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> Nearly every patient in the developed world is aware that all three of these are bad

Smoking, yes, we seem to have broad support for that one (way beyond what the facts support, even, but that's probably for the best). But the other two? I don't think so. There's a lot of confusion out there about alcohol use. Most people still think small amounts are basically fine (maybe even good!), even though more recent studies [0] suggest that isn't true.

And we're trending the wrong way on obesity, too. [1]

[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

[1] https://www.scientificamerican.com/article/can-you-be-health...




It's practically impossible to to do a controlled study on any of these, so we'll likely never know for sure. If you were tasked with creating a study to determine, for any reasonable definition of "certainty", whether small amounts of alcohol increase or decrease one's lifespan, you'd never be able to come up with anything that passed any sort of moral or practical sniff test.

So what you are left with is trying to tease causation out of relatively loose correlation, which is and always will be so problematic as to be near useless. The results will always just support the researchers' pre-conceived notions.

Smoking is only so obvious because the rates of lung cancer there are an order of magnitude more. 80-90% of lung cancer is in smokers, while only 12% of Americans smoke. No other health issue is so clear, people who are moderate drinkers only have very slightly elevated risks of almost everything, so it could be confounded.


Drinking is the kind of thing where non-obvious long-term effects can only really be determined if any other cause of issues is ruled out. It doesn't seem to have a measurable effect on maximum lifespan (assuming it's not alcoholism), so I'd rate it rather low in the list of priorities.


> Most people still think small amounts are basically fine (maybe even good!)

Legalize safer alternatives now!


The article you linked (and in fact , no study exists) to support your claims about small amounts of alcohol. In fact plenty of evidence exists to the contrary.


“The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.” Seems pretty clear.

It’s likely that the risk of,(e.g.) one drink per month is also very low. What’s not here is the inflection point where alcohol consumption goes from a (subjective) minimal risk to an elevated risk.


I would just note here that the CDC is unequivocal on this point with respect to cigarettes, saying always that there is "no safe level of consumption."

I think that sort of language is basically absurd, but the message it sends is crystal clear: this thing is bad for you, even in small amounts, and you're doing harm when you use it.

I think the CDC could easily settle on the same language with respect to alcohol, if there weren't socio-cultural reasons not to.

Another aspect of this is that we discourage even light cigarette use because of the fear that users might become addicted and escalate their usage. [0] It's interesting how rarely you hear that kind of an argument against drinking alcohol, and yet, unlike with smoking, increased usage can actually be ruinous. On the day you take your first sip of alcohol you're accepting a 1 in x risk that you'll end up a problem drinker (where x is anywhere from 3 or 4 to 20, depending on what definition of "problem drinker" you're willing to accept).

[0] I remember many years ago when I was a very light smoker trying to find statistics online about moderate cigarette use and it was basically impossible, because every single statement about cigarettes was of the form, "you won't be able to only smoke a little, so don't even bother trying."


I know plenty of people who have 1 drink a day, I know absolutely no one who smokes 1 cigarette per day. I’m sure they exist, but not in my n of several hundred, so I’d bet that’s it’s pretty rare.

Smoking is also much more obnoxious and directly harms anyone near. This is a first order effect, not a 2nd order effect like increased risk of car accidents.


You are splitting hairs. A lot of drinking is due to social effects, for example drinking behaviours due to being around friends who are drinking.

Many cancer societies are now recommending zero alcohol, for example in New Zealand (where I have some reasons to trust the organisation): https://www.cancer.org.nz/cancer/reducing-your-cancer-risk/a...


And you're arguing against something I'm not saying, which is that people seem to have a harder problem moderating cigarette use, and that cigarettes are more obnoxious to other people.


Most people I know don’t moderate their drinking.

Sure, a drink or a cigarette a day is not so harmful. I do know people that only have an occasional puff when out socialising and don’t even have one cigarette a day,p.

You chose an unrealistic starting condition for your comparison. I agree one drink a day is surely less harmful than second hand smoking from a pack a day. But choosing those starting conditions makes for an unfair comparison, so I pick different starting conditions, in part because I live in a country where alcoholism is rife and binge drinking is normal. Excessive alcohol consumption directly harms the drinker (accidents, cancer, disease, mental health) and directly harms the family, friends and children of the drinker (alcohol has different harms from second hand smoke, and the secondary impact of an alcoholic person is sometimes more acute than chronic).

Disclaimer: yeah, anecdotal, but across a wide variety of my acquaintances.


Lots of people smoke cigarettes socially. There are in-jokes amongst smokers about the people who "don't smoke" who want to bum a cigarette in the smoking area outside at bars.

It's extremely common.

> Smoking is also much more obnoxious

I'm not sure I've ever disagreed more with a claim than I do this one. People who have consumed alcohol are practically unbearable to the sober. And that's before we get into stuff like the fact that alcohol is implicated in some staggering percentage of all violent crime. Or drunk driving. Etc, etc.


We’re talking about light use here. I very rarely drink, and people who consume a drink or 2 with dinner are totally fine to be around.

On the other hand, a person smoking 1 or 2 cigarettes near me is actively harmful to my health. If you want to find a field somewhere to smoke sure, I won’t find it obnoxious, but no one does that.

>Extremely common

sure I’ve met those people, I’ve never met one who does it anywhere near daily. Also most of the ones I’ve known drift in and out of periods of being heavy smokers.

Again I have met many people who can drink a glass of wine every night. I have never met a single person who smokes a single cigarette after dinner. To me that says there is something different about cigarettes that makes them harder to moderate.


> I have never met a single person who smokes a single cigarette after dinner.

On the other hand, there are people who smoke one cigar occasionally: cigarettes, for whatever reason, seem to be a lot more addictive than other forms of tobacco consumption.


Cigarette breaks are a great -feeling way to punctuate your day because they force you to step outside for a brief moment once in a while with only your thoughts, and so they easily become tremendously habit-forming.

The good thing about cigars is that they're terribly inconvenient. They're harder to acquire, harder to store properly, harder carry around, and they take nearly 10x as long to smoke. I've smoked a few cigars per year for almost 2 decades, and I can't imagine doing the same with cigarettes. Nobody really buys and smokes an entire pack of cigarettes in one night every few months (because it would be insane), but if they did, it's unlikely they'd become addicted.


> cigarettes, for whatever reason, seem to be a lot more addictive than other forms of tobacco consumption.

Excellent observation. What is in cigarettes is not really tobacco.[1] Also, cigarettes are intentionally more addictive than natural tobacco, and far more harmful.

According to the US Surgeon General Report Smoking and Health:

No. 1103, p.112 >Death rates for current pipe smokers were little if at all higher than for non-smokers, even with men smoking 10 pipefuls per day and with men who had smoked pipes for more than 30 years.

No. 1103, page 92 >Among the pipe smokers.... The US mortality ratios are 0.8 for non-inhalers and 1.0 for inhalers.

...which means pipe smokers (smoking natural tobacco) who inhale live as long as nonsmokers, and pipe smokers that don’t inhale live longer than non-smokers.

Smoking anything is bad for you, but national brand cigarettes are deadly. There are over 300 added carcinogens in cigarettes. My personal feeling is it is the added carcinogens that is causing cancer, and not tobacco. So it isn't smoking, per se, that is killing people en masse, but smoking cigarettes made by Big Tobacco, which will be any national brand (other than Natural American Spirits, which guarantees the only ingredients are natural tobacco and water.)

Everyone smoked during the Colonial era, including nearly all the Founding Fathers. Native Americans smoked for centuries if not millennia. Ever heard of a Native American with lung cancer? Only after the Chemical Revolution did smokers begin dying en masse annually.

People feel very strongly about this, and usually the information I provide stirs a strong reaction, because everyone knows smoking kills! But the devil is in the details. Carcinogens cause cancer and kills people in droves. Smoking tobacco, actual tobacco, causes emphysema, not cancer.

[1] https://www.youtube.com/watch?v=gdV_1u-TodY&t=13m25s

[2] https://biotech.law.lsu.edu/cases/tobacco/nnbbmq.pdf


There seem to be a plethora of studies showing that hand rolled cigarettes cause lung cancer at similar rates to manufactured ones.

“Native American with lung cancer”

A quick google search shows Native Americans are more likely to have lung cancer.

If you’re talking about pre industrial Native Americans, it’s impossible to tell, because of a relative lack of written records and no accepted standard of what to even call lung cancer.

You’re entire post is so incredibly misleading. Look at the amount of tobacco smoked per capita between 1800 and the peak in the 1960s. The invention of the mass produced cigarette is certainly the cause of the increase in lung cancer deaths, but primarily because it made smoking tobacco much cheaper and therefore drastically increased consumption.


> There seem to be a plethora of studies showing that hand rolled cigarettes cause lung cancer at similar rates to manufactured ones.

That's good news, because it means you will have no issue citing these studies and the cancer rates of smokers of natural tobacco.

> If you’re talking about pre industrial Native Americans, it’s impossible to tell, because of a relative lack of written records and no accepted standard of what to even call lung cancer.

Lung cancer was first described medically in the mid 19th Century, a century before the Chemical Revolution in the 1950's. If smokers were dying as fast as they are today (and have been since the 1950's), someone would have noticed. But smoking only became linked to cancer in the 1950s, the very dawn of the Chemical Revolution.

> You’re entire post is so incredibly misleading. Look at the amount of tobacco smoked per capita between 1800 and the peak in the 1960s. The invention of the mass produced cigarette is certainly the cause of the increase in lung cancer deaths, but primarily because it made smoking tobacco much cheaper and therefore drastically increased consumption.

By the mid 17th Century, tobacco was so overproduced that it cost a penny for a pound of tobacco. Accounting for inflation, that penny is worth $4.29 today when a pound of loose tobacco costs about $15 and the average price of a pack of cigarettes, containing less than half an ounce of tobacco, is $8. Tobacco hasn't gotten cheaper, quite the opposite.

What dramatically increased consumption was that nicotine levels were intentionally drastically increased, and nicotine was intentionally made more addictive by chemically freeing it from its molecular base. Since the 1950's smokers of national brand cigarettes are literally freebasing nicotine. Along with the massive advertising budgets of Big Tobacco, it was a one-two-three punch that caused the peak of "tobacco" use in the 1960's. Mass production was incidental.

Again, let's not equivocate natural tobacco with what is in national brand cigarettes. I repeat, smoking anything is not healthy. But what is in cigarettes is a whole other level of lethal. The lung cancer rates of cigarette smokers is far beyond what it is for smokers of natural tobacco, and this is what the studies show.

And again, these facts disturb many as well as yourself, because Nancy Reagan and the American Lung Association did not discriminate. While a manslaughter is a bad thing, a mass murder is far worse. As we can objectively discriminate between a drunk driving fatality and Josef Stalin, so we also can scientifically discriminate between how lethal different types of smoking are.

For example there are hardly any cases of lung cancer among cannabis smokers, even if we can all agree that smoking anything is not healthy, it is far less lethal to smoke cannabis than it is to smoke, say, Marlboros.

In the same way, it is far less lethal to smoke natural tobacco than it is to smoke any mass produced national brand cigarette produced by Phillip Morris. But let me be clear to the curious: do not smoke. Smoking is very bad, and is made far worse by addiction. Once addicted to the nicotine levels in national brand cigarettes, it overwhelms the individual's agency to choose not to smoke. Nicotine addiction robs you of free will.

The only speculation I have made is why, that I believe the smoking gun for cigarettes causing lung cancer rates to skyrocket among smokers is the intentionally added 300+ known carcinogens, which started in the 1950's.

What is insidious is this all came out in the 1990's government case against Big Tobacco, the production methods and the chemical additives, all of it. Big Tobacco was fined, but they were not restricted in their production methods. They paid some of the fine, but the remainder, iirc more than half, was forgiven in the early 2000's. If the government wanted to make a dent in the cancer rates of smokers, they would have dismantled the industrial processes of producing those weird and bazaar things everyone calls cigarettes and incorrectly believe are filled with tobacco.

Tobacco has been demonized unjustly (and smokers, who are all victims, right along with it), because while tobacco has certainly killed, it's not as many as you think, while the substances that definitely have killed exponentially more continues to slip by unnoticed, the intentionally added chemicals like hydrogen cyanide, formaldehyde, ammonia. Hopefully we can agree that smoking hydrogen cyanide is worse for your health than smoking natural tobacco. And if we can agree on that, maybe we can also agree that it would be better for smokers, if they are unable to stop, to smoke instead just about anything other than national brand cigarettes. Maybe if we're just a little more honest about what has happened and continues to happen, we can reduce suffering and keep these poor souls around a little longer, and even if it is just a little longer.


Lung cancer was linked to smoking well before the 1950s, there were people who noticed the link almost half a century before. If you look at a graph of tobacco consumption per capita from 1900 to 1950, the shift away from chewing tobacco and to smoking tobacco easily explains the rise in lung cancer rates.

https://econpapers.repec.org/article/agsuersja/144742.htm

>What dramatically increased consumption was that nicotine levels were intentionally drastically increased, and nicotine was intentionally made more addictive by chemically freeing it from its molecular base. Since the 1950's smokers of national brand cigarettes are literally freebasing nicotine. Along with the massive advertising budgets of Big Tobacco, it was a one-two-three punch that caused the peak of "tobacco" use in the 1960's. Mass production was incidental.

Cigarette consumption increased exponentially from 1900-1950 and then the growth dramatically slows starting around 1950. Clearly the acceleration in growth happened and then reversed well before any changes to cigarette manufacture in 1950.

>For example there are hardly any cases of lung cancer among cannabis smokers, even if we can all agree that smoking anything is not healthy, it is far less lethal to smoke cannabis than it is to smoke, say, Marlboros.

Chewing tobacco causes oral cancer, this link was made all the way back in 1903. Clearly there is something different about tobacco, natural or otherwise.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246763/

>Since the 1950's smokers of national brand cigarettes are literally freebasing nicotine.

According to this study Natural American Spirit cigarettes had far more free-base nicotine than other brands.

https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?artic...

This study also finds that they have a higher nicotine content

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075288/

There are precisely zero studies showing that natural cigarettes are less likely to cause lung cancer. The only evidence you have is that lung cancer rates increased after 1950, which is also explained by the dramatic rise in smoking tobacco between 1900 and 1950. "Natural" pre 1950 chewing tobacco was suspected to cause oral cancer in 1903.

"Natural" pre 1950 smoking tobacco was suspected by many to cause lung cancer in the 1930s. In 1939, over a decade before the "chemical revolution" of the 1950s, Franz Hermann Müller, published an epidemiological study linking smoking to lung cancer. In 1943, another larger study by Eberhard Schairer and Eric Schöniger reached the same conclusion.

Clearly smoking cigarettes causes lung cancer, whether they are pre 1950 "natural" style cigarettes or not.


> Lung cancer was linked to smoking well before the 1950s, there were people who noticed the link almost half a century before. If you look at a graph of tobacco consumption per capita from 1900 to 1950, the shift away from chewing tobacco and to smoking tobacco easily explains the rise in lung cancer rates. https://econpapers.repec.org/article/agsuersja/144742.htm

You are grossly exaggerating with your assertion that any link was noticed "well before the 1950's," when the earliest historical evidence points to the late 1940s. What "people" noticed a link between lung cancer and cigarette smoking in 1850? I believe you invented this out of thin air. The Industrial Revolution also easily and more thoroughly explains the graph in that paper released when? Oh, 1956. Thanks for driving my point home.

> Cigarette consumption increased exponentially from 1900-1950

A four-fold increase indicated by the graph you cited is not an exponential increase. Again, you are exaggerating intentionally and deceptively.

> Chewing tobacco causes oral cancer, this link was made all the way back in 1903. Clearly there is something different about tobacco, natural or otherwise. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246763/

Your claim is again deceptive. The association published in 1903 was between oral cancer, tobacco, and poor nutrition. Regardless, this is a straw man argument, as I've never argued that chewing tobacco causes lung cancer; my argument only concerns smoking what is in national brand cigarettes verses natural tobacco.

> This study also finds that they have a higher nicotine content https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075288/

>>Results: Under intense smoking conditions, nicotine in smoke of NAS cigarettes averaged 3.3(±0.7) mg/cigarette, compared to 2.4(±0.4) in other brands.

Oddly, the study does not name any of these "other brands," nor defines what intense smoking conditions actually means, but it doesn't sound like average or normal smoker behavior to me. It seems obvious this study was funded by Big Tobacco in order to level the playing field with Natural American Spirits. Big Tobacco has been going after and suing independent natural tobacco producers and retailers ever since they came on the market.

> There are precisely zero studies showing that natural cigarettes are less likely to cause lung cancer.

If true, do you even realize what this means?? Absolutely nothing. But your claim here is, in fact, false. I have already cited the Surgeon General's report, Smoking and Health, which thoroughly proves otherwise.

> The only evidence you have is that lung cancer rates increased after 1950, which is also explained by the dramatic rise in smoking tobacco between 1900 and 1950.

You are deeply confused about the meaning of rates, because your claim makes no sense. Tobacco lung cancer rates prior to 1950 are what they are. Regardless of how many people were smoking, the rates would remain flat had nothing changed. Increasing the number of smokers does not increase tobacco lung cancer rates among smokers. After the 1950s, the tobacco cancer rate itself increased dramatically among smokers. That strongly suggest something changed with the product in the 1950s. Again, more people smoking doesn't increase the possibility of lung cancer in any of them. The chances were what they were, but the odds of a smoker getting lung cancer notably increased in the 1950s.

> "Natural" pre 1950 chewing tobacco was suspected to cause oral cancer in 1903.

I have no idea why you are going on about chewing tobacco other than to advance your straw man arguments.

> "Natural" pre 1950 smoking tobacco was suspected by many to cause lung cancer in the 1930s. In 1939, over a decade before the "chemical revolution" of the 1950s, Franz Hermann Müller, published an epidemiological study linking smoking to lung cancer. In 1943, another larger study by Eberhard Schairer and Eric Schöniger reached the same conclusion.

Again, you are inventing. Every study I have seen spotlights the 1950's, more accurately the period between 1949 and 1956, as when the first valid scientific studies regarding this correlation appear. And who really can tell when Big Tobacco companies began treating their product with deadly chemicals? The 1950's Chemical Revolution was driven by DuPont and pharmaceutical companies, is somewhat specific to the increase in use of prescriptions and plastics. The Chemical Revolution proper has its origins in the 18th Century. Also, not for nothing, that famous Müller study has been debunked.[1]

> Clearly smoking cigarettes causes lung cancer, whether they are pre 1950 "natural" style cigarettes or not.

Not according to the US Surgeon General's report, Smoking and Health, that I have already cited.

Your argument seems to be that smoking natural tobacco is precisely as lethal as smoking a partial tobacco product that has been infused with over 300 known carcinogens, when my argument is the precisely the opposite. My argument boils down to this: more lethal products are more lethal. I am astounded that you can not accept this.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640840/pdf/nih...


> On the other hand, a person smoking 1 or 2 cigarettes near me is actively harmful to my health.

This would be impossible to verify and strains credulity. People have gotten a little too comfortable making outlandish claims about the effects of secondhand smoke.


Are you interpreting my comment to mean that there is a measurable health impact from the 2nd hand smoke of 1 cigarette?

The EPA and the CDC have outlined the risks of 2nd hand smoke pretty clearly and convincingly, with a plethora of citations, if you care to google it.


This is incredibly easy to verify, and is a daily reality for quite a lot of people. Some of whom I love a lot and I get to see first-hand the impact on their life.


> On the other hand, a person smoking 1 or 2 cigarettes near me is actively harmful to my health.

I think you have a strange way of placing responsibility, because I am nearly certain what is actively harmful to your health is choosing to remain in the proximity of someone that smoked not only one cigarette but more than one. We know why they're smoking: they're addicted to nicotine, and it's unlikely they chose to become addicted. Why would you linger near them? Is it peer pressure?


Because they linger near the entrances of buildings, or are otherwise in a place I would like to be.

If someone walks around swinging a chain, so that everyone who doesn’t want to be hit has to run away from them, would you say that’s is my fault when I get hit?

Talk about victim blaming.


> Because they linger near the entrances of buildings, or are otherwise in a place I would like to be.

If the smoke doesn't alter your desire to be there, then it is still your choice to be there.

> If someone walks around swinging a chain, so that everyone who doesn’t want to be hit has to run away from them, would you say that’s is my fault when I get hit?

This is both the weak analogy and straw man fallacies in one.

> Talk about victim blaming.

One can believe you were offended, briefly, when they initially lit up, but once you stayed after they continued to smoke near you and completed their smoking, and then smoked a second cigarette, unless you were being restrained and prevented from leaving, then you were not being victimized. Once you chose to remain, you are stubbornly victimizing yourself. It is your choice to be offended when it is easy enough to walk away. Smoking is legal, and there are no stand your ground laws concerning it. If you were legitimately being victimized and you had the ability to move away, if you were rational, that is exactly what you would do. It would be similarly absurd for the smoker to be offended that you stayed within their secondhand smoke. You are in charge of you and not of them.


The fact that I can avoid harm by leaving the place where I otherwise want to be doesn’t mean that the person causing harm bears no responsibility. This is known in my he literature as the “Bart Simpson I’m just walking towards you swinging my arms defense”.

It also doesn’t change the fact that I am annoyed that I have to leave the area I otherwise desired to be in when someone else decides to smoke.

In most of the US smoking near the entrance to a public building is in fact illegal.

If I am waiting under an awning for an Uber in the rain and you decide to light up, you are an obnoxious, asshole, scofflaw who is actively harming me. Despite the fact that I choose to accept that harm rather than stand in the damn rain.


These are all straw man arguments and not mine. And these arbitrary decisions you describe are just as irrational and exhibit just as much entitlement as the smokers that you allow to aggravate your paranoia and are apparently stalking you. I trust you drive an electric car, because if your vehicle has an exhaust, and if you've ever parked with the engine running, the hypocrisy here is overwhelming.


Good think I use natural gasoline that doesn't contain any of those dangerous cancer chemicals that the man started adding in 50s.


It will convert easy enough to burn ethanol for much better performance and clean burning, but at the cost of a few less miles per tank.


I'm not going to pull up statistics based on arbitrary consumption thresholds, but I would reason there are way more consumers of alcohol around me than smokers. Yet the number of times I've had to bear nuisance from smokers vs from drunkards is higher.

Generally speaking, (here) smoking is forbidden in most indoor-ish spaces - which is the only reason smoking is anywhere close to the same level of nuisance as drunk people. Note that the same people that would enforce "no smoking" can also do something about the "practically unbearable" drunk person. And in outdoor-ish spaces, you can often avoid being affected - except in e.g. restaurants, where someone chain-smoking on the neighbor table can ruin the evening.


Nice to meet you.

In college, for a year or so, I smoked one cigarette a day. Eventually, I decided any number was too much, and stopped entirely.

So yeah, it's a population that probably either graduates to a big habit, or gives it up completely. Fortunately I'm in the latter group.


Smoking a cigarette makes you want more. Drinking a beer doesn't do that.


You know there's a reason you don't offer even a single drink to a recovering alcoholic, right?

A single drink is unlikely to hurt anyone, as long as it stays a single drink.

There are a lot of people who can do a good job of not having that first drink, but have a really hard time stopping once they've had it.

And beer is the beverage of choice of a surprising number of alcoholics.

So yeah, for a lot of people, drinking a beer makes them want more.


> Drinking a beer doesn't do that.

There are a lot of binge drinkers that beg to differ.


Ever met a binge drinker? I have, starting at university. Find one of those people and ask them if drinking one beer makes them want to drink more. I think you might be surprised by the answer.


That does not support the claim that avoiding or stopping drinking lightly/socially will make you less likely to die or less likely to have disease. Drinking at all is associated with other unhealthy behaviors, alcohol drinking is just easy to tease out of data, but not necessarily causal. If you are a healthy person with healthy behaviors who drinks lightly (probably almost everyone reading this thread), there is no evidence that mortality or morbidity are increased with light drinking.


You really believe that light alcohol consumption carries no risk?

For example, no one has ever, in the history of humans, had a single beer which has impaired them enough to get into a fatal crash? Even a single such accident would raise the impact of alcohol above the baseline by some tiny amount.

Perhaps the impact is minimal but it certainly exists.


Someone in history has also teetotaled, failed to make friendships, and died choking on a piece of food while sitting at home alone.


I'm not sure what your point is. Yes if humans wouldn't need to eat to survive it would obviously be better to never eat anything.


The point is about the "social lubricant" role of alcohol.

We may like it or not, but since prehistory, alcohol helped groups, friendships and couples to spawn from nothing.

It is reasonable to ask if being sober and lonely at home is healthier than making social connections that alcohol helps to create and maintain.


That's a pretty strong claim there. Yes you are right that alcohol has a role a social lubricant. But to claim not having leads to being lonely at home is extreme.


I didn’t claim that it was a binary choice. I just claimed that non socialized people do exist and that they could benefit from alcohol.


I'm sober and making social connections plenty fine


I’m absolutely not implying in any way that alcohol is needed to make social connections. It’s just a fact, either in scientific research and historical research, that it helps tremendously.

You are fine and that’s nice. But my thinking was about people who struggles to socialize and suffer from it.

From a health perspective, are those people better alone at home or should they profit from the alcohol properties, even at moderate doses to create better connections ?

The question is important because socialization is important for your health. It greatly reduces stress and anxiety, it improves self confidence, and more generally, it gives you more luck in life. COVID lockdowns impacts on mental health are real, for example.

You seem to don’t drink alcohol (which, again, is perfect) so maybe you don’t know that its social lubricant effects (making shy people talk without anxiety, if you want) are effective at really low dose, way before being drunk.


You can socialize without alcohol and you should, like people do literally all the time. Imagine being able to talk to others only when you are "socially lubricated"... a slippery slope for alcoholism.

Struggling with socializing is a matter of being inexperienced at it, like you would struggle to play guitar or to swim if you've never done it long enough to be at least proficient at them. Luckily socializing is one of the few things we've been doing since we were born so we got a degree of experience there.

If the struggle comes from having underlying issues that undermine your ability to socialize, say, lack of self esteem, depression or any other mental health issues, those need to be addressed as well and drinking is not going to solve them.

Actually those conditions will most likely improve by socializing without alcohol. Alcohol is just a false friend.

As a moderate outgoing and sober person, alcohol actually makes me shy, it numbs me down and takes away the edge I've been sharpening all my life. In other words it prevents me from actually be myself.


20 years ago in college and while in the military I drank and partied like everyone else, and have all the stories to go with it -- so I'm extremely aware of the theoretical social benefits

Looking back however, there were really zero added benefits to the relationships that were "lubricated" by alcohol that we couldn't have gotten had we put more effort into doing something creative or actively community building - rather than going out to drink and flirt. All of my best relationships were formed this way.

In fact if I think of times I was aware of or involved in when bad things happened (luckily I never had any problems personally) - alcohol was almost always involved.

At this point I will always prefer figuring out something interesting to do instead of contributing to "drinking culture."


I didn't claim that. We are talking about population level trends, not individual anecdotes. The question is: does light drinking cause people to live shorter or worse lives overall? The answer is: we have no idea, and the answer may be that it has the opposite effect.


You have no idea of the actual baseline though. Perhaps the effects of one glass of alcohol on blood pressure and some random internal protein already give light drinkers an average extra three days of lifespan, which would far outweigh your one time a beer killed someone.


There's reason to believe those earlier studies used flawed methodologies:

> But there was a problem with many of these studies: They compared drinkers to non-drinkers, instead of comparing only lighter drinkers to heavier drinkers. And people who don’t drink are pretty fundamentally different from drinkers in ways that are hard to control for in a study. Their lives probably look dissimilar.

> Most importantly, they may be sicker at baseline (perhaps they quit drinking because of alcoholism, or because of a health issue like cancer). And something in these differences — not their avoidance of alcohol — may have caused them to look like they were in poorer health than the moderate drinkers. (This became known as the “sick quitter” problem in the world of alcohol research.)

> Lately, researchers have been trying to overcome that problem by comparing lighter drinkers with heavier drinkers. And the benefits of modest amounts of alcohol wash away.

And that even moderate amounts of alcohol are harmful:

> Their findings were stark: Drinking more than 100 grams of alcohol — about seven standard glasses of wine or beer — per week was associated with an increased in risk of death for all causes, they concluded. In the US, the government suggests men can drink double that amount — up to two drinks per day — but advise women who are not pregnant to drink up to one drink per day.

> A person’s risk of death shot up as they drank more. The researchers used a mathematical model to estimate that people who consumed between seven and 14 drinks per week had a lower life expectancy at age 40 of about six months; people who drank between 14 and 24 drinks per week had one to two years shaved off their lives; and people who imbibed more than 24 drinks a week had a lower life expectancy of four to five years.

My sort of baseline here is that nobody would think twice about this if they weren't motivated to justify continued consumption. It's fairly obvious that it's bad for you.

Source: https://www.vox.com/2018/4/24/17242720/alcohol-health-risks-...


But those weren't problems at all with many such studies. For example, this one showed light drinking reduces risk of leukemia by 10%: https://pubmed.ncbi.nlm.nih.gov/24986108/#:~:text=Compared%2....


Come on

> the relative risks (RRs) for all leukemia were

> 0.94 0.85-1.03 "any"

> 0.90 0.80-1.01 "light"

> 0.91 0.81-1.02 "moderate to heavy"

There is no signal there.


> between seven and 14 drinks per week

That's already heavy drinking in my book; drinking every day of the week, or binge drinking at least once every week? Somebody drinking that much already has a clear habit and is probably developing an alcohol tolerance, a major step towards alcoholism.

To me, a light drinker is somebody who has a drink on special occasions but not otherwise. One drink a week or less, so they're going several days if not weeks between drinking. I suspect the long-term harm from that is next to immeasurable.


Alcohol is enjoyable and I prioritize happiness and satisfaction. I’ll gladly trade in some risk for a delicious beverage and a buzz every once in awhile.


Smoking is also enjoyable and gives people happiness and satisfaction. That isn't the point. The point is that cancers caused by drinking/smoking/being obese are preventable by behavioural changes.


Smoking has a pretty bad risk/reward ratio.

It’s better with alcohol and that is already not an ideal drug in that regard


Does it, in the same quantities?

Is one cigarette a day better or worse for you that one standard drink?


I’ve seen estimates of the increased risk of cancer from drinking at about 10%.

But it’s really hard to find actual estimates, most web searches just turn up the same ‘all drinking is bad’ message. I suspect the effect is small enough to be difficult to quantify.

Whereas some research puts the risk increase for getting lung cancer from heavy smoking at 2000%, or more. Twenty times the rate of non-smokers.


> But the other two? I don't think so.

IIRC the argument about obesity is simply more cells = more chances for something to go wrong that turns into cancer.


Obesity also contributes to inflammation,fat cells release pro-inflammatory adipokines.


Does cancer ever start in adipose tissue?


Yes, but fat people also have more muscle and skin.


That argument would go against growing muscle and getting taller in general.

It might be true, but real world impact of that higher probability of some cancer seem to be negligeable.


Also, more food => morr oxidation => more damage.


> And we're trending the wrong way on obesity, too.

It's absolutely creepy how there's a constituency of people who are upset by any scientific possibility that fat people could be relatively healthy, or be made relatively healthy, without losing weight. The desire for fat people to conform or be punished, damn the science, is fetishistic. That's the only motivation I can think of for being upset by the exploration of the precise effects that being fat has on health.

I'm nowhere near fat right now, but if there were an injection that saved fat people from insulin resistance and inflammation, the farthest thing from my mind would be to get upset about it. If you believe that gluttony is a mortal sin, no need to be upset if the only ways fat people are punished on earth are cardiovascularly, through their knees, and through the aggression of bullies; your deity can punish them after death for not eating as moderately as you would have preferred.


I don't necessarily disagree, because yeah, having lots of adipose tissue doesn't necessarily mean anything is wrong at the moment. In my experience, the perpetually healthy fat person is a rarity. The possibility of being fat and otherwise healthy is used as an excuse the vast majority of the time to not actually address one's own health. If someone is fat, it would really be a good idea to get a DEXA scan to confirm that they don't have too much visceral fat. As any one who's pro-fat or body positive if they know what their level of visceral fat is and chances are they couldn't tell you what visceral fat is.

There should be a reasonable medium where fat people aren't outright shamed for being towards one end of the bell curve but red flags for unhealth aren't ignored for the sake of other's feelings. America and now many parts of the west are facing various health crises to such an extent that I don't think obesity should be brushed off as perhipheral to other problems. Being fat has many comorbidities, and just focusing on losing fat is usually the best way to address those issues.

> I'm nowhere near fat right now, but if there were an injection that saved fat people from insulin resistance and inflammation, the farthest thing from my mind would be to get upset about it.

I agree, and there kinda sorta are medications currently available that would tremendously help. Off the top of my head, I don't know what it's called, but I know some people who've been on next-generation medications for obesity that target the ghrelin-leptin balance, basically correcting one's sense of hunger and satiety. Having seen the results myself, it works insanely well.

On the other hand, solving obesity with a pill still has some moral issues. If everyone could just consume anything they want in massive amounts and not get fat, I don't think that's really good for a person's psychology in a similar sense that giving someone a bunch of money often doesn't end well. It's not a scientific argument, but a philosophical one; I know. Such drugs may also give someone the idea that they can just eat whatever they want because they don't gain weight, but just because you don't get fat doesn't mean there aren't other consequences to eating lots of sugar, carbs, odixated oils, etc.

The question should be why we are so fat now. But that would mean believing that experts can be compromised and that a century of nutrition policy has been a failure, which many people aren't ready for. Just my opinion.




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