Comment by embedding-shape

9 months ago

The author says this about smoking:

> If you smoke, don’t. It’s going to kill you.

And then this about alcohol:

> I think it’s unreasonable to tell people not to drink alcohol if they like it.

Why is it unreasonable to tell people not to drink alcohol, but reasonable to tell people to stop smoking? Shouldn't the smoking section also get a "at least make sure it’s really good tobacco that you enjoy and don’t smoke too much of it"?

It seems like the personal preferences (don't like smoking, but does like alcohol) is getting in the way of their medical-but-not-medical advice, instead of being able to apply their recommendations equally regardless of what they personally like.

The inconvenient truth that the vast majority of adults refuse to acknowledge is that there is no safe level of alcohol. Any drink is going to damage you, marginal though it may be. Unfortunately the healthiest thing you can do is simply never drink alcohol.

  • > no safe level of alcohol

    I hear this kind of phrasing frequently in the discourse nowadays, but it doesn't seem like a useful framing to me. Is there a safe amount of chocolate? A safe amount of sex? Are we supposed to stop enjoying every pleasure of life as soon as someone does a large study with high enough statistical power to show some negative effect on health, no matter how small?

    The question is whether the enjoyment we derive from these things is worth the risk, not whether there is a "safe level", whatever that means.

    • The phrasing is important as the discussion about personal decisions needs to start from acknowledging it’s a poison, which was not the case for the last centuries. We’ve had narration that some wine and beer is safe and that was incorrect.

      Chocolate is beneficial in moderation as far as we know so not sure why you brought it up. So is consexual sex with repeat partner.

For alcohol, the default is social drinking which is why you don't have widespread alcoholism in most countries where people consume plenty of alcohol. For smoking the default is constant nicotine top up(the nicotine delivery is instant, lasts seconds to minutes and the withdrawal symptoms starts in an hour). Both harmful of course but the alcohol has much less harmful defaults.

  • “Alcoholism” is outdated and has been widely replaced by AUD (Alcohol Use Disorder).

    I looked at Germany, according to Wikipedia the average consumption of pure ethanol per person per year in Germany as of 2019 was 12.2 liters. This was the 5th highest in the world, and equivalent to 686 standard 5% beers per year.

    According to the WHO “moderate drinking” is 1 drink per day for women and 2 drinks per day for men, so the average German is already consuming above WHO guidelines.

    It gets worse when you consider that about 1/4 of Germans don’t consume alcohol at all, and another 1/4 barely consume any, suggesting that the “average” isn’t really telling us much and the 70th, 80th, and 90th percentiles have very concerning consumption numbers. I assume most of those people consider themselves “social drinkers” but statistically they cannot be.

    • The top 20% consumers consume a large majority of the alcohol, which means there are many Germans who consume reasonable amounts.

    • And yet, the Germans are having long and healthy lives just like other drinkers like France, Spain and Italy. So maybe just relax and have a drink.

      3 replies →

The risk factor of conventional cigarette smoking is much higher than drinking. All other forms of smoked tobacco consumption are extremely niche.