[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...

[dionidium]

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.

[dahart]

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.

[robocat]

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.

[mc32]

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

[Brian_K_White]

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.

[nefitty]

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.

[GoblinSlayer]

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

[tagoregrtst]

“ 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.

[enzino]

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.

[dahart]

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.)

[lmm]

> 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?

[dahart]

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. :)

[cleansingfire]

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

[throwawaylinux]

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?

[dahart]

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

[Brian_K_White]

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

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

[shard]

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.

[quantgenius]

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.

[shard]

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.

[dahart]

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.

[dionidium]

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

[derefr]

> 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.

[GekkePrutser]

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.

[CompelTechnic]

The bacterial spray isn't unique to smokers.

[scns]

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

[drzaiusapelord]

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.

[ifyoubuildit]

> 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.

[timpattinson]

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.

[cleansingfire]

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.

[Brian_K_White]

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.

[N1H1L]

> 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.

[01100011]

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.

[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.

[dleslie]

> 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.

[thrashh]

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?

[jimmaswell]

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.

[GekkePrutser]

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.

[sneak]

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

[shard]

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

[idontwantthis]

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.

[afcapel]

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...

[babypuncher]

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.

[wyclif]

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.

[tshaddox]

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

[tambourine_man]

Europe is the exception here, not the US.

[imtringued]

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).

[thirdsun]

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.

[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.

[tomp]

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).

[nitrogen]

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.

[WalterBright]

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

[ccakes]

> 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.

[dleslie]

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

[xyzzyz]

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.

[airstrike]

> 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.

[shard]

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.

[TameAntelope]

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.

[area51org]

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

[hcurtiss]

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.

[psyklic]

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.

[crocodiletears]

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

[noirbot]

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.

[cleansingfire]

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.

[josephcsible]

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

[zdragnar]

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).

[krrrh]

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...

[kortex]

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.

[drekk]

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

[artificialLimbs]

>> 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.

[groby_b]

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?

[artificialLimbs]

>> 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

[wolverine876]

> 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.

[mattmaroon]

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

[pirate787]

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.

[wolverine876]

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.).)

[chana_masala]

Should CDC also be involved in traffic laws too?

[HWR_14]

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".

[hidudeurcool]

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

[avar]

> 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.

[kaba0]

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

[pas]

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.

[pvarangot]

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.

[HWR_14]

> 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).

[josephcsible]

> 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.

[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

[Mathnerd314]

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.

[scoofy]

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.

[Mathnerd314]

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)

[scoofy]

>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.

[spider-mario]

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

[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.

[notahacker]

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!)

[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).

[lixtra]

> 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.

[jliptzin]

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

[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.

[slingnow]

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.

[kaba0]

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.

[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...

[robocat]

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.

[spider-mario]

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’?”)

[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.

[dionidium]

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

[Forgeties79]

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

[slingnow]

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

[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.

[estaseuropano]

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.

[vanusa]

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".

[nuclearnice1]

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...

[vanusa]

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.

[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...

[floatingatoll]

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.

[dataengineer56]

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.

[netizen-936824]

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

[RHSeeger]

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).

[munk-a]

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.

[cecilpl2]

> 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?

[AlbertCory]

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.

[netizen-936824]

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

[brnt]

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.

[floatingatoll]

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.

[robobro]

> The mind is part of the body

is it...?

[munk-a]

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

[brnt]

How could it possibly not be?

[lkfjasdlkjfsad]

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

[netizen-936824]

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

[importantbrian]

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.

[Zababa]

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/.

[nradov]

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...

[Zababa]

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.

[nouveaux]

"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?

[DarylZero]

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

[Zababa]

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.

[queuebert]

> 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.

[Seanambers]

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.

[Zababa]

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.

[throwawayboise]

> 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.

[AlbertCory]

> 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.

[clpm4j]

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.

[deltaonefour]

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.

[kekebo]

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...

[wholien]

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!

[loceng]

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.

[volkl48]

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.

[loceng]

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

[nimish]

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

You don't get attention for being modest.

[asiachick]

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

[dmurray]

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

[kunai]

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).

[frereubu]

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.

[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.

[avar]

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.

[ummonk]

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.

[paulryanrogers]

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

Is there a source?

[avar]

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...

[crummy]

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

[wolverine876]

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.

[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...

[bhk]

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...

[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.

[avgcorrection]

Another score for fasting!

[queuebert]

BRB, gonna fast the rest of my life.

[Semiapies]

That's definitely an achievable goal with sufficient dedication.

[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)

[shadowofneptune]

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.

[publicola1990]

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?

[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.

[AlwaysRock]

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.

[allturtles]

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.

[tomtheelder]

> 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.

[allturtles]

> 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.

[pasabagi]

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.

[PaulDavisThe1st]

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).

[slothtrop]

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.

[ericd]

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.

[AlwaysRock]

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.

[jghn]

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.

[slothtrop]

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".

[wing-_-nuts]

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.

[GekkePrutser]

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.

[deltaonefour]

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.

[slothtrop]

> 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.

[deltaonefour]

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.

[avgcorrection]

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.

[pcrh]

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.

[avgcorrection]

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

[zelphirkalt]

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.

[chucksta]

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.

[avgcorrection]

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

[pnt12]

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.

[soperj]

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

[chucksta]

No one is forcing you to work either

[thebean11]

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

[zelphirkalt]

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.

[thebean11]

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?

[lmm]

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)

[mrfusion]

Plus driving to buy food definitely makes you live longer.

[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.

[tarboreus]

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.

[tomtheelder]

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.

[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)