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Issue 2 1997

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Special supplement: 30 years of the breath test

Special supplement: 30 years of the breath test Top of page

Comment

The tobacco sponsorship debate has provided a salutary warning to the new government that the British electorate firmly believes that " there is no such thing as a free lunch". Large donations to party funds imply an expectation of favourable returns. As Peter Kellner in the Observer (23rd November 1997 ) states, "One of Labour's crucial advantages in this year's general election was that most voters regarded the party as cleaner and less sleaze prone than the Conservatives. That reputation is now in jeopardy following the controversy over tobacco and Formula One......"

Let this be a warning to New Labour before it starts accepting donations from the drinks industry or its front organisation which in the past has "bought " favours from a Conservative government. On the Formula One Circuit companies like FOSTERS push a substance which, unlike tobacco, causes havoc and death on our roads. A Scottish Health Minister has already remarked that alcohol, unlike tobacco, can be good for the health. We hope this is not New Labour's official justification for alcohol sponsorship.

The social consequences of alcohol are only too clearly seen. This issue of ALERT highlights the one million children who suffer from someone else's intoxication and the thousands of lives still needlessly injured on our roads through inappropriate drinking. There is also the cost of criminal behaviour. As Jack Straw has pointed out, "Every year there are almost 1.5 million victims of violent attacks committed by people under the influence of drink. Every weekend people avoid their town and city for fear they will be attacked or intimidated by drunken youths. This cannot continue". Let us hope that New Labour resists the temptation to cosy up to the drinks industry.

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Children at risk from drinking parents

It is estimated that one million children are likely to be living with a parent whose drinking has reached harmful levels

Many of these children are trying to cope, unaided, with parents who abuse them physically, sexually, and emotionally, and who may fail to feed and clothe them properly. Too often children in this situation do not know where to turn for help. Their childhood disappears under a burden of responsibility they should not be asked to carry. In other families, where there is no history of abuse or conflict, children may lead relatively normal lives, despite their parents' drinking.

This is the stark message of reports published by Alcohol Concern, the national agency on alcohol: Under the Influence: coping with parents who drink too much, and by ChildLine, the free national help line for children in trouble or danger: Beyond the limit: children who live with parental alcohol abuse.

Both Alcohol Concern and ChildLine call for a national, Government led initiative to deal with the problem. The studies carried out by the two organisations illustrate the stress children experience, the fears to which they are subjected, and the collusion within the family to keep the problem hidden.

A number of key points emerge from the reports.

Children are as likely as their parents to fear the involvement of social services, especially when they are in a one-parent family.

Teachers need to be alert to the possibility of alcohol problems being the cause of problems at home. School counsellors have an important role to play here, especially as most parents will not be in contact with helping agencies about their drinking.

It may be that some time away from the family situation would help the child in question.

It is important to remember that children not only need help when the parent is drinking but also after this has stopped in order to help them resolve their own feelings and to adjust to the new situation.

Alcohol Concern also makes the point that professionals working with parents in treatment for alcohol abuse need to find ways of involving families in the process and helping them prepare for changed roles and a new family life. Many private specialist agencies and treatment centres provide family programmes with this end in mind but a great deal remains to be done.

The two reports describe in graphic detail what life is like for some of these children. They never know what to expect from their parents because problem drinkers behave unpredictably: there are wild swings from aggression and violence, to silent withdrawal, to talkativeness, or maudlin emotion. The celebration of family events, such as birthdays, becomes impossible. Children cannot bring friends home because they do not know what they will find: a parent unconscious, perhaps injured, vomiting, or incontinent. Children in this kind of family have to deal with these situations as routine.

It is not unusual for children to feel guilty or that they are somehow at fault for their parents' drinking. They react in different ways: some become difficult or unruly, others withdraw into themselves. There is the fear that the same fate awaits them as has overtaken their father or mother.

Of the children of problem drinking parents who contacted ChildLine, 51 per cent mentioned their father as the problem drinker, 33 per cent their mother, stepmother, or father's girlfriend, 7 per cent both parents, and 6 per cent mother's boyfriend or stepfather.

Alcohol Concern and ChildLine are calling for a national initiative to combat the effects of problem drinking in families, including a high-profile public awareness campaign - along the lines of the successful drink-driving campaign - to bring attention to the impact of drunken parenting. The aim should be, the report says, "not to accuse and condemn, but to inform, explain, and encourage parents to ask for help." Being drunk in charge of a child should be as socially unacceptable as drink-driving.

They urge the Government to take a lead in ensuring that all agencies in contact with children and their families recognise their responsibility to help parents to function better and to remove from children the fear that the family will be split up, unless there is absolutely no alternative.

The recommendations of the reports are that:

  • The Government should oblige local authorities to address the needs of children of problem drinking parents in their Children's Service Plans and Community Care Plans, giving authorities specific guidance and, where necessary, making extra resources available;

  • There should be intensive local training for doctors, nurses, teachers, social workers, lawyers, police, youth workers, and many others, to help them to recognise and support the children of problem drinkers;

  • Good quality family support, such as counselling, family mediation, and money advice, should be provided to help families under stress because of job loss, death, separation, and divorce - all things that can trigger drinking problems in parents left to cope alone;

  • Counselling services and support for young people who are actually caring for parents with drinking problems, including respite and crisis care for the parents to give the children a break, should be provided.

They also call for:

  • More support for women with drinking problems, including residential, community, and day care facilities, since women are more likely to be condemned for excessive drinking than men, go to greater lengths to conceal their drinking, and remain the main carers, so that their children are strongly affected;

  • Since violence is one of the main threats that drunken fathers pose to families, help for them in changing their behaviour, and steps to protect the victims of their violence;

  • Support for the partners of parents who misuse alcohol.

Sue Baker, assistant director of Alcohol Concern, said: "One of the main barriers to helping children whose parents have drink problems is the social stigma surrounding alcohol-related problems.

"Acceptance that this is the case would go a long way to help parents acknowledge their problem and enable them, and their children, to seek support. All parents want to do the best for their children and parents with alcohol problems are no different. They need support to help them ensure that their children are unaffected."

Valerie Howarth, chief executive of ChildLine, commented: "Most children who tell ChildLine about their parents' drinking problems desperately want to remain with their families. They often still love the drinker while hating their behaviour while they are under the influence of alcohol. Our proposals are aimed at keeping families together, while providing the back-up that children need, and encouraging the parents, who are themselves terrified of having their children taken away, to seek help.

"The right kind of help...could prevent many of the problems that result in the abuse of alcohol and harm to children."

She added, "We are not seeking to make people feel guilty about drinking, nor to raise parents' anxieties...

"We are simply saying that parents should not be drunk in charge of children. Children don't want it and shouldn't have to put up with it. But neither should we be blind to the desperation which turns people into problem drinkers, nor to the need to offer help rather than just blame."

The message in ChildLine's report is greatly strengthened by quotations from the children who have called them about the problems they face from a drinking parent.

"I hate the bastard. He comes in drunk and hits me and my sister for no reason."

"She says she doesn't love me and she wishes I'd never been born. I go to my room and cry. Dad left because of her drinking."

"I've been involved with drinking, drugs, fighting, I'm desperate to change. I don't want to be like Dad."

"I can't get on with my work at school because I'm always thinking about what's going on at home...Mum drinks and Dad left".

Under the Influence: coping with parents who drink too much is published by Alcohol Concern, Waterbridge House, 32-36 Loman Street, London SE1 0EE (0171 928 7377).

Beyond the Limit: children who live with parental alcohol misuse may be obtained from ChildLine, Royal Mail Building, Studd Street, London, N1 0BR, or by telephoning 0171 239 1097/1098.

Children can call ChildLine on 0800 1111 or write to ChildLine, Freepost 1111, London N1 0BR.

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Alcohol consumption among 11-15 year olds is increasing

This is the conclusion drawn in the recent report 'Young Teenagers and Alcohol in 1996' by the Office for National Statistics.

Although there is not a greater number of children in this age group drinking alcohol, those who do are consuming more. The average number of units drunk per week has more than doubled from 0.8 in 1990 to 1.8 in 1996 (1.9 in Scotland). This average is based on all children, not just those who had drunk during the week preceding the survey.

The author of the report, Eileen Goddard, says, "The average conceals wide variation in the amounts children of this age drink. The overwhelming majority had drunk little or nothing in the previous seven days, and most of the remainder had drunk only modest amounts. However, at the other end of the scale, 5 per cent of boys and 3 per cent of girls had drunk 15 or more units in the previous week." It would be interesting were a long-term study of children in this last group carried out to ascertain what proportion developed dependency problems.

Although the drinking behaviour of most children appears to be relatively modest, "a small but significant proportion of those aged 15" (3 per cent of both sexes) said that they drank virtually every day.

Fifty-two per cent of drinkers in their early teens identified their own home or that of a friend as the place where they usually drank. Twenty-three per cent said they drank at parties, 13 per cent in pubs, 13 per cent in clubs or discos. Twenty-five per cent said they drank in places other than those mentioned, presumably being those who drank outside in the street or in parks.

Over 70 per cent of 11 year olds who drink said they did so with their parents. Of the 15 year olds, far more drank with friends (60 per cent) than with parents (20 per cent).

Whilst it is illegal for anyone under 18 to purchase alcohol, whether it be in pub, off-licence, supermarket, shop, or other outlet, half of those who drink (about 30 per cent of all children aged 11-15) admitted doing so.

The report finds that "by far the most common place of purchase was the off-licence, mentioned by 27 per cent of drinkers. The next most frequently mentioned was a shop or supermarket, where 13 per cent said they bought alcohol. One drinker in ten bought alcohol in pubs or bars. Pupils appear to be able to buy alcohol at an earlier age in shops and off-licences than in pubs or clubs."

The author of the report concedes that over- and under-reporting are possible sources of statistical inaccuracy. One 11 year old boy was excluded as he claimed to have drunk 250 units during the week preceding the report. The three pupils who placed themselves in 50 to 87 units group were included. It might be thought that children of this age are more inclined to exaggerate their consumption as opposed to the tendency to under-estimate among adults. It is obvious that anyone abusing alcohol at significant levels is likely to be an unreliable source of accurate statistical data. "It can be assumed, however," says Eileen Goddard, "that since the results compared in this report are from surveys conducted in the same way and using the same methods of collecting information, non-sampling errors will be similar on each survey and so will not affect comparisons."

Given the huge publicity surrounding alcopops the report's findings in that field are of considerable interest. The main concern has been whether alcopops have encouraged children to drink who might not otherwise have done so. The report makes the point that this question cannot be answered from a single survey. It does, however, say that the "survey provides some support for the suggestion that those who drink alcopops may do so because the taste of alcohol is masked by the addition of fruit juice and cola, but little for the contention that were it not for the availability of alcopops, many children would not be drinking at all...It has also been suggested that alcopops are particularly attractive to very young drinkers: however, even the youngest groups covered by this survey were less likely to drink alcopops than they were to drink beer, lager and cider." Whilst there is little comfort in findings which show a preference for traditional alcoholic beverages amongst children who drink, it is significant that the cynical marketing of the young with alcopops does not appear to have worked. The fact that a tactic does not succeed cannot be claimed as proof of different intentions in the first place.

The drink industry's Portman Group has also issued a report, 'Drinking with Design: Alcopops, Designer Drinks and Youth Culture', by Kevin Brain and Professor Howard Parker. Having dismissed the over-reaction of the tabloid press, they nevertheless conclude that alcopops "have certainly found their way into the drinks preference of thirteen and fourteen years olds. Since this concern was one of the corner-stone predictions of the 'regulation' panic then the findings of our survey support these concerns."

Mr Brain and Professor Parker identify high-alcohol designer drinks, especially ciders such as Pulse, as a much greater danger than alcopops. A significant percentage of the young people questioned in their survey indicated that their choice of drink was governed by the desire "to get pissed quicker".

Portman Group Taskforce

More teenagers are drinking more per session, according to a taskforce set up by the Portman Group. Its report, 'Under the Influence', arrives at the following conclusions :

  • Dealing with alcohol misuse requires an understanding of alcohol consumption overall;

  • Locally-driven multi-agency work will be more effective than a national programme;

  • Teenagers welcome information but reject advice;

  • Confiscation powers might create problems if not implemented cautiously;

  • Heavy handed policing is in the long run counter-productive since for most teenagers who misuse alcohol their excesses are temporary;

  • The age of 14 appears to be a milestone, most teenagers have begun to drink by 15;

  • The purchase age should stay at 18, to be reviewed only if and when a comprehensive ID card is in operation;

  • Parents should be better role models, better informed, and less hypocritical;

  • The drinks industry should practise responsibility, not just preach it.

The members of the Taskforce were: Douglas Allsop, Executive Director of The Scottish Council on Alcohol; Cass Edwards, formerly Director of Fundraising at Youth Clubs UK; Charlotte Owen, '19' Magazine's Agony Aunt; Lynne Friedli, Senior Manager, Alcohol Programme, Health Education Authority; Anne Norton, Chairman of the Magistrates' Association's Licensing Committee; Simon Ward, Strategic Affairs Director, Whitbread plc; Allan Charlesworth, Assistant Chief Constable (Designate), Association of Chief Police Officers; and Jean Coussins, Portman Group Director, who was chairman of the Taskforce.

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Night Clubbers Alcohol Risk

Alcohol, rather than illegal drugs, has emerged as the greatest threat to night-clubbers, a conference has been told. Delegates from the police, local authorities, drug agencies, sex advisory charities, door supervisors, and club owners met at Cream Nightclub in Liverpool to discuss the dangers faced by clubbers.

The conference, sponsored by Liverpool University and the regional office of the NHS executive, was organised after hospital staff became alarmed at the number of injured revellers appearing in accident and emergency departments. Among the problems were 'PVC bottom' (the chafing which results from knickerless friction) and 'clubber's nipple' (a painful condition arising from jumping up and down for long periods clad in a string vest). More serious are the results of poor water supplies, indiscriminate sex, and over-enthusiastic bouncers. Chris Lucas, an accident and emergency consultant at Liverpool University Hospital, carried out research in a variety of nightclubs which showed alcohol to be the main danger: "Over the last year up to 1,500 of our patients have come from clubs. Very few incidents are drug-related. Most are indirectly or directly caused by alcohol - the largest group being victims of assault.

"There has been too much hype about the dangers of illegal drugs. The real dangers are still the traditional ones of bouncers and booze." 

Dr Lucas points to a range of heat illnesses, fungal and viral infections, painful joints, and stiff muscles which resulted from thousands of people in a sweaty room dancing the equivalent of a marathon.

Chris Lucas questions government policy. "There is no point in closing clubs down, which will just alienate a million people. Drug abuse is not as big a problem for the NHS as clubbers who are victims of binge drinking and violence.

"Club culture has created a challenge to medicine, presenting a new scale of intensity in exertion, crowd and noise, alcohol and drugs. The financial cost is considerable. Soon we will be unable to cope."

The figure of 1,500 clubbers who required hospital treatment in Liverpool represented almost 1.5 per cent of all casualty cases. If a cautious 1 per cent were applied nationally, then between 16,000 and 18,000 clubbers a year would require emergency treatment.

The restriction of alcohol sales and the elimination of glass bottles would solve many of the problems, Dr Lucas believes, "The number being treated for cuts is far greater than the number of drug cases. About 80 per cent of the cases we treat are due to drinking and violence, and 10 per cent due to panic attacks or other symptoms caused by drugs." The remaining 10 per cent are made up of injuries inflicted by the flailing arms of fellow dancers, falling off platform shoes, cigarette burns, and the uncomfortable 'PVC bottom' and 'clubber's nipple'.

Andrew Bennett of HIT, a drug information centre in Liverpool, argued that liberalising the licensing laws would ameliorate the problem. "It seems ridiculous that we have pubs closing at 11pm and clubs at 2am...It causes thousands of people to cram onto the streets all at once and transport and police are put under enormous pressure."

Mr Bennett's comments are at variance with findings in other places where a relaxation of licensing hours has occurred. In Perth, Australia, a study has shown a 125 per cent increase in violent and sexual assaults in and immediately around premises which had been allowed to sell alcohol beyond the usual hours. Experience in Edinburgh showed that the expected benefits from changes such as Mr Bennett suggests did not materialise.

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Alcohol Alert Digest

You pays your money...

The Government has announced that it intends to ban pub lottery games which a number of companies have introduced.

The Home Office Minister with responsibility for gaming, George Howarth, told MPs, without any hint of irony, that it is socially dangerous to allow such potentially addictive activities into pubs. He said, "There has been a longstanding concern on the part of all governments about the mixture of alcohol and gambling in certain kinds of premises." Ministers are said to be worried that the new games will be aimed at pubs used by the poor.

Inter Lotto defied the government's wishes and went ahead with its launch on 27th November.

Injecting alcohol...

The Home Office Police Research Group has revealed a disturbing practice growing in rural communities, of young people injecting alcohol as a means of achieving a quick high. They are exploiting the ready availability of alcohol as opposed to illegal drugs. There is evidence of children as young as 14 injecting spirits, or even cider and beer, intravenously. The result is instant drunkenness since this method makes alcohol seven times more powerful than when taken as a drink. Around 10ml of whisky, less than half a measure, is sufficient to put someone over the drink-drive limit if injected.

Injecting alcohol can introduce bubbles into the blood stream, blocking the flow to the brain and inducing a stroke. It is also very easy to inject a lethal dose, especially as control of quantity is unlikely to be a priority with users of the technique.

Workers in alcohol rehabilitation have encountered this phenomenon before, but usually in people in the advanced stages of dependency and not with any marked frequency. "It is madness to even think about about injecting alcohol," said Dr John Connolly, of the Department of Physiology and Pharmacology at Strathclyde University.

In a recent article, The Sunday Times interviewed a number of young people who had experimented. Lindsay, 18, a history student at Newcastle, injected bourbon whisky in order to win a drinking competition. "I wanted to show I was madder than anyone else." Presumably she succeeded.

The Home Office researchers chose Driffield in Humberside as a representative rural town. They found that drug abuse in general is increasing in such communities, as it has in cities. Although experts in the field say that the number of people injecting alcohol remains small, they are fearful of an increase.

A penny a pint...

Shepherd Neame, the small brewery based at Faversham in Kent, which claims to have been particularly badly hit by cross-Channel traffic in beer since the opening of the Channel Tunnel and the lowering of restrictions on imports, has taken the government to court in an attempt to have the last Budget increases in duty on beer declared illegal.

Lawyers on behalf of the company argued that the extra 1pence on the price of a pint of beer, which comes into force in January, contravenes European law requiring states to harmonise duties across the European Union. Mr Justice Keene, sitting in the High Court, granted leave for Shepherd Neame to seek a judicial review.

Member states of the EU are required to work towards excise duty harmonisation and forbidden to introducelegislation that contravenes the principle of the single market. Shepherd Neame has been granted a High Court hearing to decide whether the 1pence increase in duty breaches this principle. It is almost certain that the case will have to be decided in the end by the European Court in Luxembourg.

The Government is confident that it is well within its rights to apply the increase in duty and it is questionable whether the arguments put forward by brewers in general about the adverse effects of cross-channel traffic in drink are valid.

Statistics of UK alcohol consumption over the last few years do not reflect any major impact of cross-channel imports, legal or illegal. The trends in overall consumption, the consumption of individual drink types, and in on-sales do not appear to have been greatly influenced by the single market. The conclusion of the Treasury Select Committee that "industry claims that cross border shopping is primarily responsible for declining sales, particularly in the public house sector, have to be treated with considerable caution" appears to remain the case.

In the light of the fact that consumer expenditure on alcohol, per capita alcohol consumption, and, therefore, Government revenues, all increased in 1996, it appears that a substantial proportion of cross channel imports consist of additional purchases rather than ones which would have otherwise have taken place in the UK.

The Treasury Select Committee also concluded that "it is the brewing industry's costs and profit margins which have driven up the cost of beer, and until it addresses these issues the industry cannot expect the taxpayer to subsidise its operations by reducing excise duties."

The Government has set up a commission into the problem of cross channel smuggling and fraud.

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"Patron Saint" of travellers honoured

Representatives involved in public health and road safety assembled in London on 9th October for a special luncheon to mark the 30th anniversary of the 1967 Road Safety Act, which introduced the breathalyser and the 80mg. legal alcohol limit for drivers, and to honour Barbara Castle, the Minister responsible for the Act. The luncheon was hosted by Professor Brian Prichard, chairman of the Institute of Alcohol Studies.

Guests included Baroness Hayman, the present Minister of Road Safety; Miss Betty Boothroyd MP, the Speaker of the House of Commons and a long-time friend and colleague of Baroness Castle, and broadcaster and journalist, Nick Ross.

The Prime Minister, Tony Blair, and EU Transport Commissioner Neil Kinnock provided written tributes to Baroness Castle.

Speaking for the Association of Chief Police Officers, Assistant Commissioner Paul Manning also paid tribute to the tremendously beneficial effect of the 1967 Act over 30 years in saving tens of thousands of lives, and to the personal contribution made by Baroness Castle.

Turning to the future, Mr Manning said that 'the police service has now taken the view that there is clear evidence to support a reduction in the current acceptable level of alcohol in the blood from 80mgs to 50mgs.'

Mr Manning continued: "We are convinced this will save additional lives not only by curtailing the current drinking habits of drivers but especially by reinforcing to all drivers, including the younger ones, that really it is not safe to drink at all if you intend to drive.

I am aware of the arguments which imply that lowering the limit will not deter the hardened drinker who drives in excess of the current limit and that is why one of the other strands of our strategy is important - namely, targeted enforcement. In order to deliver this element... it is necessary to remove restrictions which control when police can administer a breath test. The present restrictions are now preventing us from targeting the persistent drunk driver or those locations to which they resort."

In her reply, Baroness Castle referred to the intense opposition aroused by the Act. She became public enemy number one for the licensed trade and its customers. There was a huge sense of outrage with some people believing that the 80mg. legal limit and the breathalyser interfered with human rights and were an infringement of civil liberties.

Baroness Castle said that she was delighted by the turnaround in public opinion and, in particular, by changed attitudes among publicans. She referred to The Licensee, the newspaper of the licensed trade, which had marked the 30th anniversary of the breathalyser with an article and an interview with herself. The article stated that the breathalyser had come to be accepted by both licensees and their customers. Not only that, but "Pubs have more reason to thank the introduction of the breath test than they have to criticise it, for it forced pub owners and individual licensees to reconsider the future role of their outlets and, in particular, that new role has meant a focus on food."

The event was a well-deserved tribute to the courage of Barbara Castle and an Act which has contributed to the saving of probably more than 60,000 lives.

The last word is best left to Lady Castle herself. In her autobiography Fighting All The Way she says, "As I had anticipated, the breathalyser, when it was finally launched in 1967, caused a stir throughout the land. My postbag was full of abusive letters, usually anonymous. One...showed a dagger dripping with blood over the words: 'We'll get you yet, you old cow.' Other letters were more conciliatory. One of then gave me an interesting insight into the mentality of the British male. It was from a woman who wrote, 'Thank you for giving my husband back to me. He used to leave me at home when he went to the pub, now he takes me with him to drive him home.' " Then there was the small boy who was asked by his teacher to name the patron saint of travellers. "Barbara Castle," he wrote.

...and finally remember
none for the road...

This year's £3 million Christmas drink drive campaign is aimed

particularly at young and middle-aged men who are confident they can "hold their drink". In it, drivers are warned not to accept even one social drink when driving over Christmas.

Ministers are concerned that the number of drink-driving deaths has not declined recently, having remained at the same level for three years. More than ten people die in drink-related motor accidents weekly in this country.

The campaign follows Transport Minister Gavin Strang's announcement that he is considering avariety of measures to reduce alcohol-related deaths on the road such as allowing police to target the car parks of pubs and restaurants. He plans to release a consultation paper in the new year on the lowering of the drink-driving limit (Alert passim).

Implying that the present limit is indefensibly high, a spokesman for the Department of Transport, Environment, and the Regions (DTER) said, "We will emphasise that there is the legal limit, and then there is...

...the common sense limit - which is nothing."

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Here's mud in your eye

Andrew Varley reviews To Your Good Health: The Wise Drinker's Guide by Dr Thomas Stuttaford

Until quite recently the name of Thomas Stuttaford was known only vaguely to me. If asked, I suppose I would have said he was the Editor of the Times' medical attendant. I might well have had a type in mind. You know the sort of thing, an amiable old buffer, half moon spectacles, robust tweeds, club tie. Definitely no nonsense about psychology, newly-invented diseases, or, God forbid, counselling. Probably from a solid, middle-ranking public school of Anglican temper, and, say, St Thomas'. Now, when his name is the currency of daily conversation --- well, mine, at least --- I learn that he was a Conservative member of the Lower House. Not only that, having been ejected from the Commons by the voters of Norwich South, he tried to get back in at two subsequent general elections. The Isle of Ely preferred Clement Freud. I do not know how I feel about that. On the one hand, I can be confident that he is not an earnest research medic officiously striving to extend my life well beyond the tolerable Biblical span, on the other, it seems rum to trust one's health to the care of a man who was anxious to be Member of Parliament. He also served in the 10th Hussars.

In my drinking days, it was a matter of some importance to consult understanding doctors. It was not my good fortune to find one whose background was the Members' Smoking Room and a cavalry mess. Dr Stuttaford's surgery, I like to imagine, must be a convivial place. Perhaps his patients pass round To Your Good Health: The Wise Drinker's Guide and

discuss vintages in the complacent certainty of enviable cardiovascular health. I cannot think for what other reason the book was written. Surely it cannot have been for the purpose for which I see it most used? Everyone I speak to in the field of alcohol rehabilitation admits the same experience in recent weeks: the problem drinker quoting Dr Stuttaford as authority for his abuse. Anyone whose alcohol intake falls effortlessly within the sensible limits defined by the government is not interested enough in booze to buy books on the subject. If achieving the limit is not effortless, then there is a problem. A History of Malt Whisky or The Wines of Bordeaux are not usually found on the shelves of moderate imbibers, still less so is a book extolling the health-giving properties of alcohol. Problem drinkers, on the other hand, are in denial and look for anything which helps them maintain this. These, along with people with an interest in the success of the drink industry, are the natural readers of Dr Stuttaford's book.

The drink industry will be delighted with To Your Good Health. Dr Stuttaford wants people to drink. He tells us so in one of the many anecdotes which litter the book. (Dr Stuttaford is very anecdotal and I am sure he entertains his neighbours at dinner parties. Indeed, a friend confirms this after sitting next to him at the Eton Medical Society Dinner, so my speculation about his school may be wide of the mark. I hope he is not sensitive on the subject.) He tells the story of a patient of his. This man, it is emphasised, was a very important City figure, the director of a bank. Unfortunately for a man in his position, he was allergic to alcohol when this was combined with the pressures normally associated with his job. This, it seems, was a serious disability when entertaining clients. Red wine led to arthritic swellings and it was necessary for the poor man's wife to unfasten his collar at night such was the painful state of his hands. He might "manage a glass or two of Chateau Lafite" if all was going well at work and home, but the awful possibility of a lunch without booze loomed. Fortunately for the bank's continued success, help was at hand. Dr Stuttaford found a cocktail of drugs which alleviated the symptoms of arthritis and allowed the director to put away the claret without offending clients. Personally, I would take indications of sobriety in my banker as a good thing, but this may be an eccentric view. The whole point of the story, which Stuttaford tells at some length, is that simply not drinking alcohol was an alternative so appalling that it could not be taken seriously: it was necessary to have recourse to a doctor able to supply one set of drugs in order to allow the successful ingestion of another. There is something seriously wrong with a banking system, let alone a medical practice, which allows this incident to be trotted out as an edifying example of responsible use of alcohol. By the way, the banker, relieved in retirement from the stress of lunching with clients, finds he is able to "drink as much as the next man." We are not told who the next man is.

Dr Stuttaford uses the expression "in these Calvinistic days". His intention, in choosing this particular adjective, is to tell us that any objection to alcohol is dour, repressed, and judgemental.

It is a hackneyed method, much favoured by Dr Goebbels, of rubbishing an opponent's case by saddling him with views and intentions he does not hold. There is a case being made for certain limited health benefits from alcohol and Dr Stuttaford does a good job of popularising its arguments. He omits to mention that they are very far from being generally accepted in the medical world whilst at the same time, again by facile use of anecdote, minimising the risks involved in the use of alcohol. This is sad, because in many parts of the book he speaks with sound good sense and rightly highlights some of the more florid dangers of abusive drinking. But why tell the tale of the City solicitor who, in aged widowhood, tippled all day to the horror of his family? Stuttaford paints a picture of a kindly old soul, doing harm to no-one, passing the last days of his life in gentle toping, but harried by Goneril and Regan who want him in a home enduring "enforced teetotalism". Grim thought, isn't it? Or what about Lady Smith, the widow of another Tory MP, drinking whisky from a silver teapot? Charm-ingly eccentric because her social position and money cushioned her.

Although Dr Stuttaford is as discriminating when he reports research as he presumably is when selecting vintages, the principal danger of To Your Good Health lies in these asides. The reader is asked to accept Stuttaford's assessment of each situation. It is hard to escape the conclusion that for him, the bankers, city magnates, and dowagers who pass through his consulting room suffer only from an endearing failing which impinges on no-one else. Real drunks, who do not drink madeira with coffee in the morning, who would not know a bottle of Chateau Lafite if hit on the head with one, and whose whisky drinking is not out of Georgian silver, are vulgar fellows a world away from the author's fantasy. The reader is being seduced into a conspiracy: we are gentlemen, we enjoy fine wine, decent malt; we discriminate, have civilised tastes. I shot that kind of line for years.

Dr Stuttaford is keen to display an historical knowledge and scatters authorities liberally throughout the book. Galen, Hippocrates, and Pliny rub shoulders with Chesterton, Rabelais, and Toulouse-Lautrec. Their views on booze are usually quoted uncritically. I was surprised not to find Dylan Thomas and Brendan Behan in the Index: both of them spoke favourably of alcohol. There is no reason to expect medical men to be familiar with Charles II's mistresses, but Faber and Faber fail their author when the Duchess of Portsmouth's name is misspelled in both text and index.

What is this tendentious book for? It seems to me that the only answer is to encourage us to drink. Sensibly, Dr Stuttaford would say. Well, up to a point, Lord Copper. What else can you make of this statement in the Introduction? "This tranquilising effect ...has made it (alcohol) a desirable part of any celebratory occasion by allowing us to be our natural selves." There you have it, drink is sexy (consult Macbeth's Porter), it is part of celebration, it empowers, but, more than this, "it allows us to be our natural selves." I am in two minds as to whether this statement is contemptible or pitiful. What is certain is that a man capable of penning such a sentiment has no business influencing attitudes to alcohol. But it makes me worry about Thomas Stuttaford himself. He thinks it is only possible to achieve authenticity by using a mind-affecting drug.

Perhaps this is a cry for help. I have the number of a good counsellor, if Dr Stuttaford needs him.

To your Good Health: The Wise Drinker's Guide is by Published by Faber and Faber.

BOOZE AND THE FAMILY

Justifying the moderate drinker carries the risk of encouraging the abusive drinker. Why do it?

On the one hand...

"An alcoholic drink, because it dulls those parts of the brain which respond to the stress and strains of life, enables the weary worker to shrug off the worries of the day and concentrate on his family" DR THOMAS STUTTAFORD

...and on the other...

"Dad drinks and hits Mum. I took an overdose last week - I want to die. I can't talk to Mum because it only adds to her problems. It's all my fault." CINDY, aged 15

"Dad gets drunk every day, he hits me and Mum...we don't provoke him...he broke my arm once. If I have bruises he locks me in the house and stops me going to school. He says that if we ever tell anyone he will kill us...I'm scared...it's getting worse." TRACY, aged 12

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