The current issue of the Journal of the American Medical Association (JAMA) carries a lead article and accompanying editorial that are long on advocacy, short on data. The topic: alcohol consumption in America, who is drinking how much and how much is too much.
The authors present data that suggest American teenagers are drinking early and often and when the stats on teens are combined with some unknown number of heavy-drinking adults account for more than 50% of all alcohol sales annually. The authors go on to claim that half the teenagers who drink consume nearly fifty drinks a month and that "excessive drinkers" are also likely to be users of illegal drugs. They conclude by noting that the solution to the problem they have characterized is, in part, higher taxes on alcohol products.
The study comes from the National Center on Addiction and Substance Abuse, which is headed by Joseph A. Califano, Jr., who was Secretary of Health, Education, and Welfare under President Jimmy Carter. The source of the study alone should have been a red flag for the editors at JAMA: last year, the same group released a study, which later had to be withdrawn, that carelessly doubled the estimate of how much of the nation's alcohol was drunk by teens. In l994, the same authors were caught up in another misrepresentation of data, claiming that 28% of adults on welfare were impaired by drugs or alcohol, when the actual government estimate was more in the order of 4.5%.
And as if that were not enough to put the JAMA editors on notice, the new study had glaring inconsistencies and non-sequiturs:
The JAMA authors defined "excessive drinking" as anything over one drink per day for women and two for men. Think about that. Let's say you have a gin and tonic before dinner and two glasses of wine with your meal. You are, according to Mr. Califano, drinking "excessively." Clearly, for a healthy adult who is not planning on driving, that level is anything but excessive.
Stating that those who drink "excessively" one or two drinks daily are likely to be users of illicit drugs defies pure common sense. If they were to argue that those who consume over a fifth of distilled spirits a day are more likely to use drugs, well, maybe.
In considering drinking patterns, the authors regarded the twelve to nineteen age range as a homogeneous aggregate as if comparing a twelve-year-old girl who drinks two beers a day with a nineteen-year-old college junior who consumes two mugs daily were reasonable.
The researchers, in estimating who drank 50% of the nation's booze, lumped together two groups to reach that number: "teenagers and people who drink too much." What could possibly cause them to think of such a heterogeneous group as having some common base? As the points enumerated above suggest, there is too much variation within these categories of drinkers to treat all of them as though they were alcoholics though CASA is right in some sense that all teenage drinking is a problem, insofar as underage drinking is illegal.
Clearly alcohol abuse and misuse is a serious problem in the United States generally particularly among American teens, and on college campuses. A study like this one, however, diverts attention from sensible solutions by wildly exaggerating the problem and shifting the focus from problem drinkers to nearly all those who consume alcoholic beverages. Surely the best way to focus attention on the l0% of Americans who do misuse alcohol is not raising taxes. Why should the 90% of drinkers who use alcohol in a safe and health-promoting matter be forced to pay more for a pleasurable, life-enhancing product one which in moderation dramatically reduces the risk of heart disease?
The publication by JAMA of this flawed Califano study raises serious questions about the credibility of this prestigious journal and puts the spotlight on the inherent dangers of using the pages of a scientific journal to promulgate biased views in this case, anti-alcohol propaganda.