[solox3]

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.

[dionidium]

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.

[dahart]

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...

[babypuncher]

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.

[mattmaroon]

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.

[scoofy]

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

[spacemark]

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...

[temporalparts]

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.

[ineedasername]

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.

[ausername42027]

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).

[hn_throwaway_99]

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.

[ABeeSea]

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.

[kaba0]

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.

[Xixi]

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...

[ethanbond]

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.

[quantgenius]

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.

[justatdotin]

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

[nuclearnice1]

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...

[vanusa]

“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.

[f38zf5vdt]

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...

[mam4]

Yes but "The Lancet"

[some_random]

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.

[jillianschuller]

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.

[ethanbond]

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...

[thinkling]

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.

[JumpCrisscross]

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

[jcadam]

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

[shadowofneptune]

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.

[ummonk]

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)

[slothtrop]

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...

[allturtles]

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.

[zelphirkalt]

> […] 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.

[gregwebs]

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...

[kirso]

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.

[BurningFrog]

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

[cleansingfire]

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?

[Kutta]

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)