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    Weighing up your cancer risk every time you drink isn’t rational — it’s miserable

    3 February 2016

    Dame Sally Davies, the Chief Medical Officer, has issued some seemingly autobiographical advice to the worried well of Britain. At a parliamentary committee meeting yesterday, she expanded on her claim that there is ‘no safe level’ of drinking:

    ‘I would like people to make their choice knowing the issues and do as I do when I reach for my glass of wine and think, “Do I want my glass of wine or do I want to raise my risk of breast cancer?” And I take a decision each time I have a glass.’

    This peculiarly gender-specific advice relates to epidemiological evidence linking alcohol consumption to breast cancer risk. According to Drink Aware, ‘women have a 9.5 per cent chance of getting breast cancer before they are 75. One study found that drinking every day — even a small amount — raises that risk to 10.6 per cent’. Put another way, the chances are roughly one in ten regardless of whether a woman chooses the path of self-indulgence or the path of self-denial. Moreover, it is a risk that needs to be put in the context of the proven health benefits of moderate drinking — particularly to the heart — but since Davies has previously dismissed these as an old wives’ tale, she fails to do so.

    If Dame Sally was serious about people making an informed cost-benefit analysis every time they uncork a bottle of wine, she would acknowledge the lower mortality rates among those who drink a moderate quantity of alcohol every day — and, indeed, among many of those who drink above her miserly guidelines.

    There is plenty to be said about those questionable guidelines (the latest episode of More or Less covers some of the issues very well), but let us put those to one side and examine Dame Sally’s injunction to ‘consider cancer risks with each glass’, as the BBC put it. She insists that she weighs up this trade-off every time she takes a drink. Just think about that. This is how she lives her life.

    Economists are sometimes accused of believing in a cold, calculating ‘rational man’ who scrupulously weighs up the costs and benefits of every transaction. The thing about homo economicus is that he doesn’t exist. Nobody could live like that. More importantly, nobody would want to live like that. Dame Sally is proposing a medical equivalent of rational man, in which every decision involves thoughts of cancer. In the midst of life, she is truly in death.

    It is difficult to see how such a life could be a happy one. I have never met Sally Davies. She could be the life of the party for all I know, but something tells me she probably isn’t. One of the great ironies of the healthy living movement is that those who wish to maximise their days on this planet seem to have the least to do with them. Mark Twain concluded his magnificent polemic against the proto-epidemiologists of the 19th century, whom he termed ‘moral statisticians’, by asking why they didn’t just ‘go off somewhere and die’ since they had no apparent use for the life they were so set on extending.

    There is a distinction between understanding risk and being so preoccupied with death that you can’t pour a glass of wine without thinking about tumours. Cross that line and you enter a dark realm inhabited by neuroticism, unhappiness and the Chief Medical Officer. Before long, your only pleasures in life will be reminding other people of their impending death and punishing them for living in a manner that displeases you.

    The lowering of the alcohol guidelines is merely the opening salvo in a renewed war on drinkers. Dame Sally is an influential, well connected and wealthy individual. She is bound to succeed on some level, but whatever she throws at us in the years ahead, always remember that if you are able to crack open a bottle of booze without dwelling on thoughts of cancer, you have already beaten her at the game of life.

    Christopher Snowdon will be speaking at the Spectator’s annual health debate at IET London, Savoy Place, on Tuesday February 9


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