Response to the Comments on Alcohol
The good, the bad, and the ugly
My essay Against Alcohol prompted a lot of reader discussion – some good, some bad, and some downright strange.
Readers were correct to point out empirical inconsistencies in the book. It appears some basic fact-checking was not done by the author, Professor David Nutt (nor his publishers). We added in some of the errors we spotted in the book as notes on the original article. It’s not at Walkerian proportions, but it’s pretty bad.
Rob Wiblin writes:
In order to tell at what point the marginal cost of drinking exceeds the marginal benefit we also need a full accounting of the benefits people derive from drinking alcohol. Evidently many people believe or behave as if alcohol makes their lives better and gives them pleasure in some ways, and I expect they are right about that (I'm talking gross benefits, not necessarily net benefits).
I have no doubt the costs are also substantial and it's likely people in the UK and Ireland drink more than is optimal for their own wellbeing.
But given the measurement problems I don't really know how someone can know with any confidence where the optimal level of alcohol consumption lies (or that the optimal is zero).
Regardless, I do believe people should have a right to do things others feel are misguided and not in their selfish interest (barring truly exceptional cases). Living in a society without that as the general rule sounds very unpleasant and inasmuch as we don't follow that principle now I mostly do find it unpleasant.
I don’t know what the optimal level of alcohol consumption is. By way of analogy: the ideal number of murders is zero, but bringing murders down to zero would require some kind of dystopian police state. I think there is nothing objectionable in arguing that, at the margin, we should reduce the number of murders.
I feel less strongly about precise issues of policy than about issues of culture. There should be a strong cultural norm against drinking alcohol. You have a right to make bad decisions, but you do not have a right not to be judged for it.
You are talking about a product that people voluntarily consume, and there’s not even an attempt here to measure the enjoyment they get from it.
Seems to me that the problem with prohibitionists and those who want to reduce consumption of drugs is that they see that you can measure the costs of drug use, but we have no way of measuring the benefits. So because only the costs are measurable they assume it’s the only thing that exists.
You worry about the norm of alcohol consumption, I worry about the norm created by this kind of thinking as a threat to human liberty and happiness.
It’s true that the benefits of alcohol are hard to measure, and I don’t want to deny that some exist. However, some of the costs of alcohol are hard to measure too (the damage to productivity, the damage to families, and more). The measuring problem cuts both ways.
I also suspect that some of the benefits are illusory. For example, multiple people mentioned that alcohol helps them talk to members of the opposite sex. Part of me then fears that some people never learn how to socialise across the sexes, which would be a big underlying problem that we shouldn’t use alcohol to resolve.
As regards my alleged authoritarianism, it’s first worth noting that negative externalities are the classic example of a market failure, and taxation is a well-known way to remedy this. If people are not paying the full costs of alcohol to society, then in some ways the market for alcohol isn’t capitalistic enough: there is a ‘missing market’ in the secondary effects of alcohol. This is the same motivation as for a carbon tax: When producers can pollute with impunity, then trying to limit them is trying to satiate demand for a product of which the cost is zero.
As well as taxes, I discussed other regulations on the buying and marketing of alcohol. In defence of this, I would say that people are not perfectly rational consumers, and regulation is occasionally justified to protect themselves from addiction. There are lots of antibiotics and painkillers that we don’t make available without a prescription, for example.
I don’t believe people should be forced not to drink, but at the margin, I favour trying new policies to reduce the amount that people drink. Try a few policies, and let’s see what the new equilibrium looks like.
In countries without a drinking culture, such as Islamic cultures, they tend to develop other cultures such as hookah smoking. Doesn’t seem like much of an improvement.
I admitted in my post that there are substitution effects worth worrying about – for example, if you tax alcohol too highly, people might switch to more dangerous drugs. However, the size of this effect is an empirical question. I’d happily consider evidence that showed that the move to alternative drugs leads to more harm caused overall, but I’m not sure whether that would be the case or not. Sometimes people assume they already know how large the substitution effect is – reasoning from the conclusion to the evidence rather than the other way around.
He also writes:
The CDC estimated the cost of hangovers to the American economy as $249bn in 2010. The Institute of Alcohol Studies estimates a cost of £1.4bn a year for British productivity.
Such a vast difference in estimates just shows that both estimates are basically garbage.
On the contrary, the publisher’s fact-checking is basically garbage.
Anyone who pushes booze on folks or knocks them for being sober is a jerk. I can agree with you that the near-ubiquitous pressure to drink is probably overkill. Suggesting moderation is fine. But you lose me when you:
-Universalize your experience onto others. You don't enjoy it; that's fine. A -lot- of folks do. I don't want to speak for you, but this is not right vs. wrong. It's different strokes for different folks.
-Make incredibly subjective statements with massive implications that merit magnitudes more evidence than you or the author presented, e.g. "this seems like a sound policy", "alcohol is bad"; "alcohol occupies a sinister position...".
-Make -large- leaps based on limited data: e.g. that relationships and family lives would be healthier. That is a giant claim that's impossible to come close to proving, and flies in the face of my experience.
-Presume that government's or social norms' jobs is/are to optimize society towards some collective end, rather than facilitate individual prosperity...much of which is subjective. We all die; our time is finite, and exercising control of our daily activities is central to a meaningful existence.
-Imply that drinkers are at the mercy of industry groups and peer pressure. I'd guess it's the other way around: darn near everyone who drinks -loves- it, and -that- informs supply/messaging.
Alcohol has helped me befriend strangers; grieve a dead parent; dance at weddings; learn more about colleagues/clients; console friends; bond with family; open up about things I normally wouldn't; talk to romantic partners I normally would lack confidence to; etc.
Please leave those of us who are enjoying alcohol alone, and stop pushing these notions of a uniform idea of happiness/utility/"the good life".
This is not “different strokes for different folks”. If I didn’t like asparagus or something else inconsequential, I wouldn’t have written a blogpost about it. We’re talking about massive social harms here – this topic should be very much up for debate.
Saying that I can’t “prove” that family relationships would be healthier without alcohol is an isolated demand for rigour. We are talking about a fairly fuzzy topic that has arguments on both sides – it would also be hard to “prove” this one way or the other.
Maximising individual prosperity is one goal of government, but it’s not the only one. Alcohol can undermine the common good – recall its link to violence, for instance.
The claim that “damn near everyone who drinks loves it” is a huge exaggeration, in my experience. And if there is a small minority who still drinks despite not enjoying it, what explains why they do so? Peer pressure or social norms are very plausible candidates.
I deny that to be anti-alcohol, one is committed to a “uniform idea” of the good life. We’re talking about whether or not to consume one specific substance. Does that substantially diminish the breadth of beliefs, values, traditions, and goals you could pursue?
I’m persuaded that at the margin, many families and lives would be better with less alcohol. I’m not particularly optimistic about governments’ ability to optimise society toward a collective goal, so policy is not my number one response here, but I’m willing to consider it.
Christopher Snowdon wrote a whole blog post to rebuke me. We at the Fitzwilliam appreciate this attention (seriously!), but the article fairly quickly becomes unmoored from what I actually believe and is mostly an attack on David Nutt.
Argument 1: There are health benefits to moderate drinking
The evidence is so overwhelming that it takes a huge amount of motivated reasoning to ignore [health benefits from moderate alcohol drinking]. The response from the likes of Nutt is exactly the same as the tobacco industry’s response to the evidence on smoking and lung cancer in the 1950s. They dismissed it as a mere statistical association and demanded an impossible burden of proof.
It would take me hundreds of hours and statistical training to evaluate this claim. I don’t know – maybe there are health benefits from moderate drinking. But the health effects on problematic drinkers (which might be 5% or 10% of drinkers) are so overwhelmingly negative that it would shock me if the net effect on human health was positive.
I note that Snowdon doesn’t really discuss people who drink too much, or how they might be helped in a society with a lax attitude to alcohol. Now, you might say that whether someone is an alcoholic is very predictable based on genetic factors and so on. Again, maybe. But that assumes that people know whether they are likely to be problematic drinkers, which seems pretty unlikely. And I haven’t seen any pro-alcohol pieces that include caveats about how addictive you might find alcohol.
Argument 2: Productivity numbers are fake
So two-thirds of the ‘cost to society’ consists of lost productivity as a result of hangovers? As health economists tire of having to point out, lost productivity is not an external cost. If you are less productive, you get paid less and get passed over for promotion. The cost falls on you. It is not a cost to society and certainly not a cost to ‘the Exchequer’. In any case, drinkers seem to be more productive than teetotallers and get paid more, probably because they increase social capital and have larger social networks.
Fair enough: lower productivity is not a ‘cost to society’ in the strict sense of being a negative externality. I used the term ‘cost’ in a more colloquial sense that the no-or-low alcohol equilibrium is superior to the current equilibrium.
That drinkers get paid more is an interesting result. If we could determine causality, this would make me update my views in the direction of alcohol not being so bad for productivity. It’s certainly plausible that moderate drinkers make more money from social networking. In a world where everyone else drinks, you pay a social penalty for not doing so. But I think as a whole society would be better if going to the pub wasn’t such a big part of personal and professional socialising.
Argument 3: Alcohol duty > cost to NHS
…there are good reasons why we don’t ‘ease the burden on its workers’ by reducing our alcohol consumption. It’s because alcohol duty comfortably pays for alcohol-related healthcare costs and because the NHS is there to look after us, not the other way round.
Snowdon makes a good point that alcohol duty should be remembered when discussing NHS costs; apparently, it will raise £12.7bn for the government in 2022-23. This does exceed Nutt’s suggested cost to the NHS of £3.5bn. It doesn’t necessarily follow that alcohol is a good thing, or a neutral thing.
Argument 4: Cost in real terms
It does not cost less in real terms. It costs more in real terms. The price of alcohol has gone up by more than the cost of a basket of goods, i.e. above the general rate of inflation. It has come down in relation to average incomes which means that it is more affordable - making things more affordable is the whole point of raising incomes - but the price has not fallen in real terms. This is a common misunderstanding.
I’ll take the L on this one. According to this graph, the consumer price index in the UK is up 160% since 1988, compared to a 356% increase in the price of alcohol. In other words, alcohol is more expensive in real terms – and Nutt was sloppy and incorrect to claim otherwise. But alcohol has become more affordable relative to incomes, which is significantly more important to my argument.
Argument 5: MUP has been a failure
As for minimum pricing, the jury was still out when Nutt was writing his book in 2019, but his high hopes for the policy have not aged well . . . As I discussed in a recent post, minimum pricing has backfired horribly. The official evaluation concluded that…
“There is no clear evidence that MUP led to an overall reduction in alcohol consumption among people drinking at harmful levels or those with alcohol dependence, although some individuals did report reducing their consumption.”
This was my fault for not checking more recent figures. But note that we’re getting into the minutiae of tax policy here. In the report, it says that there was evidence of a substitution effect, wherein people switched from drinking cider to spirits. In my article, I mentioned taxing alcohol in proportion to its percentage alcohol content (which would prevent these cases where e.g. spirits get cheaper relative to cider). So it looks like MUP is worse than straightforward taxation, and that I made a mistake here. I don’t think that changes that taxing alcohol should be the first line of policy defence.
Argument 6: Hedonism
The only justification people need to drink is that they enjoy it. Same with vaping. Same with cannabis. Same with ecstasy. So long as you pay your way and don’t hurt anyone, do what you like.
Consuming alcohol hurts other people indirectly, by helping to normalise its consumption. Again, the benefits may be greater than the harms, but let’s not pretend that the harms aren’t real. Ultimately this is where Snowdon goes awry – he works very hard not just to say that he disagrees with me (fair enough), but that I don’t have a leg to stand on, despite there being some very clear downsides to alcohol consumption.
Snowdon and some other English libertarians have suggested that my personal dislike of drinking was some kind of gotcha. This is frustrating: If I loved drinking alcohol, but held negative views about its effect on society, I’d be called a hypocrite. Since I don’t like drinking it, my opinion is invalid. Apparently, these libertarians’ love of alcohol doesn’t bias them one little bit… Can’t we just agree to actually evaluate the arguments on their merit, and not degrade into ad hominem attacks?
Argument 7: Alcohol isn’t the default
What does this even mean? When is drinking alcohol the default? In a pub, I suppose, but even there you still have a choice. If you really don’t like drinking, pubs might not be the best place for you, especially if you’re going to spend the whole time citing dodgy factoids and demanding neo-prohibitionist legislation.
Either Snowdon is being deliberately obtuse (just a few lines earlier he states that 83% of British adults drink alcohol), or his personal experience is extremely weird. It’s pretty clear that drinking alcohol is the default in our society, where it is regularly bundled with team sports, hanging out with friends, and finding a partner, to form part of regular adult experience. If you opt-out of it – readers may wish to try for a short while – you might be surprised just how abnormal others think you are!
Fergus McCullough works at an energy startup and received an Emergent Ventures grant.
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