the population as a whole, and a very, very small percentage of the people who make policy and resourcing decisions related to how substance abuse is handled.

You may be in a particular microcosm that handles this well, but that is definitely not the universal experience (not by a long shot). I'd also dispute the "literally everyone" part of your comment, as I can think of countless examples of attempts at substance abuse treatment and support being actively harmful to the person struggling with addiction.

Have 1000 people tell their boss they need a month of paid leave to deal with an acute cancer treatment or recover from a kidney transplant.

Have 1000 people tell their boss they need a month of paid leave to deal with alcohol addiction.

Measure the immediate reactions and future performance review and employment outcomes of the two groups. Do you expect them to be the same as each other? I don’t and I think it comes down to “I or a family member could get cancer or kidney failure” vs “alcohol addiction is a choice” thinking.

Apples and bowling balls. As I said in another comment:

While substance abuse is an illness and should be treated as such, it's not leukemia or muscular dystrophy. It requires an active participant to make a concerted effort to obtain and abuse an addictive, destructive substance. So it's no surprise that substance abuse might not be given the same level of sympathy.

I think many managers would prefer the latter because getting sober should have mainly positive effects on my employee's health and performance whereas an organ transplant or cancer seems much more likely to come with longterm disability and accommodation needs...

What is the value of "consistency" in this matter?

Legal consistency has many benefits. The two that first come to mind are:

• making it easier for non-experts to reason about the law

• consistency is, in my experience, usually a property of fairness

Let's keep it practical. Alcohol is here to stay and will not be prohibited. For historical reasons, culture, whatever...it stays.

Yet other harmful substances are currently banned and you opt to unban them for...consistency. It's like saying when two countries are at war, why can't we all be at war? Seems "unfair".

> to at least be consistent.

No not be a total joke as a gov't. I love the stories on "refer scare" and the prohibition (which has become some big historical period like the renaissance, merely by retarded gov't policy).

And not like we're done with it. New Zealand is considering to ban tobacco sales to the next generation. What could probably go wrong with that? Is age discrimination now all of a sudden okay? (this is not about prohibiting sales to kids -- which im cool with obviously -- but also to adults of the next generations, when they are of age).

We need a constitutional law prohibiting all victimless crime or this insanity will never end.

Most victimless crimes have victims, they’re just hard to singularly identify.

No. Not even close.

Most victimless crimes have literally no victim. There is no victim without some sort of harm. The reason we have speed limits and drugs are illegal is because if you go overboard enough with them there is a high likelihood of harm. In the vast majority of cases people don't go overboard and there is no actual victim though. These things are crimes because our system of justice is not good at punishing people for "going overboard" with the consistency and fairness we desire.

While I disagree with some victimless crimes, like drug possession, victimless crimes that put others at risk does victimize them.

It’s the reason that shooting a shotgun down a busy street is (and should be) a crime even if you don’t hit anyone.

Also, many violations of regulatory requirements are “victimless” but are entirely necessary cooperation for things to work properly, or to prevent consequential harm. Particularly for things where shared resources are used, like spectrum, roads, airports, the air we breathe, etc.

Who is hurt when I blow a little bit of lead dust into the air? Probably no one, and certainly nobody identifiable. Who is hurt when everyone blows lead dust in the air? Potentially many, and still likely unidentifiable.

You aren't getting it. Who does the bare risk itself victimize? Where is the damage? The risk is just that, a risk. There's a chance it may go bad and a chance that it may not. The risk produces no damage, no victim. But in sufficient quantity the bad outcome will happen enough to be worth making the activity is not allowed. Normally we prohibit the bad outcome but for some highly subjective cases we have to just draw a somewhat arbitrary line.

Risk victimizes those who are exposed to it. When it is trivial to identify a single person who is exposed to the risk, we don't call it "victimless", we call it "endangerment".

Why, when an act exposes multiple unnamed people to a risk, do some call it a "victimless" crime? Just because it's difficult to identify those exposed to a risk doesn't mean that people haven't been placed at risk.

>Risk victimizes those who are exposed to it.

If you share the road with a drunk driver but they crash into someone else are you a victim? Does their insurer compensate you?

Being exposed to risk does not make you a victim. You need to actually be harmed.

If your brother takes opiods but stops you are not a victim. If your bother takes opiods, gets addicted and ruins your family then you are.

Shooting a gun in the air, speeding, all sorts of unsafe things can have no victim, or they can have a victim depending on how things go.

We don't criminalize these things because they have victims when you do them right. They are usually victimless. We criminalize them because there's too much luck involved and we don't like the odds.

> Being exposed to risk does not make you a victim. You need to actually be harmed.

Crimes of endangerment are an exact counterpoint to this. They often do have identifiable victims, in a way that most people would agree.

> The reason we have speed limits and drugs are illegal

Are very different reasons.

Drugs are illegal because of big alc biz lobby, religious interference and orchestrated mass hysteria. The effect: the police can target any group, search them hard and lock some up because "drug". If the police would search hard in Beverly Hills they'd also find a lot, but they choose not to. It gives the police the power to hurt any group they choose because we all do drugs.

Speeding is an offense because it causes harm to others in some cases. Also there is an environmental impact. You choose to roll your car in public roads, you need a license, a proper car and to follow the rules. Cars can be seriously dangerous for other people on the roads. And it is in most cases "an offense"! Not a crime. You get a fine, not a jail sentence.

The only reason tobacco isn't banned straight up is it would cause untold disruption in the older addicted population. By banning sales to younger people, they are trying to prevent the next generation from becoming addicted, reducing the impact a future complete ban would cause. It's a temporary solution that will eventually lead to total ban.

> Is age discrimination now all of a sudden okay?

Hasn't society already decided a while ago that, for some reason, age discrimination is okay as long as it's only against younger people?

Different law fir children/elderly/childbearing are not the same as saying a whole generation (no matter how old) cannot do something.

Please re-read my comment and see https://www.bbc.com/news/world-asia-59589775

> Is age discrimination now all of a sudden okay?

This line of reasoning doesn't capture any nuance. These kinds of things operate on an allowlist. Unless there is a law enacted specifically as an exception then no, in general age discrimination is not okay.

Voting, alcohol, weed, driving, truancy, parental control, marriage, consent for sex, contract law, criminal law, social security, retirement accounts, and military service all discriminate based on age despite it being the guiding principle that you should avoid using age for restrictions when possible. The law has plenty of examples of min and max ages.

If there was any other way to ban cigarettes without making life miserable for people who are currently addicted? Because we should absolutely ban cigarettes. The victim is the cigarette smoker and the crime is the manufacture and sale of a an addictive substance that it not safe to use in any amount.

I agree with you that a law making it illegal for people to smoke is silly, the law should apply to manufacturers and distributors.

https://www.bbc.com/news/world-asia-59589775

please see this. it is not protecting children, it is excluding a generation (no matter how old)

All drugs should be decriminalized. Shooting people in drug raids is far worse for those people than are the drugs. Likewise, locking people in cages with other misfits, criminals, malcontents, and addicts isn’t smart (especially considering that drugs are in the prisons too). If the goal is truly harm reduction, people need to simply work to convince drug users to not use drugs (whether those are opioids, alcohol, tobacco, meth, whatever).

Slippery slope.

What happens when a drug addict looking his next fix attacks someone? This is why we have drug laws to start with, was to protect people.

There are no simple answers here.

Arrest them for assault...? Basically every study or reasonable implementation of decriminalization has shown both fewer negative effects of drug use, and in many cases decreased drug use itself.

So there is in fact a simple answer, and I think you'll find that drug laws were likely conceived much more cynically than for the protection of the common person.

We have already (as a society) decided we will no longer forcibly help people, so what do you do with someone that hurts others to feed their addiction?

Put them all in jail for every little offense? Fine them? (they have no money) Force them into rehab? (another form of jail) Let the roam the streets attacking people? (recycle through jail or rehab)

No, it's not simple.

Assault is not a "little offense". Anyone convicted of criminal assault should spend a significant amount of time in prison (regardless of whether they're a drug addict or not) in order to protect the rest of society.

It is in San Francisco

We just elected a district attorney in Manhattan who has adopted a policy that he will not seek imprisonment for charges of simple assault.

Assaulting people for drug money is an artifact of the drug war, not the drug. Alcohol addicts don't typically assault people for alcohol money. Alcohol gangs do not shoot each other up on the streets over alcohol territory. Or they haven't since 1933.

Assault is already a crime.

What happens when a person robs someone so he can buy a new car? You don’t outlaw cars.

Cars don't cause impaired judgment and withdraw.

I don't believe the poster above is saying that there should be no intervention, they're saying they shouldn't be criminally prosecuted.

There should be a non-criminal route for helping drug addicts that doesn't result in prison.

I can agree with that, but what is it? It can't be forced rehab, that is just jail but different. And addicts by definition _won't_ seek help or a solution.

I don't agree with your definition, often people affected by addiction will desperately seek help. Unfortunately, many fall into relapse cycles and it's a long and hard process to recovery.

I think a good solution would be making quality non-forced resources available for free. For example, rehab, therapy, or jobs specifically created for those seeking to overcome their addiction. Ideally these programs could pay for themselves in net returns for society as a whole.

There is help right now for addicts. What change are you suggesting?

Sorry for the late reply. I think much of the help available is cost prohibitive, I think addiction treatment programs should be free. A much better use of money than locking people up in cages which is both inhumane and more expensive.

What you are thinking of as the side effects of drug addiction are mainly the side effects of prohibition. Alcohol addiction is a serious problem, with serious negative consequences. So we made it illegal. And then we had two problems instead of one. Drug laws do not decrease addiction rates. They do make drugs unnecessarily expensive, and force addicts to interact with violent criminal gangs to get them. The negative unintended consequences of drug prohibition are worse than the problem they purport, but fail to solve.

Which drug will do more harm if freely available to all children? Alcohol, meth, heroin or crack?

I will pick alcohol every time over the others.

Which vehicle will do more harm if freely available to all children? Car, tank or crane with wrecking ball?

I would suggest that children shouldn't be driving at all.

Why am I forced to choose any or just one? Why do you think alcohol does less harm then any of the others?

Currently far, far more children die due to alcohol than the others, and while that's definitely due to availability it's not obvious that wouldn't still be the case if all were legal.

> Why do you think alcohol does less harm then any of the others?

A simple test, give each to a baby/small child and see what happens... I lived in a time where babies were given tiny amounts of alcohol for pain relief and it did no harm that I ever heard. I doubt you can say the same for meth.

I believe that the consensus is that it did cause a small amount of harm and there likely are horror stories you never heard, that's why the practice stopped, but giving children meth is called adderal.

Children also had regular access to small amounts of coke and heroin probably in your grandparents or great grandparents life, remember Coca Cola and laudanum was used for teething. You've never heard of harm from that. Your test says all of them pass.

Babies are not given adderal.

Are pregnant mothers?

No babies are given alcohol either anymore so you'll accept that heroin and cocaine should be legal based on your bullshit test?

You are mistaken. Vast numbers of American teens are prescribed amphetamines every day. The main difference between elicit recreational methamphetamine use and medical/psychological amphetamine use is circumstances and dosing. Kids on Ritalin are generally in safe situations where they have consulted a psychologist with the involvement of their parents, and are given a pure, unadulterated, small, carefully dosed amount of amphetamines. Meth addicts are typically people with more serious mental issues and in precarious situations, given massive and uncertain doses of unpure, perhaps adulterated amphetamines.

The disparate outcomes of those groups are much more about the dosage and the personal/social situation.

Pharmacologically, they are pretty much the same drug.

No babies are prescribed amphetamines.

This conversation is like telling a man he can't have a steak just because a baby can't chew it.

> What happens when a drug addict looking his next fix attacks someone?

You arrest and charge them for attacking someone?

But if the person they attacked dies, arresting the attacker after the fact doesn't bring them back to life. Do you also think DUI should be legal until you get in a crash?

> Do you also think DUI should be legal until you get in a crash?

No clearly we should charge anyone found in possession of alcohol with a felony to lower the possibility.

Drinking is not a crime, being drunk alone is not a crime, driving is not a crime. Being drunk, while driving is. On the other hand, assault is a crime regardless.

Have assaults gone up in the states where marijuana has been legalized?

I would argue that any drug that are depressants would have a different effect when high vs when the user is in withdrawl. Marijuana is considerably different than narcotics from my first hand experience/witness of it's effect on people.

Dope heads don't jones for their next hit. But I have seen a sweet young naive young teen turn into a mugger from meth.

I'm not refuting and generally agree with your sentiment here in harm reduction but I tried to see the collateral damage of drug raids vs drugs.

In the US the CDC reported 100,000 overdoses from drugs in the 12 months preceding April 2021[1]. I can't find how many people die from drug raids specifically but this Al-Jazeera article shows 1,068 people being killed by the police a year after George Floyd died[2].

And for a little more context Statista[3] shows 21,750 people being murdered in 2020.

Police kill at ~1% the rate of drug deaths. Citizens kill at ~20% the rate of drug deaths.

1. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/... 2. https://www.aljazeera.com/news/2021/5/25/how-many-people-hav... 3. https://www.statista.com/statistics/191134/reported-murder-a...

An addict can become not an addict. A person killed by police cannot become anything other than a corpse. The severity of the harm has a temporal component due to time preference.

EDIT: Also, dying of overdose is both a symptom of illegality and of the addiction. If a thing is outlawed the production isn’t exactly regular and therefore strength/purity of the substance varies.

Agreed. I'm in no way advocating people dying from any source. Drugs laws are ridiculous in so many ways. I was just trying to wrap my head around what the true numbers are as it helps put things into context.

Now count how many people are sitting in jail for marijuana possession and the impact that arrest has over the course of their lives.

Oh absolutely. Something like marijuana should not have ever been a crime. It's absurd and horrifying to think of people spending their lives behind bars for that and many other drug offenses.

I am not sure where I fall on the all drugs should be legal argument but I do know that because I spent ~$400 to get a medical marijuana card I can legally buy pot at the local dispensary in my state and smoke it with zero repercussions. In the mean time the jails are absolutely full of people who are there because they did not spend the $400. It is morally insane for that to continue. People are getting rich off selling marijuana in a dispensary while others are serving life sentences for selling it out of their home.

I take a lot of Non-FDA approved gray market and black market medicine. If all drugs are legal then such medical drugs should be legal as well. At least the ones I take are health promoting, non-addictive and non-habit forming.

I think a big part of the resistance to legalization is the medical establishment maintaining their monopoly supplier status on medicine.

Legalize medicinal meth.

Isn't it already legal if you have prescription? (In pill form ofcourse)

Yes, it's sold under the brand name Desoxyn.

Please no.

Back in the 90's I worked on a concrete crew for a summer. Building big box store type buildings. They pour the floor, then pour the walls on top of the floor, then tip the walls up and weld them together with metal flanges embedded in the concrete.

Nearly everyone on the crew did meth (except like 2 guys, I was one). Often work would start like 3:00 AM to prevent rapid drying. No lunch to speak of. Expected to literally run on the job site from one task to another. I suppose there may have been potential labor complaints but they never happened or weren't investigated.

It wasn't unusual for people to burn out and just not show up. That was part of the calculus I think by management. One guy fell asleep in his truck and could not be woken up (after presumably being up for a few days).

I quit after a few months but later saw my (low level) supervisor at a restaurant. He was alone and didn't look good. He told me how his life had gotten increasingly out of control and he had tried to kill himself (before finding Jesus per his words).

Company didn't care. They were making money. They turned a blind eye to what was going on. The human wreckage generated was awful however.

You think if meth is legal over the counter this won't be more prevalent? I'm pretty sure it will. Meth kills, and not just the body.

I would consider it the worst or most powerful drug in terms of access, addiction and intoxication. It's literally poison, and what it can do to an individual I feel is unlike most other illicit substances.

What about meth, fentanyl or oxycotin? (to name just a few)

I would consider these more literal poison by comparison to alcohol by any objective manner. If they are all legal, then access/addiction/intoxication are not even close to compare to alcohol, they are all far worse.

They're not poison though based on they way they work with neuroreceptors whereas alcohol limits neurotransmission all together. None of them are good, and in excess they're both terrible.

An argument I have often heard is that everything can be poison based on the amount ingested.

Therefore, if we can classify water as poison (which it can be) it sort of makes any of these simplistic comparisons moot.

Or glue sniffing?

Alcohol is only a problem because some people do it so much. Alot of people I know drink all the time-- like several times a week. They could look a little younger but generally have passable bills of health.

Also we have to question who's behind this statement. For all we know it's the PRC starting a new teetotalling campaign in their land.

Alcohol is legal because the population would tear the society down if it weren’t. That’s it. None of the other drugs have that kind of following.

Agreed. Banning it has been tried at least once, in the USA, and apparently it didn't work very well. There were too many people that wanted alcohol and were willing to defy government to have it. Government is at least partially (more in some countries than others) by consent of the governed.

But also on the contrary to your "none of the other drugs" point, I can't think of any possible reason why cigarettes weren't outright banned 40 years ago, except that they have exactly the same mechanism keeping them legal.

Counterpoint: alcohol is one of the best drugs on the planet for anyone on the spectrum of introversion to crippling social anxiety.

In all my (many) years, I have found no better path to becoming socially acceptable (even likable) to neurotypicals/extroverts than 3-4 shots of vodka. This is an unfortunate, but very real fact for many of us. I've heard good things about Phenibut, but (1) it's very difficult to obtain, and (2) it is also apparently habit-forming.

I’ve recently taken to trying Kava, which seems to be relatively popular among people trying to quit alcohol/benzos/etc.

Supposedly it also helps with disinhibition and socialization, but admittedly I haven’t tried it in a social setting so I’m not sure myself. It certainly does relax me and chill me out though without the dumbing down of alcohol.

Of course, by the things I’ve seen in those “pop-medical” sites that fill Google search results, you’d think it’s much more dangerous than alcohol.

Kava is great and for sure is wonderful in a social setting. I've taken to Kava recently and enjoy it casually (1 to 2 times a week) as its a shorter duration than alcohol, I get no hangover, and while I relax I don't lose my inhibitions. I also have drank it at a kava bar and find it to be an enjoyable social experience where the atmosphere is very bar like. I'm not totally against alcohol but Kava for sure is underrated and scratches many of the same itches as it were. Highly recommended.

Can definitely second kava. I went to a kava bar several times a few months ago and found it to be a great alcohol alternative. It also filled the niche of being a place where the atmosphere was more similar to a cafe so I could read a book or work on something in isolation, but without the downside of caffeine where you can't do that in the evening without ruining sleep quality. The social effects were definitely there.

Like you said, the crowd was largely people trying to quit or who had quit alcohol or benzos along with a fair amount of neurodivergent people. Being able to set aside some of my social anxiety and talk with them is part of what led to me getting assessed and diagnosed for autism recently.

The grandparent comment also mentioned phenibut which I find even more enjoyable, but like they said it can be habit forming and has a tolerance build up that limits safe use to once or twice a week.

I love kava. I used to use a lot of substances when I was younger, but quit for health reasons. Still, I get bothered by stress pretty often. Kava at the end of a long day is exactly what I need. Bonus points that there's no habituation.

GHB is probably an even better replacement than Phenibut as it's safer, has less of a hangover/rebound and can be used more often to no detriment but it has a worse reputation, needs to be dosed correctly (taking twice the dose accidentally means you pass out for 4 hours), and if you for some reason end up using it 24/7 the addiction is as bad to kick as with benzos or alcohol.

Oh-ho, no, not in my experience.

I used to be devastatingly introverted. Alcohol helped, but it’s nothing compared to GHB or MDMA. Ecstasy will give you the gift of gab like you can’t believe.

minor edit: I should say I am ignoring the context of where it’s acceptable to do such things. You probably shouldn’t do G at Christmas with the in-laws. (Though our quarantine Christmas this year with friends…) I’m just making a bit of a pedantic bit that there are club drugs out there that are pretty wild in how they can open you up socially.

You can drink alcohol after work with colleagues though. It’s far more helpful socially than party drugs due to its ubiquity.

I’ll grant you that 7 years of working remotely have slightly warped my idea of what people do at office parties.

sure, but its not really socially acceptable to drop X at the company happy hour. also mistakenly falling into a G Hole at the local BBQ is generally frowned upon. Having a couple beers is unlikely to lead to career or social suicide.

IF the "few beers" turns into ONE too many, it will lead to the same career and social suicide. Driving under the influence, fighting, lewd acts, etc... I live in a state where Weed is legal. I don't see people high decide to fight everyone at the party. I have seen this with alcohol more than I care to admit.

G yes, but MDMA can hardly reliablyreplace alcohol for general social settings given that you cannot do it all that often without issues, and that it has an even worse comedown for most people.

There are also many people who self medicate with opioids to treat chronic depression. I certainly wouldn't recommend that depressed people try opioids, but empirically it seems to be effective in reducing symptoms for some patients at least temporarily.

> Counterpoint: alcohol is one of the best drugs on the planet for anyone on the spectrum of introversion to crippling social anxiety.

I completely disagree and I think you should consider the possibility that alcohol is creating your anxiety in the first place. My years-long struggle with social anxiety disappeared after I decided to quit drinking for good.

Speaking from experience, as an older guy with crippling social anxiety and 30+ yrs of alcohol use/abuse, I can say that it superficially helps with social anxiety. However, it does not get to the root cause(s) of said anxiety. Professional help is needed to find and work on fixing those. The side effects, physical and psychological, of regular alcohol consumption are far worse than living with social anxiety. I also think it's unhealthy to try to fix one's psychological issues with drugs/medications without also looking at and trying to fix the reasons for their use in the first place.

Also, I now have to undergo quite a few yearly medical tests to keep an eye on my body after years of self medicating for my extreme social anxiety.

FWIW, I don't say these things as a teetotaler. I believe in harm reduction.

> it is also apparently habit-forming.

I hear that vodka shots also have this property.

I agree with the point on consistency, but must substances be viewed through the lens of "abuse" and "mental health"? It's not clear if you are implying that use of alcohol is generally a form of drug abuse related to mental health. In fact I'm not sure we can adequately define what is "abuse" in this case.

Take for instance Lemmy from Motorhead, who used alcohol and drugs heavily throughout his life and probably died an early death as a result; can that really be considered abuse when he, pardon my French, didn't give a shit?

For some people, things like alcohol are a serious issue and overuse can stem from both physical and psychological addiction. Then you've got people who use it sparingly. And yet there are people who drink heavily, know exactly what they're doing, and can't easily be classified as addicts without projecting one's own life choices unto them.

I've never understood the arguments like yours, which I used to hear a half-century ago in high school, and now see presented online. They distill down to "We allow this one bad thing, so we should allow all of the other bad things, too." As if having more bad things is better than having fewer bad things.

I don't drink, so I don't care if alcohol gets banned or restricted or whatever. But these type of arguments always strike me as little more than "Billy jumped off the bridge, so I can, too!"

I really don't see the logic here.

Banning alcohol didn't work out so well the last time we tried it and I seriously doubt it would go any better if we tried it again now.

If alcohol in moderation is so bad then why is it taking so long to prove it?

I would much rather legalize pot over alcohol being illegal. If alcohol had the same usage as pot we would have far fewer deaths. My only complaint is that pot smells awful (though alcohol isn’t much better).

There is such thing as a slippery slope and a dam that overruneth.

We’ve inherited use of alcohol over millennia —it’d be an uphill battle to rid ourselves of it short of fundamentalist dogmatism.

Some places in Central Asia have socialized opiate usage —but they too have unwritten rules about usage, or at least traditionally had them observed (it was a ‘luxury’ of old age).

If you allow an anything goes policy, you’ll end up with a decaying society. While I don’t propose prosecuting consumption because it’s the wrong focus, we should prosecute production and distribution of hard drugs.

Else you may end up with the likes of XIX century in China, or huffers in metro Manila.

Two bad things is worse than one bad thing unfortunately, but yes I agree that alcohol is one of the worst

Just to show how facile this reasoning is, let's flip the bit:

"Alcohol is one of the worst 'drugs' on a personal/societal harm scale - if we're going to tolerate this at large, we should make sure we keep other drugs illegal by default unless shown individually, through decades of research, to be safe. Otherwise we will burden our healthcare system and create a national catastrophe. As evidence of this danger, I submit the history of alcohol abuse, drunk driving, and liver disease, and their effects on our healthcare system."

I offer that you can only do one of two things now:

1. Argue against my advocacy for inconsistency using personal incredulity

2. Provide a deeper argument that relies on something more than an appeal to consistency

Edit: added a clause to sweeten my argument for inconsistency

> we should probably consider legalizing everything else that's less harmful to at least be consistent

This argument is brought up fairly regularly but I don't think it's very good. We cannot go back on alcohol, Americans tried pretty hard.

Our choice is limited to alcohol or alcohol plus whatever we legalize. Harm from alcohol is the hard lower bound on harm from substance use.

I hate the term "legalize" because all things are legal (in the U.S.A.) until they are made illegal. "Legalize" verbiage constantly tells people that they have to be selectively given rights, not selectively taken away.

Yep! We should legalize 'political' drugs like Hydroxychloroquine and Ivermectin too.

Well I think there are far more dangerous substances than alcohol which are considered legal and advertised.

Eating sugar for example in excessive amounts leads to way worse diseases - https://www.webmd.com/diabetes/features/how-sugar-affects-yo....

The worst thing about alcohol today is how America is letting alcoholics dictate pandemic responses, as if we believe that bars are more important than schools.

This comes from the point of view that harm is a scalar quantity. There are many different dimensions of harm and they vary wildly for each activity/drug. Reality is more nuanced than any single measure we select.

>to at least be consistent.

Also worth noting that consistency could be achieved by outlawing alcohol. In the U.S. at least, that proved an impractical solution. So I don't think "we allow one bad thing and we can't get rid of it, so let's allow all bad things" makes a particularly compelling argument.

(FWIW, I'm generally not against legalization nor do I think all drugs are net-negative. I just find the argument as laid out to be unconvincing.)

> Also worth noting that consistency could be achieved by outlawing alcohol. In the U.S. at least, that proved an impractical solution.

It was recognized as impractical fairly quickly, despite having fairly similar concrete outcomes to the drug war, for which a similar recognition has been much slower and less complete. But, again, that's just another layer of inconsistency in the same direction, not a mitigation of it.

Again, I'm not against legalization. But I'd like to see more concrete mitigation of the downsides. Just stating that we should aim for consistency does nothing about the blowback. "Legalize it to be consistent" seems as facile a solution as "Prohibit it because it can be dangerous" in that they ignore the complexities of implementation.

> Alcohol is one of the worst "drugs" on a personal/societal harm scale

Addiction is, not alcohol in itself. I haven't been anywhere close to drunk in a decade. I still enjoy a glass of whisky or a cold beer here and there.

People who have problem with alcohol would have problems with "less harmful" (weed I assume?) drugs too, it's a personality trait. I've seen the damage of weed in my friends, it's just as bad as alcohol tbh. I never understood the "it's bad so let's legalise other bad things"

>People who have problem with alcohol would have problems with "less harmful" (weed I assume?) drugs too, it's a personality trait.

You're blatantly assuming here and making it a categorical statement. They usually don't, neither statistically or at least in my experience, anecdotally. I and many friends of mine regularly drink, but most of us barely touch other drugs. Weed occasionally for some of my friends (I personally dislike it intensely) but things like coke and so forth, pretty much nothing, in a wide group of people who are regular consumers of alcohol.

> The evidence is clear: any level of alcohol consumption can lead to loss of healthy life.

No it isn't. The studies change on this constantly. Literally, it is why they are making their policy- because its confusing to people.

They also need to conduct a longitudinal study (or more than 1) to prove this... and guess what? They won't do it.

Note the weasel word: "can".

If you see a study that purports to show health benefits of drinking check to see if it distinguishes lifelong teetotalers vs recovering alcoholics. Lifelong teetotalers are much healthier than an alcoholic who's quit drinking, on average. The studies, at least in the US, should also control for wealth.

Bingo. A lot of studies that purport health benefits from drinking are comparing "sick quitters" who drank themselves into health problems to normal people who have the occasional drink and don't bother to control for socioeconomic status

Ah, thank you, I knew the phenomenon had a name and couldn't remember "sick quitters"

They've been consistent on the positive cardiovascular effects from mild consumption of red wine forever.

> 48 animal and 37 human studies were included in data extraction following screening. Significant improvements in measures of blood pressure and vascular function following RWP were seen in 84% and 100% of animal studies, respectively. Human studies indicated significant improvements in systolic blood pressure overall (− 2.6 mmHg, 95% CI: [− 4.8, − 0.4]), with a greater improvement in pure-resveratrol studies alone (− 3.7 mmHg, 95% CI: [− 7.3, − 0.0]). No significant effects of RWP were seen in diastolic blood pressure or flow-mediated dilation (FMD) of the brachial artery.

https://link.springer.com/article/10.1007/s00394-020-02247-8

It's pretty hard to build a study... You have to get a group of participants who are willing to drink alcohol everyday or never drink it again depending on which group they are assigned to.

One more of these huh? https://www.youtube.com/watch?v=w7l2hUp0CkQ

Alcohol is a carcinogen, it's bad for the liver, and while I didn't know, I'm not surprised it's bad for the heart.

Keep drinking to a minimum, and if possible keep it social. Life's short, enjoy a beer or glass of whiskey, but try to minimize it's harms, or just take mushrooms.

Also keep an eye out if you're a binge drinker, it's the second type of alcoholic, you don't drink everyday, but when you do drink you drink until you pass out.

That is strange. But I am sure a small amount of cigarettes is good for lungs.

Smoking cigarettes actually has a protective effect for contracting covid. You’re less likely to get it but if you do the outcome is worse.

That's interesting. I decided to look up to see if there were any theories on why that might be the case. It looks like results on this are inconclusive across the board and conflict of interest rears its ugly head yet again, but I found this:

https://www.bhf.org.uk/informationsupport/heart-matters-maga...

"One study suggests this could be because nicotine interferes with ACE2 receptors, which may prevent the virus from entering cells."

Glad to see them calling it out but let’s be honest.. we all knew it was BS.

So what. I have to die of something. Let me have my glass of wine or beer.

No amount of walking outside can guarantee not being hit by a car.

Seems like 0 could? Not at all recommended of course.

What if the car goes through your window? :)

Unscientific propaganda.

The best scientific evidence we have suggests moderate consumption of alcohol protects the heart.

From the Harvard School of Public Health:

> More than 100 prospective studies show an inverse association between light to moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes. [20] The effect is fairly consistent, corresponding to a 25-40% reduction in risk.

https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/...

Pardon, I'm perplexed here. When you say this is propaganda, what I take that to mean is that it's framed to serve a certain agenda at the expense of the truth, that is, that it isn't merely erroneous but that it is manipulative to serve a certain interest. Do you mean something different than that? If not, what agenda do you propose is served by this? Cui bono?

I don't know what the truth is here, and the article you cited doesn't have a date on it, but the sources it cites are pretty old - flipping through them, the most recent seems to be 2017. The source that's cited in that quote you posted is 20 years old. Nutrition is a notoriously difficult field to study. It's easier for me to believe that the consensus has shifted, and is perhaps not yet stable, than that there is an organization which stands to benefit from people believing alcohol is a modicum more harmful than it is.

Anyone else interested by the wording here?

"No amount of alcohol is good for the heart" is not exactly the same as saying "Any amount of alcohol is bad for the heart".

The former statement is hardly a surprise, but I think it will be harder to prove the latter statement.

They mostly do make the stronger version of the claim:

> The evidence is clear: any level of alcohol consumption can lead to loss of healthy life. Studies have shown that even small amounts of alcohol can increase a person’s risk of cardiovascular disease, including coronary disease, stroke, heart failure, hypertensive heart disease, cardiomyopathy, atrial fibrillation, and aneurysm.

It's honestly pretty clear that this is true if you dig into the research a bit. I say this as a regular drinker, by the way. I don't think the takeaway should be to drink zero, just that we (and doctors particularly!) should not be fooled into believing that there is a quantity of alcohol consumption that is entirely risk free, or even beneficial.

Side note: in a related story, the Don't Go Stark Raving Mad During A Pandemic Foundation issued a statement saying that large amounts of alcohol are definitely sometimes good for not completely losing your shit during accursed times such as these.

Lots of scholarship disagrees, but: before this press release, I'd never heard of the "World Heart Federation". Now I have.

That was the real purpose of it issuing this provocative, but not quite scientifically-settled, statement.

I drink in moderation. I eat good, dark chocolate in moderation. I have a dessert occasionally. I over indulge in rich foods sometimes.

MANY things are in the category of "No Amount is Good for ...".

This is NOT a useful categorization.

> They ask you about wine (khamr) and gambling. Say, "In them is great sin and [yet, some] benefit for people. But their sin is greater than their benefit."

https://quran.com/2/219

> O you who have believed, indeed, intoxicants (khamr), gambling, [sacrificing on] stone altars [to other than God], and divining arrows are but defilement from the work of Satan, so avoid it that you may be successful.

https://quran.com/5/90

I guess I need to try that sacrificing at a stone altar thing next

This might lead one to the reading that intoxication rather than alcohol is prohibited.

That's correct, all intoxicants are prohibited in Islam. The word (khamr) refers to any substance that masks a person's thinking ability (the word "khimaar" is a face veil, and both khimaar and khamr derive from the same root). And it's not a reading as much as an explicit text:

> "Every intoxicant is Khamr and every intoxicant is unlawful."

https://sunnah.com/nasai:5699

>Studies have shown that even small amounts of alcohol can increase a person’s risk of cardiovascular disease

I've never drunk alcohol before. Is it worth never having it? Does one drink really ruin your body that much.

If you mean literally having one drink once in your life I highly doubt there is any meaningful impact.

If I had to guess, the air I breathe and other environmental factors would be more harmful over a long term period than having a single drink.

Disclaimer, not a scientist, just a (3 year) sober alcoholic

One drink once in your life is not going to harm you. I think this is talking more about the "moderate" drinking of 1-2 servings per week.

That said, I've been down the whole alcohol path before and it ain't good for me. I don't know of any time since I've gotten sober that I thought back and said "Man, I wish I had been drunk for that"

It's an unnecessary risk. Maybe you'll do fine trying alcohol, maybe you'll become an addict and ruin your life. I don't think you're going to enhance your life by trying alcohol.

My parents and grandparents drinks wine daily… every single meal (no water at their table)… have done their entire life… grandpa died at 94 due to an accident… grandma 98 and going strong… both my parents are 75 healthy and a active (always around travelling). But for them alcohol is not a drug… is a beverage that goes very well with food! They never drink for the sake of it! As long as a person sees alcohol as a recreational drug he has a problem but it must not always be the case!

P.S. we are from Southern Europe

It's fine to never drink alcohol. One drink won't change anything measurable. Even this press release doesn't claim that one drink per day is harmful -- it merely claims that one drink per day has never been definitively shown to cause benefit.

Somewhat related: what have you found to be a good replacement for alcohol as a habit/relaxation device?

I enjoy my evening wine, but I slowly realised I mainly crave flavour (sorry hydrohomies). I don't want to do the sugary drink/juice route so am attempting to replace wine with roiboos tea or similar infusions, but I haven't found the right spot yet. Maybe it just takes more habituation or there is some element that simply doesn't bring me the same enjoyment/pleasure as unwinding with a glass of merlot or primitivo.

For anyone curious to collect, explore, and becoming mindful of their own personal data more, there's a nice free alcohol tracker app called Less (iOS only) [1][2] from the same company that created the fasting app Zero.

[1]: https://lessdrinks.com/

[2]: https://apps.apple.com/us/app/less-alcohol-tracker/id1484828...

Yes but a moderate amount with good friends is great for my soul.

My friend and family groups have been making a consistent effort to stop romanticizing alcohol and have gatherings without it. There's no denying alcohol is a social lubricant that can be very enjoyable.

I think it's important to normalize having alcohol-free excursions, especially when younger people are around. Demonstrate that self control is valued. And I say that as someone with a drinking problem who sweats about going more than half a day without one.

What's a good alternative, though?

It's delicious and it lets you collectively guard down in a way that creates a bond of trust. It's a difficult thing to substitute.

When one of my friends went to China on business and came back with "stories" I realized that KTV visits (prostitutes) performed a similar function, but honestly a glass of wine seems a bit more wholesome.

My father, an alcoholic (25 years sober), gave the best description ... he was always worried about if there was going to be alcohol at the event and how much.

If you are turning down attending events because they are dry ... you have a problem.

Agreed. I'm not against alcohol but I find I can get 80%-90% of the benefits by following the "ritual" of it with a mocktail and simply setting aside time where I give myself permission to relax and socialize. Alcohol is fine in moderation but its not as necessary as folks think to having those enjoyable experiences.

But what do you replace Alcohol with, Soda? Thats not good for health either. May be tea is a good substitute for social ocassions.

I was thinking about this recently watching a conversation between Lex Fridman and Bryan Johnson and it struck me that there is a huge difference in optimizing lifestyle choices for human physical and mental performance, and optimizing lifestyle choices for human flourishing, or even say joy and wonder. I feel like there is this growing misunderstanding that the "optimal" human is one that can be the most productive at work.

I think saying its a misunderstanding is not giving people enough credit: we are constantly incentivized if not required to eschew joy and wonder in order to be productive and optimal. I don't think most people even have the chance to reflect on what they really want, they just need to make money to pay their rent.

But it seems to me that the people that are most focused on being productive and optimal in this weirdly obsessive way are pretty high income -- they are not just scraping by to pay rent. I work with a company that does manufacturing here in the US -- it is pretty clear to me that the group of folks in our company that are skilled labor, hourly employees that are pretty well compensated, have more fun and make more time to experience joy and wonder than folks (like myself) that are more highly compensated and in the white collar world. This does not hold true for the lower end unskilled labor folks who have almost unavoidable material financial concerns due to income level. Now, I acknowledge this is very small sample size, but it makes me think.

Isn't it more of an American phenomenon though - because of the country's puritan roots?

Indeed, it is always good to know the science but we should balance that against the benefits. I like this quote from David Spiegelhalter[0]

"Given the pleasure presumably associated with moderate drinking, claiming there is no 'safe' level does not seem an argument for abstention," he said.

"There is no safe level of driving, but the government does not recommend that people avoid driving.

"Come to think of it, there is no safe level of living, but nobody would recommend abstention."

[0]: https://www.bbc.co.uk/news/health-45283401

I don't see it as a good quote and was puzzled as to its inclusion. It is simply a play on the words 'safe level' and equating it to other things. My best guess is that it's meant to appeal to the "I hear you but wish to continue drinking anyway" thought process, which is fair. This kind of equation is not.

I do see it as a good quote and wasn't puzzled. Perhaps we simply disagree?

Not necessarily. Driving for example is dangerous, a fatal crash can occur even if all parties involved are driving safely and are in complete control, and for that matter anything has a risk carried with it, but you balance out the risks and the rewards, just as you would with alcohol

I've wondered for a long time if the studies showing health benefits from alcohol are being confounded by the health benefits of socialization, which often involves alcohol in many societies. People who drink less might (statistically) socialize less.

This reminds me of something a friend once told me. This was about 10 years ago, he was a commander for the navy at the time.

In the navy, while at sea, you are expected to drink during social events. Alcohol is considered the 'social engine' of the ship.

Now I must disclaim that obviously the crew wasn't forced to drink. Those on guard, or who had any medical, religious or other objections were dismissed. And naturally they have very strict limits, as getting intoxicated on board of a operational warship would be very dangerous.

But, with moderate use, alcohol was (at least back then) viewed as an efficient method to prevent stress and mutiny among the crew. It probably is still today.

I usually spend time with friends over coffee which has very much been rehabilitated in the medical world over the past ten years.

I forgot which podcast but someone mentioned it was their opinion that alcohol is a social lubricant and that without it we'd be waring and fight more. IIRC the podcast was talking about research in Asia, China in particular, where people gather after work at the drinking place (bar, tavern, whatever) and via alcohol they open up, negotiate, apologize, learn details and reasons that weren't spoken at work.

The point being, if true, maybe the without alcohol the world will go to shit (unless we find substitutes).

Is anyone surprised by this? Alcohol being good for the body was pushed by the Alcohol lobby a long time ago and made its way into the mainstream consciousness. It has lingered because people enjoy drinking and because of powerful incentives not to change.

How large is the alcohol industry and how many people are directly tied to it?

Am I saying we shouldn't drink? No the amount of stimulating conversations I have had with people is somewhat a function of alcohol and being more comfortable to talk about ideas in a less formal setting.

I guess you could say the alcohol lobby was "cooking with gas"

It's not good for the heart, but is it good for the soul?

I don't think the article is stating anything controversial here. The position that any amount of alcohol is harmful is not contradictory with the position that alcohol is beneficial in reducing cardiovascular risk. In other words, the framing effect is leading to a cognitive bias. One position is framed in terms of negative outcomes, while the other is framed in terms of positive outcomes. Hence the visceral reaction to the article.

Actually the headline implies that there is no cardiovascular benefit.

“Studies have shown that even small amounts of alcohol can increase a person's risk of cardiovascular disease”

“To date, no reliable correlation has been found between moderate alcohol consumption and a lower risk of heart disease”

Yes, relative to abstaining. If there's a 40% risk reduction in cardiovascular mortality in moderate drinkers, then there will be a 60% increase in risk for the moderate drinking, relative to someone who abstains.

Not sure I follow, what group are they comparing the 40% risk reduction to?

Interesting how there's a major shift in the knowledge about risks of things like sugar, cigarettes, alcohol, etc. And it usually turns out there was an industry group involved in sort of a coverup. The lesson here is to take any health claims or dismissal or risks with a grain of salt when there's a big industry behind it.

> The lesson here is

Do not allow victimless crime to exist. And big biz lobby efforts should be illegal.

One of my favorite examples of this is how coconut oil is advertised all over youtube by thousands of influencers as a superfood that must be a part of a healthy diet.

(Especially since it's hardly an oil in my opinion -- it's partially solid at room temperature)

There's absolutely no reliable evidence that coconut oil has any beneficial effects on the human body, and I really don't see why anybody would believe that an oil high in saturated fats is good for you.

Same goes for agave syrup and other health fads.

There's a ton of alternative kinds of sugar that are marketed as healthier than sugar but are in fact just sugar extracted from a different plant or other source. Sugar is sugar.

Sugar is sugar but fructose does seem to be particularly hard on humans.

Just more horseshit from Big Coconut, that's what I think.

Those coconuts have definitely got blood on their hands:

https://en.wikipedia.org/wiki/Death_by_coconut

Because there is ample evidence that saturated fats are not bad for you, or at least no where near as bad as previous science led us to believe.

It would be more accurate to say that there is no strong evidence that saturated fats are bad for you.

Lots of the previous science was bad science that did not account for confounding factors, such as not taking into account that lots of fast food has lots of saturated fats(and made up for a large portion of saturated fat consumption) and adjusting for that. ie the difference between "do sat fats make people unhealthy" and "does eating fast food(which happens to have sat fats) make people unhealthy"

If you want to go down the rabbit hole, there is also no strong evidence showing cholesterol/eggs are bad, and neither is there any evidence showing salt is bad(if you are healthy). Lots of nutrition studies have such laughably silly methodology. Not sure why they were ever taken seriously.

You raise several nutritional theories here.

Dietary Cholesterol / Blood Cholesterol - cholesterol restriction has been removed from dietary guidelines in the US, so people have taken that seriously.

Increased saturated fat is pretty well associated with LDL levels, which is associated with cardiovascular disease risk. Not sure that I've ever seen any contrary studies recently - I would be interested if you could link any you are aware of... I guess the questions I have seen are around carb intake and fat intake, but that's kind of a separate issue

Salt is definitely more questionable, but seems like if you are avoiding hyperprocessed foods, you are going to intake less salt, so maybe a non-issue...

Well for fats we have this:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...

There seems to be a moderate reduction in cardiovascular events, BUT - there is NO CHANGE in mortality or even cardiac mortality. Also note, these studies may be victim to the saturated-fats-are-fast-food issue.

If saturated fats were actually bad, like smoking is, I think we would see more significant results than "10-15% decrease in events that doesn't even change peoples' overall outcomes".

I'm not saying you should avoid coconut oil, I just think it's a very questionable claim that cooking with coconut oil instead of other plant based oils like canola oil is going to improve your health in any way.

I suspect that high fats are fine and high carbs are fine, but having both high fats + high carbs leads to health problems. Fat heavy leads to keto metabolic state, heavy carbs lead to the other metabolic state. Having both at the same time is the issue, my opinion.

> I really don't see why anybody would believe that an oil high in saturated fats is good for you.

A lot of people do if you look around. Serious people I mean. They usually sing the praises of butter (and ghee), but the same reasoning is applied now to coconut oil.

I always scoffed at people who believed "a glass of wine every night is good for you." It seems pretty obvious that ingesting literal poison every day is not good for you.

Protein is a literal poison as well if you consume excessive amounts (above 35-40% of all caloric intake).

It can also be infectious, in the case of prions.

Ban all protein!

Here's an experiment: take two bugs. Pour alcohol on one and a protein shake on another. Which one do you think will be more biologically destructive?

Calming your nerves lowers your heart rate. Lower heart rate leads to less heart problems. Less heart problems leads to longer life.

A glass of wine calms your nerves.

Alcohol increases your heart rate.

Interesting, I hadn't known that: https://www.escardio.org/The-ESC/Press-Office/Press-releases...

Separately, consider that your assertion would likely be more persuasive to doubters if you'd included a link defending it.

Indeed, an NIH funded longitudinal study on alcohol kicked off in 2014 and it was shut down for being tainted by industry money: https://www.nytimes.com/2018/06/15/health/alcohol-nih-drinki... - you can't necessarily even trust publicly funded science when it impacts large industries.

It's at least encouraging that it was caught and shut down.

Of course you'd say that. You clearly work for the salt lobby! In all seriousness though, who stands to benefit from this? In the case of sugar, doctors wanted to suggest limiting it, but lobbyists pushed for the advocation of limiting fat intake instead (which was thought to be just as unhealthy at the time). Sugar was a clear substitute because removing fat makes things taste like, well, cardboard. Off the top of my head, I'm not aware of any substitutes for tobacco products or alcohol. Recreational services, maybe? Even Bowling alleys typically have bars.

> major shift in the knowledge about risks of things like sugar, cigarettes, alcohol...

In each of these case, the medical and scientific community didn't have a vested interests in these entities. I mean, the medical community didn't come up with smoking or alcohol consumption...

Now imagine some entity or procedure that the medical/scientific community came up with and the big business found way to make huge money off of, such that there is a natural alignment of incentives for the scientific community and big business to keep this thing propped up. Such a thing, even if doing great harm, is sure to go on for a vastly longer period of time, if not perpetually....

Funny that they're saying this now because fermented drinks used to protect people from health issues when the water supply was not clean enough to drink.

With beer, this was because the brewer needed to boil the water used in order to kill off any microbes which would compete with the yeast, or it would go "off". It's a very important step for brewing beer. Then the beer would be stored in barrels/casks to help reduce the chance of introducing further microbes, plus the use of preservatives like hops to help keep it longer.

With wine, people generally mashed the grapes immediately after picking to ensure that the yeast took hold before any harmful bacteria did. Then followed the same process of barrelling it to prevent other microbes from getting in. People also learned that added sugar served to further preserve wines that would be stored for longer periods of time.

If people would have boiled their drinking water, it would have been safe to drink.

> If people would have boiled their drinking water, it would have been safe to drink.

For a limited time. The live cultures and then alcohol in fermented drinks keep the bad bacteria at bay.

Keep in mind in the past, not everyone had a convenient source of heat in their homes.

> With beer, this was because the brewer needed to boil the water

No, they didn't - you do not need (or should) boil the water. If you did boil it, you would then need to let it cool down before adding the yeast. Home-brew kits suggest using a fairly small amount of hot water to disolve the malt extract, and to get it up to fermentation temperature.

Beer is safer to drink because the yeast out-competes pathogens, and because it causes a pH change that inhibits and/or kills them.

Speaking as an ex microbiologist.

I once toured a microbrewery which produces beers the same way they did in colonial times. This involved pumping the water up ~20 feet into a copper kettle situated above an elevated brick furnace. The water was boiled, then gravity fed down canals via ladles to other kettles for mashing and lautering.

Now, this brewery was replicating 19th century American brewing, but these ideas probably came from Europe.

How else are they going to get water to a specific temperature before the invention of thermometers?

This is false - boiling the wort is used in probably 99% of commercial and home brewing.

Yes, but not all of the water - you would be talking about many gallons.

Please consult literally any intro guide to home brewing. They all call for boiling all of the water. I have brewed dozens of batches of beer at home and always boil all of it. I don't know as much about commercial brewing but I've never heard or read of partial boiling as a common technique in commercial brewing. (There is such a thing as "raw ale", but the fact that it has a special name to indicate the lack of boiling tells you it is the exception to the rule).

Boiling is also not only about sterilization. It is also fundamental to the character of the beer. It causes isomerization of the alpha acids in hops which is responsible for the bitter flavors in beer. It also denatures proteins in the wort resulting in clearer beer. See: https://www.love2brew.com/Articles.asp?ID=573

Is it possible that boiling the water and then adding the yeast is a modern practice? People in older times didn't know about yeasts (they didn't know anything about microorganisms). So they couldn't go and buy brewer's yeast from the shop to make beer, they'd have to culture it by natural fermentation. So they couldn't boil the beer before it fermented. Although they could perhaps keep a culture from an early batch and then boil the water of subsequent batches, until they needed to replenish their culture?

That's how traditional yogurt making works. If you ask most people who know how to make yogurt they'll tell you: 1) you boil the milk, 2) you let it cool, and 3) you add yogurt. The yogurt is the fermentation culture (lactic acid bacteria rather than yeasts) and while making yogurt propagates it, at some point someone needs to make yogurt without already having yogurt. The only way to do that is to start with milk that wasn't boiled because boiling kills the culture (the bacteria in yogurt are thermophiles but they won't survive being boiled!). Perhaps something like that happened with brewing also?

Or maybe it's more like modern cheesemaking? Nowadays most cheese is made with pasteurised milk. To make cheese, the milk has to be cultured with lactic acid bacteria, but pasteurisation kills those off. So modern cheesemakers add lyophilised culture to their milk after they pasteurise it. Traditionally though the only way to obtain culture was to leave the milk alone, use it raw. Back in the day people didn't even know about the existence of bacteria so they had no reason to pasteurise their cheesemaking milk in the first place.

So how old is the practice of boiling the water for beer? Is it possible it's something that's only done today thanks to the knowledge of microorganisms?

Well, here's one (first on google) that doesn't:

https://www.thehomebrewforum.co.uk/threads/beer-from-kit-boi...

> No, they didn't - you do not need (or should) boil the water. If you did boil it, you would then need to let it cool down before adding the yeast. Home-brew kits suggest using a fairly small amount of hot water to disolve the malt extract, and to get it up to fermentation temperature.

Boiling is a pretty important step in brewing, both in the home and in the commercial brewery. Yes you could technically make beer without boiling it, but that is not the norm. Boiling is used not only for sanitation, but also to allow the hop oils to isomerize and become soluble in the wort, as well as reduce the wort volume to make the wort more concentrated, since the sparging step produces a lot of diluted wort (when using grains rather than extract). Wort in a can (malt extract) means you may not be concerned with concentrating the wort since you could control that, but you still generally want to isomerize the hop oils.

Your point about needing to wait for the wort to cool is correct, but that's precisely what brewers do.. they cool the wort until it gets to yeast 'pitching' temperature

This is myth which was debunked countless times already, people always drank water (even in the middle ages).

Yes. There's a reason every early human civilization was located near a body of water. Water is necessary for humans. Clean water. Alcohol also doesn't have a significant disinfecting property until at least 30% ABV. And it wasn't until the middle ages that distilled alcohols became common

The psychological benefits of drinking may not be quantifiable, and may impact long term heart health.

“Who can’t stop drinking may get drunken three times a month. If he does it more often, he is guilty. To get drunken twice a month is better; once, still more praiseworthy. But not to drink at all - what could be better than this? But where could such a being be found? But if one would find it, it would be worthy of all honour.”

― Genghis Khan

And yet they won't say anything about how they have been wrong about fat for so long. How about sugar ? Anything against that ?

They want to keep all the alcohol to themselves.

We often say "trust the science" when we agree with the conclusions of a study, and "question authority" when we don't. The phrase "trust, but verify" is an appealing middle ground, but isn't it really a euphemism for "I don't believe you yet"?

God I can’t fucking wait until we’ve moved on from this world where maximizing health outcomes overrides all other considerations.

Living in a bubble where I eat a perfectly balanced diet of Soylent and refuse to interact with anyone will probably add to a miserable existence where I’d rather fucking kill myself.

This should have been obvious to anyone who has ever gotten drunk.

Alcohol is a poison. To think otherwise is wishful thinking.

Everyone knows this. Some choose to believe the 1 or 2 debunked and unrepeatable studies that show small amounts of alcohol is good for you rather than the mountain of evidence that says it isnt.

If you want to drink alcohol, that is fine. But pretending its healthy in some way is lying to yourself.

I love studies like this. Because it shows exactly where our lines are.

If this is true, we should stop drinking. That's what the data says.

But if you won't, I really don't want to hear you opining on anyone else's choice of unhealthy vice.

It's interesting how much opposition these articles get. I notice a lot of people are annoyed just at the declaration that alcohol is bad for you. People almost seem to take it personally. I know people like their alcohol, but I'm surprised how defensive people get just at the idea it's unhealthy.

I've heard this more lately and can't square it with what I had understood about those super long-lived cultures; like in Italy or Japan, where supposedly they drink moderate amounts of alcohol approximately daily.

There are so many factors that effect health its really hard to isolate one. I think moderation is key to preventing one of these things from having an undue large effect. grandmother (Irish/English) drank and smoked a lot, she lived to her mid-nineties. She had a relatively stress free existence though. But she's one person and without an identical twin control, its hard to tell how much better she might have been had she abstained.

But that's why I thought these studies of long-lived _cultrures_ were significant. These things, including moderate alcohol consumption, which are common to multiple very different large groups that live longer than average.

Generally, doing things in moderation is way better than going to extremes. Drinking moderately as a culture may be correlated with eating moderately, exercising moderately, etc.

In any case it has always seemed clear to me that studies showing beneficial effects of moderate alcohol consumption are heavily influenced by some combination of paying interest-groups and the researchers really wanting to justify a daily beer/wine glass.

The clearest evidence for me that a glass a day can not possibly be healthy is the effect just a single glass has on athletic performance the next day.

For the record I do drink and have for a long time, but have no illusions about the negative effects.

I definitely see why you'd be suspicious. But on the other hand, the Okinawa Japanese are definitely one of those groups that DOES live really long and DOES drink moderately. I've traveled extremely widely, used to live in Japan, and (sure, anecdotally) it feels reasonable.

I don't doubt they live long and prosper, but attributing it to moderate alcohol consumption rather than anything else seems suspicious.

There's no doubt that alcohol in excess is very bad for a person.

There's enough doubt about whether light-moderate alcohol consumption (i.e. a small glass of red wine with dinner and two or three once in a while with friends) is harmful or protective that it seems pretty clear that, whether the net effect is positive or negative, it's not terribly strong.

We get really hung up on whether something is "good for you" or "bad for you", without focusing as much as we should on exactly how bad it is: we just want to sort things into either the "good" bucket or the "bad" bucket and feel the corresponding dose of pride or guilt.

I've heard of having a glass of wine in meals in Italy, but does Japan really have a culture of daily drinking? Either way, that brings up use patterns. Here we tend to binge drink, with the purpose of getting drunk. That's not the same in such cultures. They have a much more moderate view of alcohol. A glass of wine and shots are two very different things

There's generally "No Safe Level of Living in the World" either.

But the tannins in red wine (consumed in moderation) are good for your heart?

I don't consume alcohol because I think it's healthy, I consume it because it tastes sometimes good and because it feels good.

So the real question is: is some amount of alcohol neutral or not health-wise?

It's a good question. Without any research, I'm going to continue to have a few drinks every week since it's been done for centuries just fine.

as someone who grew up i a community that has for many reasons, religious, social, economic that no one really does alcohol. when there is nobody who is drunk, we have 0 drunk driving cases, 0 cases of people ending up in wrong places, 0 cases of alcoholism, 0 cases of "well we will just mix a drink with something more recreational", no need for AA among a host of other things including not having to budget alcohol in your daily budget because people are generally still poor.

why is that not more prevalent?

Because alcohol has been purposely drunk by people for literally thousands of years, and the vast, vast majority of people are able to drink without having a problem?

people have purposely been doing a lot of slavery for thousands of years as well. took us some time but we got over the whole "its been fine for millions of years so it must be good or at least fine" to get to the root of the issue. once we found that, slavery was abolished pretty much everywhere.

my point is, why bring "societal pressure of 500 years" into an argument for an inherently bad thing. just thinking out loud

Slavery is not alcohol, and equating the two is a very obvious strawman argument

The point was the "doing something for a long time is not a good reason to view it as okay"

I don't know what the slavery has to do here... but as for psychoactive drugs, it's not only a bad thing, it also has its upsides that are well-known, hence why humans have been consuming drugs since forever. The downsides/upsides ratio varies greatly depending on the dose and the frequency.

I think there's better education around alcohol now than there was 30 years ago (at least where I live). Still, a lot could be done, particularly for the youth, like banning pre-mixed cans and other sugary ready-to-binge beverages. Habits start early.

Could it be that it’s the result of prohibition? Because the Temperance Movement advocated a few of the things you mentioned. Ken Burns has a great doc on Prohibition!

from my small understanding of "prohibition" it was like thry tried to enforce it by way of brute muscle and people found ingenious ways to fool the system. what would the result have been if they had worked on educating people and building a society wide consensus about its ill effects.

Well, they did educate people, alcoholism was a huge problem in the US at the time and men who became alcoholics often abused their families and could not provide for them, leaving them destitute. AFAIK, these issues did change for the better as alcoholism rates were lower after Prohibition than before, and less hard spirits were consumed. But building a society-wide consensus in the US confirming teetotalism? Outside of the highly religious communities, it's just impossible.

The answer to your question is in your statement. Most communities don't have "many reasons" to favour prohibition, in fact most communities don't even have one. Yes there's the idea that no alcohol = no alcohol-caused problems, but people don't assume they will have a problem when they start to drink.

In my area, the only dry communities are small towns with strong Mennonite backgrounds. And in every one of those towns, there's a bar right outside city limits, or in the next town over, where people in the dry community go to drink.

Alcohol use around the world over the centuries is a vast topic, but coming from a US religious community that prohibited all alcohol, I was duly impressed while serving in the peace corps in rural South Korea with the social utility of drinking to moderate the rigid hierarchies of local culture there and to provide a place for blunt truth telling otherwise impossible.

The costs of alcoholism were readily visible as well, but I do believe drinking culture in South Korea is a hidden partner to its vaulting economic and cultural success from the ruins of the Korean War.

Studying the effects of alcohol and pornography consumption is difficult because they're so widespread within some cultures, that you can't have a representative control group.

Big discussion of original source: https://news.ycombinator.com/item?id=30009882

Comments moved thither. Thanks!

Edit: actually, this submission was posted first, plus the Bloomberg article seems a bit more informative than the press release, so I think we'll merge hither instead.

I doubt advice about moderate drinking influences behavior, outside perhaps where pregnancy is concerned.

Pretty much everyone at least occasionally eats food they know isn't good for them.

"They ask you about wine and gambling. Say, In both there is great sin, and some benefits for people. And their sin is greater than their benefit ...”

Quran (2:219)

Islam is always right about everything Hamdou'Allah

Can we have the heart people and the liver people duke it out, because the liver people seem to think a little low grade abuse was good for the liver.

When they say the evidence is clear, you have to ask, where's the evidence? Did they have a randomized control trial I don't know of?

Click through to the download and chase the citations, if you want to see what they're referring to as "evidence."

Evidence? Didn't you see those dirty MGD bottles next to the broken window on page 2?

Many of the comments focus on the individual. There should also be consideration for societal concerns and overall public health.

What do the French have to say about that? France is one of the countries in the world with the highest life expectancy.

A poet once said, “The whole universe is in a glass of wine.” We will probably never know in what sense he meant that, for poets do not write to be understood. But it is true that if we look at a glass of wine closely enough we see the entire universe. There are the things of physics: the twisting liquid which evaporates depending on the wind and weather, the reflections in the glass, and our imagination adds the atoms. The glass is a distillation of the earth’s rocks, and in its composition we see the secrets of the universe’s age, and the evolution of stars. What strange array of chemicals are in the wine? How did they come to be? There are the ferments, the enzymes, the substrates, and the products. There in wine is found the great generalization: all life is fermentation. Nobody can discover the chemistry of wine without discovering, as did Louis Pasteur, the cause of much disease. How vivid is the claret, pressing its existence into the consciousness that watches it! If our small minds, for some convenience, divide this glass of wine, this universe, into parts—physics, biology, geology, astronomy, psychology, and so on—remember that nature does not know it! So let us put it all back together, not forgetting ultimately what it is for. Let it give us one more final pleasure: drink it and forget it all!

--Richard Feynman

I don't drink to live a long time, I drink to make the time I'm hear a bit more bearable.

And in 10 years they'll find out they're wrong, but that's the way this stuff goes.

No amount of World Heart Federation is necessary for human survival, so there's that...

Isn't the oldest person in the world an old lady who is a daily vodka drinker?

I've been waiting for something like this. Now we need to get the AMA to reverse its stance too. I've seen too many people start with the one drink excuse, and multiply by the number of days they HAVEN'T had a drink. It's totally irresponsible messaging.

As is no amount of obesity. But it’s easier to demonize alcohol.

A room full of cardiologists will raise a glass to that.

This is as bad as the disastrous Wakefield Autism "study". People will deny alcohol is bad for them for the next 100 years even with multiple studies showing the results.

So “any amount of alcohol is bad for the heart”?

Loneliness is also detrimental to the heart.

People like you are why the rest of us drink

this might be just me - i find people that alebriate every once in a while more normal than those who claim otherwise

Meh, we are going to keep drinking anyway

Cheers. Also, don’t eat the yellow snow.

Yeah but it's good for the mind .

This has been obvious for a long time.

Tangent but I started a “sober January” and the benefits to my life are so striking I don’t intend to ever drink again.

"I knew a man who gave up smoking, drinking, sex and rich food. He was healthy right up to the time he killed himself." - Johnny Carson

"You're gonna feel like a damn fool, laying out at that hospital, dying from nothing!" - Redd Foxx

https://www.youtube.com/watch?v=6grI16niGXA

One of those things is not like the others.

I don't think sex is linked to many bad health outcomes.

The point is that they are considered vices. Sex, drugs, rock and roll etc. It's a joke, lighten up.

> I don't think sex is linked to many bad health outcomes.

Sure it is. STDs, risk of injury, etc.

Bad comparison. Too much of the other stuff will harm you regardless of how careful you are. No amount of sex will harm you, if you're careful.

"Futurama - Death By Snu Snu" => https://youtu.be/3f8sjzETQ5o

Weird phrasing to try to make a point; no amount of alcohol will harm you, if you're careful?

Too much of anything will harm you.

Life is so complicated now a days that stress will probably kill you first

great, now they will want to ban alcohol

Cheers

"Alcohol consumption increases the risk of CVD(20). In the Global Action Plan for Prevention and Control of NCDs, the World Health Organization (WHO) calls for a 10% relative reduction in the per capita use of alcohol between 2013- 2030 (21). Based on recent evidence, it has been concluded that there is “no safe level of alcohol consumption”(5). Risks attributable to alcohol use increase for all the major categories of CVD(20). Thus, alcohol increases the risk for hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, and strokes. In moderate drinkers, the risk of stroke is 1.14 times greater (95% CI, 1.10-1.17); coronary disease (excluding myocardial infarction) is 1.06 (95% CI, 1.00 – 1.11); heart failure is 1.09 (95% CI, 1.03- 1.15); fatal hypertensive disease 1.24 (95% CI, 1.15-1.33) and fatal aortic aneurysm is 1.15 times greater (95% CI, 1.03-1.28)(20) than for non-drinkers. It has been argued that people with moderate consumption and no binge episodes may appear to have a slightly lower risk of ischaemic heart disease (IHD), but the protective effect of moderate alcohol consumption for IHD has been challenged as the evidence is based entirely upon non-randomized studies(22)"

An increase in high-density lipo-protein (HDL) cholesterol has been the most compelling potential source of biologic plausibility for how alcohol might help prevent CVD. However, the cardioprotective effect of HDL is under challenge: many studies find no effect from increased HDL levels on reducing the risk for myocardial infarction(23)(24)(25). Other proposed cardioprotective biological mechanisms have also been shown to be inconsistent with sound epidemiologic studies. These include coronary calcification and carotid intima-media thickness, where alcohol consumption is associated with worse vascular health(26)(27). Contrary to popular opinion, alcohol is not good for the heart. This directly contradicts the common message over the past three decades from some researchers, the alcohol industry, and the media that alcohol prolongs life, chiefly by reducing the risk of CVD. For example, the use of red wine has been promoted through various diets as a “heart-healthy” beverage for the longest time. The presence of resveratrol in wine has been known for its cardioprotective characteristics in light to moderate drinkers. However, there are multiple reasons that the belief that alcohol is good for cardiovascular health is no longer acceptable:

• Such evidence has been based on observational studies • No randomized controlled trials (RCTs) have confirmed health benefits of alcohol • The presence of unaccounted confounding factors further weakens the quality of evidence • Studies misclassify unhealthy ex-drinkers as abstainers • Most evidence is observed only in the Caucasian population • Studies that show positive effects are funded by the alcohol industry.* Research in the latest decade has led to major reversals in the perception of alcohol in relation to health in general and CVD in particular. These developments have prompted health authorities in a number of countries, e.g. the Netherlands(28), England(29) and Australia(30), to lower their recommended amount of alcohol for low-risk drinking. The alcohol industry has also perpetuated misleading information about the benefits of drinking alcohol. This interference by the alcohol industry closely reflects the universally vilified activities of tobacco companies. Alcohol industries deceptively promote their products under the labels of “healthy” and “safe”. Portrayal of alcohol in print and electronic media as necessary for a vibrant social life has diverted attention from the harms of alcohol use. Youth-targeted advertisement and encouraging alcohol as “heart-healthy” have created a conducive environment for young adults to relate alcohol with ‘having a good time’. Contrary to this belief, evidence from all around the world exists to link alcohol with a range of noncommunicable and infectious diseases."

https://world-heart-federation.org/wp-content/uploads/WHF-Po...

Of course it isn’t. Drink water. Unfortunately some people believe they can’t enjoy themselves without alcohol.

It’s curious:

- babies have fun without drinking

- kids have fun without drinking

- some teens have fun without drinking

Then at some point some people, as adults, feel like they have to drink to enjoy themselves? I wonder what happened.

Edit: explicitly clarifying that I’m only talking about some people here

As we age, we feel more pressure to conform socially, I think. Alcohol lets people feel uninhibited like kids temporarily.

>>I wonder what happened.

I think you start working and the only "fun" situations you are in are meetings at a pub after work with drink involved. After few years you naturally start to associate fun off-work time with drinking.

We run out of fun

You forgot many to most adults that can have fun can do so without alcohol

Not at all, I’m referring mainly to those who feel like they have to drink to enjoy themselves. Of course there are adults who don’t have to drink to enjoy themselves (there are many who have never had a drink)

I saw some drunken adults. Looks like they are having more fun than babies, kids and teenagers. And they get some form of "support" by other adults, unlike babies, kids and teenagers would get if they behaved the same. Until it starts ruining your life, being a drunken adult seems fun and acceptable.

My take on it is that as adults you mature and begin to abide by all the rules of society. Alcohol lowers your inhibitions and "allows" you to act like you were as a child.

Babies and kids have a lot of fun with sugar, does that mean it's OK to consume it recklessly?

Ignorance is bliss

Yes, but wine makes food taste infinitely better. I don't want to eat my rare filet with a glass of water, I want to eat it with and chilled bottle of natural Syrah from the North Rhone (preferably Dard et Ribo)

You chill red vine? Savage.

Most reds are meant to be served a good notch below room temperature, but not quite as cool as whites.

Not all -- but some. Syrah tastes better at cellar temp or below (IMO), Gamay usually tastes great chilled also.

Why yes, I freeze all my candy.

I have tremendous enjoyment in my life without drinking. Running, hiking, biking, cooking, movies, road trips, museums, concerts, new restaurants, etc…

There are also enjoyable things that involve drinking too, but _needing_ a drink to enjoy oneself seems a bit hyperbolic for the average adult, no?

I hike and camp a lot with my kid’s Scout troop, and agree: there’s so much fun you can have without alcohol. That said, there’s also a time factor. When we’re up in the mountains, we have a couple of days dedicated to the activity, and we can all relax into it. When a bunch of coworkers go out after work, they’ve got a couple of hours to go from work-mode to play-mode before going home for the night, and alcohol can greatly facilitate how quickly a person can switch from one to the other.

I enjoy the same things you’re talking about sober (except maybe concerts — is that even legal?), but understand why a group of friends would start their evening together with a round of drinks.

Sure but if you are stuck at home because its 8pm on a tuesday because you work all day you can’t exactly go hiking. If you have money and time its easy to entertain yourself.

> Then at some point people, as adults, feel like they have to drink to enjoy themselves? I wonder what happened.

It feels like this question is disingenuous. You don't need fire starter to start a fire either, but wouldn't it be silly to conclude fire starter doesn't make starting a fire easier? Moderate alcohol consumption in an intimate environment is a lot of fun.

Put differently, if alcohol didn't present such serious health risks, I wouldn't be making an effort to cut it out of my social circles. As it stands, though, my friends, family and I have started referring to it as "poison", just to be totally transparent about what we're doing when we meet for drinks.

I don’t understand your comparison with a fire.

Your claim that moderate alcohol consumption makes things more fun is part of the point of my post. Is this actually true, or just a rationalization of people who already drink?

No judgement for those who do drink, by the way.

It is true. It allows some people open up in ways they wouldnt before. Your point could apply to psychedelics, are they necessary for personal growth and changing perspectives? No. Can they help & accelerate the process? Yes.

- anecdote from someone who doesnt like drinking much

I used to hate drinking and only drank very small quantities of alcohol at parties/gatherings. That's changed somewhat in the past few years. I've only been drunk 3-4 times in my life (I'm 29, male, living in a Western country), and even then it was mild (no blackouts, hangovers, feeling sick, etc.). However, I believe that when I do drink for social lubrication purposes, it does help. I'm quite introverted/withdrawn usually, and a few drinks definitely help with altering that balance a bit.

Of course, I've not done control trials on myself, with placebos and so on. It's just anecdata.

It's true.

I mean come one, are we really going to argue that huge numbers of people are just fooling themselves into thinking that alcohol is fun? Yes. It is actually true that alcohol consumption makes many social situations more fun for many people.

Before I continue, I think it's also important to note different people metabolize alcohol differently and feel its effects differently. Many Russians can take care of 0,5L of vodka in one sitting and still function. (Russian men aged roughly 20-45 also die from alcohol at absurdly high rates.) So as with all things, our discussion is purely a subjective one -- I find it useful, though, as it helps me analyze my own drinking habits.

> Your claim that moderate alcohol consumption makes things more fun is part of the point of my post. Is this actually true, or just a rationalization of people who already drink?

Right. It's a good question, and I don't know the answer, and I've tried hard to introspect and distinguish between rationalizing and it being true.

As someone pointed out above, the fire starter analogy is better than one might think -- if you are enlightened enough, you don't need alcohol to start a fire. In my experience, though, few things open up a conversation with a stranger as quickly as a little alcohol. I'm not saying I've never had an intimate conversation with a stranger in which we both showed vulnerability without alcohol. But the psychoactive aspect of intoxication makes those conversations with alcohol more memorable, stranger or closest friend. I've tried hard to determine whether I'm just fooling myself, or if alcohol is actually making something "funner". My conclusion is that if I am fooling myself, the trick is good enough that I'll probably never figure it out.

More apt analogy than one would think. lighter fluid and any product specifically labeled a fire starter do not really help if one has a basic understanding of fire except in extreme cases like for some reason the wood is soaking wet. And they have significant downsides in cost. lighter fluid is just gross. With even a modest understanding of how fire works all one needs is wood. Newspaper is good for charcoal.

“Fire starter” products are mostly only useful to people who don’t know what they’re doing or aren’t actually using it to start the fire but want to squirt in lighter fluid just to see big flames.

we're missing the point here, but newspaper isn't good for charcoal. You need sustained heat to activate charcoal--paper burns too quickly. The one time I tried to do this, I ended up slathering it in olive oil which would retard the flames a bit and drag the burn out.

It's fine if you don't like to drink, nobody is saying you have to, but saying that it doesn't lubricate social situations is just naive. Is it a crutch? In some cases, sure. In other cases--an enhancer.

With a chimney you use olive oil on newspaper?! Anyway enough about fire starting. To be honest if you’re having fun with campfires like once in a blue moon and don’t really know what you’re doing, a fire starter can be an okay crutch, but if you want to go camping often to have fun it’s much easier and cheaper to just use the wood and maybe a bit of paper. But that’s enough hijacking this thread to fire starting.

People come reliant on alcohol and can’t do it without it. It becomes a prerequisite not an enhancer. That sounds more parasitic than anything else.

> I wonder what happened.

What's the difference between the life of a child and that of an adult? You seem to be very close to figuring it out. (Tip: adults have little to no leisure time).

A bit of alcohol makes you feel good, there's no two ways about it. And, for many, it soothes their anxieties - or just loosens them up.

I can have fun without alcohol, no problem. But I can't deny that I like the taste of alcoholic drinks / beverages, and I enjoy the effect.

Same with sugar - I can enjoy a life without candy, but once in a while, I enjoy eating candy.

It's all about moderation.

"People with as yet undeveloped pre-frontal cortexes to limit their inhibitions, and analyze, second-guess and evaluate their actions before they take them, don't need a drug that specifically suppresses the executive functions of their PFC, so why do you?"

> I wonder what happened.

Among other things, alcohol became legal to drink. Adults take more road trips than babies and teenagers too, I wonder why they can’t have fun at home anymore.

I don’t really get this jump from “I enjoy drinking alcohol with friends” to someone accusing me of “being unable to enjoy myself without alcohol.” You could throw the same accusations at anyone for literally everything they enjoy doing. You can’t enjoy yourself without going out to see a movie! You can’t enjoy yourself without camping! You can’t enjoy yourself without listening to music!

- babies have fun without money

- kids have fun without money

- some teens have fun without money

Then at some point /some/ people, as adults, feel like they need money to enjoy themselves?

I believe it's really just cultural. If you spend time with people who don't drink, they often have just as fun a time as drinkers. Humans have been around for a while and if we couldn't have fun once in a while we'd be long extinct. I think people overestimate the necessity of social lubricants. This probably goes hand in hand with the greater culture as well-- at least in America I think it's seen as more necessary because socially its seen as weird to behave really friendly with strangers unless you're imbibed.

cheers!

reminds me of when the WHO said fertile aged women should not drink any alcohol and the wine aunts had a meltdown while also citing WHO as a source for anything covid related. hypocrisy at its finest.

I was unfamiliar with the term, so from the Urban Dictionary:

> wine aunt: An aunt with little to no interest in having children. Has much more interest in having a free and carefree life than the responsibilities of a family.

I know of a man who had a shot of 96 percent alcohol (192 proof) every single day and died at the age of 96.

Yes that is an anecdote. We get better info by looking at large groups of people and that is what the recommendation is based on.

Agreed, although a single shot of moonshine is a equivalent to a little over a pint of beer. You can drink that and be well within alcohol consumption guidelines in US. Even most alcohol-naïve people would only be minimally intoxicated from a single shot of moonshine.

The guidelines are probably wrong. All recent scientific data I see shows that, like most poisons, the best amount to intake is zero.

Here’s one for brain health.

https://www.medrxiv.org/content/10.1101/2021.05.10.21256931v...

"The dose makes the poison" - Paracelsus

I'm sure drinking has some effect on you, but I'm not sure one non-peer reviewed which by their own papers shows <18 drinks / week shows baseline within the uncertainty band is evidence of any noticeable mental decline. In fact several of the graphs, it shows an increase in matter volume for low non-zero amounts vs zero.

From Wikipedia: Survivorship bias or survival bias is the logical error of concentrating on the people or things that made it past some selection process and overlooking those that did not, typically because of their lack of visibility. This can lead to some false conclusions in several different ways. It is a form of selection bias. https://en.wikipedia.org/wiki/Survivorship_bias

should have gone for 98 percent alcohol, would have lived till 98 :-)

Damn! Good thing he wasn't drinking 40 proof spirits, otherwise he would have died much sooner.

My great grandfather sat in a chair and drank from his handle of whiskey every day until his death also at 96. I had heard stories of workers on his farm not realize he was drinking during the work day until the tractor plowed through a neighboring fence causing them to look up in concern to see him passed out on the seat.

I unfortunately saw many in my family use his fortunate long life span, regardless of drink consumption, as an enabler to drink like that. Including myself, up until about 90 days ago.

What happened 90 days ago?

I gave up drinking.

These studies have clearly run into some local maximum... the trick is to blow past it!

Yep, and there's always that one person who trots out that their grandmother smoked 2 packs of unfiltered cigarettes a day and lived to be 100. Anecdata is not data.

He was known to have said that it's the 4 percent water that's going to kill him.

The statement is only interesting when you consider a sizeable population who regularly drank the % alcohol and lived to 96. It’s a classic case of selection bias

I can't wait until they announce that DHMO (dihydrogen monoxide) is unsafe because it can so easily lead to death in children and adults. Perhaps no amount of DHMO is safe.

http://www.dhmo.org/facts.html

Aside from the still dubious "certainty" of this clinical conclusion, there are far too man y puritans on this comment threat hoping to optimize every last possible, squeezable ounce of supposed health from life by railing against alcohol as well. Quite simply, some things have social, personal and emotional benefits that might just be worth a bit more in the long run than being an absolutist who weighs the most minimal uncertainties of pleasurable acts at all times. To each their own, but what a terrible way to live a life, and especially with the full knowledge that many previous health studies by many large organizations have frequently fucked up in their claims that X or Y is bad or good, only to later change their tunes with new evidence.

Instead of downvoting, why not someone justify with a decent counterargument that goes beyond simply "alcohol is unsafe!"? Life comes with risk, many pleasurable activities come with risk. It's possible to balance between enjoying oneself and moderating one's behavior without sinking into a morass of absolutist, puritanical and medically ambiguous health "optimization".

Counter-point: Alcohol was key in the creation of the United States.

"In the drink, a dream; and in the dream, a spark."[1]

"...the Founding Fathers despised each other. Like, these bros couldn’t stand the sight of one another and it’s a goddamn miracle our country ever came to be, that’s how much they hated one another."[2]

In 1787, two days before they signed off on the Constitution, the 55 delegates to the Constitutional Convention partied at a tavern. According to the bill preserved from the evening, they drank 54 bottles of Madeira, 60 bottles of claret, eight of whiskey, 22 of porter, eight of hard cider, 12 of beer and seven bowls of alcoholic punch.[2]

[1] https://books.google.com/books?id=s3SqDAAAQBAJ&lpg=PT9&ots=R...

[2] https://brobible.com/life/article/america-founding-fathers-b...

>Counter-point: Alcohol was key in the creation of the United States.

Some people theorize it was one of the main driving forces for agriculture and civilization itself.

https://news.stanford.edu/press-releases/2018/09/12/crafting...

A bit related, I can't remember the exact details but I read or watched somewhere recently that it was key in taking over some regions. They would gift village chiefs alcohol and have them sign away rights to their land under the influence.

How is that a counter to to claims about its health effects? They're not saying alcohol has no positives and it's for terrible people, just that it has negative effects on health.

I've taken liberty on the word "heart" to mean the overall character of a person. I.e. alcohol is beneficial in many other ways, and it must not be dismissed as "just a bad drug" in discussions.

It's a liberty you exploited because clearly the intent of that word refers to a physical heart. Nobody dismisses it as a bad drug, alcohol is too ingrained in human culture to ever be dismissed.

What's going on in this thread is scientific reconciliation and justification of ones own behavior. Lots of people live their lives off of scientific facts and conclusions to improve their own health and productivity. This new conclusion from the WHF flies in the face of an old conclusion and habitual drinkers of alcohol. Thus people need to twist and reconstruct the logic in such a way that their own behavior is justified.

>Nobody dismisses it as a bad drug

There's an instance right here:

https://news.ycombinator.com/item?id=30010131

Well, it's a small minority. A technicality basically. Alcohol is too ingrained in every culture to be anything other than that.

Sit down, John.

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