It is fortunate that the editorial on alcohol consumption in Malta (May 24) followed close on the heels of an earlier report under the optimistic and reassuring title ‘Alcohol consumption below European average’ (May 14).

This editorial fortunately arrived in time to put the picture back into its correct perspective by looking more realistically at the writing on the wall. Neither the editorial nor the May 14 article elicited any website comment; this rather suggests that nobody is particularly worried about the rampant alcohol abuse among so many of our youngsters and the alarming finding that Malta ranked second for binge-drinking in this wide survey.

But then, we do tend to whistle in the dark in regard to our more serious problems; there are anyway more immediately important things to worry about – like the lack of parking space on our tiny island.

That Malta’s alcohol consumption is below the European average is meaningless because it is the pattern of drinking that determines the extent of harm. If the WHO findings are looked at more closely, and assessed realistically, the message should be a cause for great concern to our policy makers and Health Department.

The pivotal issue is this: it is how the alcohol is consumed – that is, the pattern of drinking – and not the total amount that is drunk annually that determines the health consequences.

In other words, in determining the harmful effects of alcohol, analysis of survey results must distinguish between episodic heavy (binge) drinking, on the one hand, and regular moderate drinking, on the other. Earlier studies on the harmful effects of alcohol yielded contradictory results precisely because they failed to take into account the pattern of drinking. They only looked at total average alcohol consumption over time.

It is now accepted that it is the pattern of alcohol consumption that determines the health consequences.

This became apparent after a study found that men in Northern Ireland, who tended to “binge” drink once a week, had nearly twice the risk of myocardial infarction or death from coronary disease when compared with French men who were regular heavy drinkers, some of who on average drank just over a bottle of wine per day, which is more than the Irish on an annual basis.

These results were confirmed by a subsequent meta-analysis which showed that the risk of heart disease was reduced at any reported level of alcohol, even up to heavy consumption, so long as it was consumed over two or more days a week

Put simply, regular alcohol consumption with meals or regular ‘social’ drinking is relatively harmless in comparison to heavy (binge) drinking – which is often done with the sole object of getting drunk, as is the case with many of our youngsters.

It is how the alcohol is consumed and not the total amount that is drunk annually that determines the health consequences

The drinking behaviour (i.e. ‘pattern’) of our young people therefore deserves to be given great importance by our health authority. In addition to the health consequences, heavy (binge) drinking in teenagers is also of special significance since such a binge drinking pattern between the ages of 15 and 19 is a predictor of heavy drinking or alcohol-dependence in later life. Thus the stage for future alcohol abuse or alcoholism has been set for many of today’s young generation.

To this are added the violence and risk-taking behaviour that often accompanies intoxication. Youngsters who get drunk are much more likely to be involved in an accident or assault, be charged with a criminal offence, contract a sexually transmitted disease and, for women, greater likelihood of unplanned pregnancy. In addition to harm to society in general, binge drinking is also associated with longer term health threats as an increased risk of overweight, cirrhosis of the liver, chronic pancreatitis and cancers.

Unfortunately little is done to encourage our young to indulge in wholesome activities. This leaves them with few means to make good choices so that a rite of passage has become the first time a youngster gets drunk. Not only is alcohol easily available; our young are subjected to enormous, mostly commercial, pressures to drink at a vulnerable age in such a way that drinking becomes a part of life and a major outlet.

The commercial pressures on our youth are such that alcohol consumption has been defended by those with vested interests on the basis that young people “need an outlet in life” and that drinking ‘moderately’ is part of the growing experience. This is irresponsible cant.

As the editorial rightly concludes: there is no room for complacency.

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