Drinking by numbers: should we count our alcohol units?

Saturday 29 October, 10.30am until 12.00pm, Henry Moore Gallery

The UK government recommends men limit their consumption of alcohol to 3 or 4 units a day, while women keep within 2 or 3 units, a unit being 8g or 1cl of alcohol. This recommendation underpins the government’s approach to alcohol policy and is implicit in responsible drinking initiatives supported by the drinks industry. Drinkers are encouraged to count their units much as dieters count their calories, and young people are taught from an early age to understand alcohol consumption in terms of units. Some even talk about how many units are ‘allowed’ rather than recommended. Meanwhile, doctors routinely ask patients ‘how much do you drink?’, even when it is seemingly irrelevant to our actual complaints. Does the idea of recommended limits make sense?

Critics argue the focus on chemically-defined quantities of alcohol is too crude, since it ignores such physical variables as body size, genetic differences, habituation to alcohol, how much drinkers have eaten and so on. A few pints might have no discernable effect on one person, but put another under the table. One member of the committee responsible for the recommended figures later admitted they were more or less ‘plucked out of the air’. Perhaps more importantly, though, unit-counting abstracts drinking from its cultural context – an alcoholic’s liquid breakfast is surely very different from a bottle of champagne to wet a new baby’s head. So should we make decisions about what constitutes ‘one too many’ based on cultural norms rather than the number of units?

Certainly the recommendations are jarringly at odds with the lived experience of drinking in Britain. Many if not most people who drink regularly get through considerably more than the recommended guidelines. Either they are too low to be credible, and should be raised or abandoned, or most people really are drinking too much and a serious cultural shift is necessary. The prevailing consensus in public health circles, and consequently in the media, is that the latter is true. So should we all cut down, or should we challenge the experts? After all, the recommended unit limits encourage just about all drinkers to think of their drinking as problematic, regardless of its actual effects on their health and lifestyle – and their own decisions about what risks are acceptable. Do public health initiatives fail to distinguish between genuinely problem drinking and normal drinking? Would it then be better, and more effective, to use commonsense, cultural standards to distinguish between normal and problem drinking, and scrap the idea of counting units altogether? Or are objective guidelines of some kind still the best way to help us all keep within sensible limits?

Listen to session audio:


Dolan Cummings
associate fellow, Institute of Ideas; author, That Existential Leap: a crime story (forthcoming from Zero Books)

Dr Richard Smith
chair of trustees, ICDDR,B; former editor, British Medical Journal; chair, Patients Know Best

Professor Raymond Tallis
fellow, Academy of Medical Sciences; author, philosopher, critic and poet; recent books include NHS SOS and Aping Mankind; chair, Healthcare Professionals for Assisted Dying

Christine Thompson
manager, UK government relations, SABMiller

Josie Appleton
director, civil liberties group, Manifesto Club; author, Officious: Rise of the Busybody State
Dolan Cummings associate fellow, Institute of Ideas; author, That Existential Leap: a crime story (forthcoming from Zero Books)
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