Today, Explained - Dry January

Episode Date: December 28, 2023

The start of a new year is increasingly a time when people choose to abstain from drinking for a month. We’re using the moment as an opportunity to revisit an episode from last year, about new health guidelines in Canada that raise questions about whether there’s any safe amount of alcohol to consume. This episode was produced by Amanda Lewellyn and Miles Bryan, edited by Matt Collette, fact-checked by Laura Bullard, engineered by Efim Shapiro, and hosted by Sean Rameswaram. Transcript at vox.com/todayexplained Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

You guys hear the one about young people not drinking as much anymore? Gallup did some polling on it. I'm going to quote it. Young adults in the United States have become progressively less likely to use alcohol over the past two decades, with the percentages of 18 to 34-year-olds saying they ever drink, that they drank in the past week, and that they sometimes drink more than they should all lower today. With 2023 almost over, we're hearing some of you are thinking about a dry January, but what about a dry February? What about a dry 2024? What about joining the Youngs and maybe

choosing to go for that mocktail or that non-alcoholic beer? I hear those taste not quite as bad as they used to. On Today Explained, we're going to revisit an episode we made earlier this year. It features some compelling research that might convince you to join all those youngs who would just rather not drink. Stay tuned. BetMGM, authorized gaming partner of the NBA, has your back all season long. From tip-off to the final buzzer, you're always taken care of with a sportsbook born in Vegas.

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1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Today is gonna be explained to you. Sean Sean Ramosferm here with Dr. Tim Namy, director of the Canadian Institute for Substance Use Research.

It's one of the groups behind the latest study on how alcohol affects our health, and we wanted to go straight to the source. Alcohol is related to a number of different causes of death. You know, it's a small molecule. It can affect DNA. So, alcohol, especially drinking over a small amount, is related to all the major forms of heart disease, like, you know, heart attacks, heart failure, irregular heartbeats, and high blood pressure. It's also related to, causally related to at least seven types of cancer, including colon cancer and breast cancer, and also a variety of stomach and intestinal problems

and liver problems. And we can also talk about the risk of injuries or accidents, which start to increase. That's more based on your, you know, how much you drink on any one occasion as opposed to your average consumption. And if you're like, cancer? Really? I gave up smoking on account of cancer? Just to give your listeners more of a sense of it, there are studies that have compared, for example, alcohol to tobacco to cigarettes as a cancer cause.

And it's estimated that one drink of alcohol is approximately the same cancer-causing potential as one to two cigarettes, depending on if you're a man or a woman. Another way to think about it is that for breast cancer, which is a pretty common cancer among women, for each drink, each additional drink that a woman consumes per day on average, that that results in about a somewhere between an 8 and a 10% increase of the risk of cancer over her baseline risk of cancer, right? So not everyone's, you know. But if we say that, you know, depending on what number you look at, like 1 in 12 women will develop, or 1 in 12, 1 in 11, 1 in 10, depending on what age you use, will develop breast cancer. An additional drink per day is about a 10% increase in risk. So it's an absolute 1% increase in the risk of developing breast cancer.

These are complicated messages to get across, but that's just to give you kind of a sense. All this might feel like a buzzkill compared to all those previous studies that said, go ahead and have a glass or two of wine a day. But Dr. Namy says that isn't actually what those studies said. Actually, the results of this study are actually very similar, which is even the previous studies that were thinking, oh, maybe a little bit of wine is maybe good for us.

What was very clear is that even in those studies, above even a half a drink a day on average, the risk started to climb up. But I think even there, the risks were underestimated. But if you view it in that light, what we're seeing in our study, which is based on thousands of studies over the past 20 years, it's kind of a consistent message that above very low levels of alcohol, the risk of an alcohol-caused death starts to increase. Before, it was like up to six or seven drinks a week. And now we're saying it's probably more like that risk starts to climb up, you know, starting at three drinks a week and higher. Hmm. But what my mom would say back to you is that the queen had a gin every day, if not multiples, and she lived to be like 98 or whatever.

Yeah. No, no. Well, I think that's great. Like, so all of these restaurants are massive averages, right? We are developing sort of national guidelines. For example, is the queen living longer because she has a glass of gin every night? Or is the queen living longer because she has the best doctors and she, you know, enjoys walks and has a healthy lifestyle and has no stress? Not saying, you know, I don't has a healthy lifestyle and has no stress. Not saying, you know, I don't know. I've never been a queen myself, right? But I'm just, if the queen lives to be 99, do we think it's because she drinks a glass

of gin or you think it's because she's the queen? I bet it's because she's the queen myself. But even if she weren't the queen or even if the queen wasn't in a very socially advantaged position, and we know that actually social advantage is probably the most important determinant of life expectancy and quality of life. Even if that wasn't the case, I think we all know, you know, the aunt or the uncle who drank like a fish and smoked like a chimney and lived to be 100. And we also know, you know, unfortunately, other people who like were super healthy, did everything right, and, you know, passed away of some god awful disease,

you know, in their 40s, right? So I think, again, these are giant averaging effect and, you know, long live the queen and her gin. But again, I think, making light of the situation, but I think that that's sort of the issue. We can all think of exceptions or drinking is sort of an upper, it's considered a luxury item because if you look throughout society, actually, people in middle and higher incomes are more likely to drink alcohol than people in low incomes. So again, I think we have to kind of keep that in mind when we're thinking about who lives longer and why. Does this study that you and your outfit published... My outfit. I like it. Does it purport to be the final word? Because I think part of the frustration here is people

can't keep track of whether it's good or bad or what's okay, one drink, two drink, three drink, and now maybe zero drinks. Again, not don't ever drink, but the least amount of risk is associated with zero drinks. You know, I feel like people just roll their eyes, but here we have one that feels to be, I don't know, different at least. Yeah. Well, let me ask you, because here at my outfit at the Canadian Institute for Substance Use Research, again, we were just one of 16 outfits across Canada that worked on this. As a scientist, I would say to you, absolutely, science is never definitive. Anyone who tells you that any study is definitive is probably not a great scientist, in my opinion. But what I would say to this is that this represents the best current science. We're using, I think, the best methods

that is the way that the World Health Organization calculates alcohol attributable deaths. And again, the main message that's coming out of these guidelines is actually consistent with all the other research, which if you boil it down, at the end of the day, if you drink alcohol and you want to help your health, drinking less is better than drinking more. How low you need to go, there's some play in that. But I can absolutely tell you that what is the most consistent finding in the literature that's been there for decades is that, you know, when it comes to longevity, less alcohol is the way to go. We did a show a while back on the social benefits of drinking. It was called The Case for Drinking. Human civilization requires people to cooperate.

And there's a line of thinking that, you know, alcohol may have helped us to do that. It sort of socially disinhibits us just enough to sort of cooperate. In a way, it may be similar to what religion did for early humans. I mean, essentially, just as early religions gave people something to rally around, alcohol may have played a pretty similar function. Did your study take into account any of those factors, or is that sort of a different question for you guys? First of all, there are, and we acknowledge this in the report, there are many reasons why people choose to drink or not to drink. Our report is primarily focused on health. You know, for some people, drinking alcohol has some of those kind of social benefits. Again, typically at really relatively low levels.

We also have to remember that also alcohol is a leading preventable cause of intellectual disability in children. Alcohol causes blackout. People often don't remember what they did in a state of intoxication. The dangers of that are enormous. We see domestic violence, abuse, rape, neglect occur in the context of alcohol. So, like, if we want to get into the social aspects, good and bad, of alcohol, we should consider the full spectrum of them. And again, I think in terms of the social benefits, those are happening more at the lower, you know, aspects of consumption. We didn't try to quantify those benefits.

But again, I think when you increase consumption, the number of harmful social consequences increases, and the beneficial ones start to decrease. So when people are deciding, you know, how much they want to drink, they're going to be thinking about a bunch of different stuff. And we just want to have good, credible information on the health aspects and let people kind of put that into the mix. Can I ask you about loneliness before we go? Sure. Because there's like a loneliness before we go? Sure. Because there's like a loneliness pandemic. You've surely heard of it.

Loneliness is deadly in its own way. It seems to be spiking across the Western world. And I wonder if there's like a competing phenomena here that people are maybe drinking less, and thus they're more lonely because they're socializing less, and they're not leaving the house. Do you think there is any relation between alcohol consumption and loneliness? I know you just listed a host of things that are negative associations with alcohol.

Is loneliness a byproduct of people drinking less? Well, that's an interesting way of thinking about it. I guess I'll just sort of go off the top of my head. I think it depends on what kind of activities you do. So for people whose social networks and a lot of their activities are very alcohol-centric, well then, if they stop drinking, they may lose some of those friends or some of those activities may be more difficult. But I think one of the ideas behind Dry January is to see how we feel not doing that and actually to like maybe reach out to other people

or to try other activities that are less dependent on alcohol because, lo and behold, they might be pretty good. And they might help with loneliness. So, actually, I think your question, which is a really good question, points to the fact that for many people, alcohol equates to being social or not being lonely. And I think that I understand that that's the reality for some people, but I also think that it's good for people to see all the other things that can open up to them when they drink less or not at all, other things that they can do

and sort of kind of achieve a balance. That was Dr. Tim Namy. His outfit is called the Canadian Institute for Substance Use Research. They're based in Victoria, British Columbia. We're going to take a break, and then we'll hear from a guy who hasn't been drinking since before it was cool. It's Today Explained. Support for Today Explained comes from Ramp. Ramp is the corporate card and spend management software designed to help you save time and put money back in your pocket.

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a member of the FDIC, and terms and conditions do apply. According to the Chronicle, there has been a big growth in non-alcoholic beers, wines, and spirits during the pandemic. The demand has become so high that sober bars and shops are opening up. Restaurants have also added non-alcoholic drinks to their menu, saying it's the same as offering gluten-free options to accommodate everyone's taste. Today Explained is back. Abstaining from alcohol seems to be having a moment, which is great news for Ross Henfler. Yeah, that's right. Like a lot of young kids, I grew up just thinking that drinking was one of the things you did on the way to adulthood. And especially as a young man, I felt a lot of pressure to drink and drink heavily at a fairly young age.

And I never liked the taste. I didn't appreciate the peer pressure that came along with it, the sense of having to prove my masculinity by drinking a lot. And fortunately, I was lucky enough, this is in the late 1980s, to encounter the punk rock scene and I met some people that were straight edge. So-called straight edgers don't even drink,

they don't smoke, and they don't do drugs. Who had made a commitment not to use alcohol, drugs, and tobacco and made it cool not to use. All straight edge is, is a way to live your life better, it's a way to live your life positive, and it's a brotherhood. And I fell in love with not just the hardcore music, but with that lifestyle as well. Straight Edge emerged in the punk rock and hardcore scenes of Washington, D.C. in the early 1980s, and it was really just a bunch of young people in that scene who loved the question-everything mentality of punk, the arts, the aggressive music, but weren't so interested in kind of the heavy drugs and alcohol use that were really going on in the scene at that time.

So there were a couple of bands, the Teen Idols and then more famously Minor Threat, who promoted kind of an alternative. Minor Threat wrote this song called Straight Edge, the idea being that one shouldn't be picked on or judged for the fact that they don't want to use, that there are other paths. And it was really a statement for individuals to live life in the way that they wanted to live life. But it must have struck a chord because even pre-internet age, it caught on all across the U.S. and soon beyond. And now, in 2023, is a worldwide movement with young people in many, many countries adopting the universal symbol, the X, on the hand or in a tattoo or on a shirt to proclaim their allegiance to that identity. Grown-up Ross still doesn't drink, and now he's a professor and the chair of sociology

at Grinnell College in Grinnell, Iowa. I asked him why there's so much less of a stigma associated with abstaining from alcohol in 2023. Yeah, I think in a lot of ways, attitudes have just shifted and there's not one perfect explanation for that. And I think it's important to note that there's declines in drinking, especially amongst young people in many different countries, you know, across Western Europe, across North America, Australia, New Zealand. This is really something bigger than any one, you know, one country or one state or one city. Speaking, you know, for the U.S. case in particular, there was a recent study in the Journal of the American Medical Association, the pediatrics version of that journal, that looked

at young people from 2002 to 2018, the number of college students that choose not to drink, that abstain completely, rose from 20% in the early 2000s to just about 28%, you know, in 2018. And the same was true for non-college folks who are almost at 30% choosing not to drink. So there is some good data out there that's just demonstrating that it's not as big of a priority for a lot of people. Teen drug use in the United States is in decline. A government study finds that the overall use of alcohol, marijuana, prescription medications, and illicit substances dropped among American teens last year. But why? What are these kids doing instead? Are they vaping? Are they spending all their time on TikTok? What is it? I hear they're not having sex either.

Well, you know, I have to say that as much as previous generations want to sort of say, kids these days have it so easy, that's just not the reality for young people today who, I think, in many ways experience a very uncertain future. I mean, all of the social problems that many of us think about on a daily basis, but they're just a little more risk averse. They don't want to do anything that might jeopardize their future prospects. They're not even sure if they work hard and go to university, if they'll be able to pay off their student loans or get a good job or just have a reasonable standard of living. So there's just a lot more of kind of being careful, you know, planning for the future. And then on top of that, I think that this decline in drinking in some ways overlaps with the rise of social media. According to Pew

Research, 97% of U.S. teenagers go online every single day, and 46% say they're almost constantly online. 54% of teens say it would be really hard to give up social media. Some young people feel like they're under constant surveillance, so anything that they do while intoxicated could be recorded by anyone, and they could be, you know, the next meme circulating at their high school or their, you know, their workplace or their university. And there's also just better ways to connect. So there are all kinds of groups, sober groups on Facebook, on Twitter, and there are people making TikToks about their sobriety. After five years of trying and failing, here's how I finally got sober. Whereas in the past, one might have felt really isolated in their sobriety, now there are ways to reach out and connect with like-minded others. Hey, my name is Dagan. I am fighting for sobriety.

Are we seeing residual benefits in society? Are there fewer alcohol-related deaths? Are there fewer instances of, you know, drunk driving? Do we yet see the sort of payoffs of fewer young people I think it's a really powerful thing to note that the heavy drinking of the 1990s and into the early 2000s wasn't just a natural state of affairs. It wasn't just something that was going to happen regardless. Like there were industries that were promoting this and profiting from connecting youth culture, especially to alcohol use. Hello? Hey, who? What's up? Nothing, V. Just watching the game, having a bud. What's up with you? You know, we find ourselves in, you know, kind of a culture where alcohol is almost inseparable from most social gatherings, no matter what your age. So when you say, let's grab a beer, it's never just about the beer. Come on, I'm buying you a beer.

And so I think the real impact here to keep our eyes on is will this cultural shift persist? You know, it's kind of remarkable to have people suggesting, you know, it's okay not to drink. It shouldn't be remarkable. But in the face of all of the pressures and all of the moneyed interests that, you know, we're profiting in many ways from people's suffering. It's pretty fascinating to watch unfold. To bring this back to your straight edge experience in the late 80s and early 90s, how does it feel to be someone who doesn't drink in 2023 for you? Yeah, I feel like I'm finally in better company. So I haven't had alcohol for well over 30 years at this point.

That means I went through my later high school years, all of my college and graduate school years and beyond being sober and often being the only person who was sober in my social circles. And so now to see people that have never heard of punk or straight edge, sometimes identifying as straight edge, even if they're not in the hardcore scene, it's kind of wild, actually. It's a little surprising. But for me, I just always wanted people to have a better sense of themselves and their choices. And we think of peer pressure as something that middle schoolers

have to deal with, not adults. We're supposed to grow out of that. But the fact is, is our social surroundings create our opportunities and constraints, and going against that grain can feel tough. So having gone against that grain for several decades, it feels good to see that that's beyond my little punk rock scene and is now more widely accepted. Ross Hentler, sociologist, Grinnell College. Our show today was made by Amanda Llewellyn and Miles Bryan with help from Matthew Collette, Laura Bullard, and Afim Shapiro. Thanks to Bill Shufelt at Athletic Brewing, too.

The podcast is taking a couple days off to close out 2023, but we'll be back in your feeds on January 2nd. Happy New Year. Thanks for listening to Today Explained this year and next year and the one after that and the one after that and definitely the one after that

and the one after that. Most importantly, the one after that one. And I'm thinking you'll probably stick with us the one after that. And if you don't come back the year after that, I'm never going to forgive you. But please join us the year after that.