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When is the Seventh-day Adventist Church going to change its position on alcohol use?”
 
This question was asked of me during one of my recent itineraries when I had the privilege of speaking at an alcohol symposium, following an Adventist health professionals conference. I was stunned!
 
Studies abound that tout numerous benefits of alcohol consumption on heart health, and many people now are questioning the church’s position of total abstinence when it comes to drinking alcohol. But the simple answer is that the Seventh-day Adventist Church cannot change its stance, because it’s not merely an issue of physical health. So, how should practicing, health-conscious Adventists respond?
 
As a physician I understand the dilemma, and will seek to clarify the issue in order to help people make a well-informed, evidence-based, and, most important, spiritually sound decision.
 
We should avoid all things harmful, including—perhaps especially—those that cloud the mind and may impair our sensitivity to the prompting of the Holy Spirit, jeopardizing our relationship with our Lord Jesus Christ. Although the consumption of alcohol has many significant health risks, the prime reason to abstain remains a spiritually moral one.
 
Alcohol Consumption and Global Health
Alcohol consumption varies widely between countries, depending on cultural traditions. A disparity between developed and emerging economies also exists. Alcohol, like tobacco, is being exported to developing countries, adding huge burdens to already inadequate health systems. According to the “Global Status Report on Alcohol and Health,” released by the World Health Organization (WHO) in Geneva, February 2011:1
  • Approximately 2.5 million people die from alcohol-related causes each year;
  • Fifty-five percent of adults have consumed it;
  • Four percent of all deaths are related to alcohol through injuries, cancer, cardiovascular diseases, and liver cirrhosis;
  • Globally, 6.2 percent of male deaths are related to alcohol, and 1.1 percent of female deaths;
  • One in five men in the Russian Federation and neighboring countries dies from alcohol-related causes.
The pattern of alcohol consumption is changing, as mentioned previously. Figures for 2001-2005 released by the World Health Organization (WHO)2 revealed that worldwide, 6.13 liters of pure alcohol were consumed per year, per person, aged 15 years or older. This amount appeared to be stable in the Americas and the European, Eastern Mediterranean, and Western Pacific regions; however, marked increases were noted in Africa and Southeast Asia. Health risk increases even more when binge drinking occurs; in other words, when people drink to get drunk. Binge drinking may be defined differently according to the region of the world: in the United States more than five consecutive drinks for a male and more than four for a female; in Australia more than four drinks per night (previously, more than seven drinks per night for men and five for women). Binge drinking is increasing in many parts of the world, mainly among youth, but all age groups are affected.3
 
A recent book on research and public policy states that “alcohol is a risk factor for a wide range of health conditions and social problems. It accounts for approximately 4 percent of deaths worldwide and 6 percent of the global burden of disease, placing it alongside tobacco as one of the leading preventable causes of death and disability.”4
 
Alcohol is no ordinary commodity and is dangerous.
 
Risks of Addiction
Alcohol is a known addictive substance. The susceptibility (or likelihood) of becoming an alcoholic (euphemistically termed “problem drinker”) depends on numerous factors. The chance of alcoholism developing over a lifetime is 13 percent (13 people of every 100 who drink alcohol). If there is a first-degree relative (father, mother, uncle, aunt, grandparent) who suffered from alcohol dependence, this percentage doubles. If experimentation with alcohol begins under the age of 14 years, the percentage chance of dependence increases to 40 percent-plus.5 This demonstrates the importance of alcohol education from an early age and fostering relationships and connectedness with youth. This social support develops resilience, enabling youth to cope with difficult decisions and choices despite peer pressure. An additional and vital layer of protection for young and old is connection to a set of values, such as the principles of the Bible and walking with the risen Savior.
 
Alcohol and Cancer
Cancer is one of the leading causes of death globally. An interesting example of the relationship between drinking alcohol and cancer comes from the European Union, where cancer is the second-most-common cause of death and 2.5 million people are diagnosed with cancer each year. It’s estimated that 10 percent of cancers in men and 3 percent in women can be directly attributed to alcohol use. It’s further estimated that 30 percent of cancers in this part of the world could be prevented through healthier lifestyle choices. The 2010 Eurobarometer Report, however, found that 1 in 5 European citizens do not believe that there’s a connection between alcohol and cancer; 1 in 10 is totally ignorant of the fact that alcohol consumption can cause cancer.6 Sadly, being ignorant does not spare us the consequences.
 
There is robust evidence linking alcohol as a cause of breast cancer in women and colon cancer in both men and women. These findings have been summarized and reported in the World Cancer Research Fund’s comprehensive reports in 2007 and 2011.7 The point strongly emphasized in these and many other scientific reports is that there is no safe limit/dose of alcohol that may be recommended to avoid its carcinogenic effect. This places the perspective on any recommendation that alcohol be used for health benefits, even cardiac, because the associated side effects are real and dangerous.
 
Alcohol and Society
It is well known that alcohol use is associated (often causally) with accidents of all kinds: road fatalities, domestic violence, murder, rape, and other criminal activities. In 2010 Professor David Nutt and coresearchers published an analysis in the prestigious Lancet medical journal showing that in the United Kingdom alcohol is more harmful than heroin and crack cocaine. This is because the researchers focused on the effect the drugs/toxins had on not only the user but others as well (family, community, and society). Heroin, crack cocaine, and methamphetamine were the most harmful drugs to individuals.8
 
Alcohol is also the leading cause of preventable mental retardation in the world. This is because alcohol readily crosses the placenta and damages the developing brain of the unborn baby. Again, there is no safe level of alcohol consumption during pregnancy.9
 
Alcohol and Heart Health
For the past 30 years alcohol has been promoted as being “heart healthy” and protective against coronary artery disease. Much has been written in the popular and scientific literature on the subject. All the scientific studies have been retrospective analyses, which makes them subject to what are known as “confounders.” Confounders are factors that make interpretation of the results of the data being analyzed more difficult and also may result in erroneous conclusions. Naimi and others concluded in 2005 that some or all of the apparent cardiac protective effect of moderate drinking may be because of these confounders.10 Other studies have continued this caution and noted that the non drinkers included in many of the studies had more risk factors for heart disease, were less well-educated, had less access to health care and insurance, and were from poorer socioeconomic groups. Some included in the nondrinking group had been drinkers prior to the studies being done and had stopped drinking for health reasons.11 A recent paper by Dr. Boris Hansel adds weight to the view that the real explanation of positive cardiac outcomes in moderate drinkers is not that alcohol is protective, but that the average health status and healthful lifestyle in other behaviors, such as exercise and diet, is better than that of nondrinkers.12
 
In summary, taking into account the significant health risks related to alcohol use, it does not make sense to promote its use for heart health, especially when there are proven and safe interventions for heart disease prevention, such as daily exercise and a healthful diet.
 
Conclusion
We sometimes persist in trawling the shark-infested waters of the definite evidence showing the dangers of alcohol in search of one sardine’s worth of positive, healthful evidence in favor of alcohol use. Instead, we are blessed to have a blueprint that offers protection against the problems alcohol inevitably brings in its wake: informed choices, exercise, rest, healthful eating, fresh air and sunshine, pure water (within and without), trust in God, social support, a good dose of optimism, and, of course, temperance, which by definition encourages us to dispense entirely with all things harmful and to use wisely those things that are healthful and good. Temperance, lived through the enabling power of our gracious Lord Jesus Christ, serves as a foundation for a Spirit-filled experience that can celebrate life free from alcohol and its attendant ills.
 
So should people who don’t drink start to drink alcohol? Based on the evidence, definitely not! Should those who currently drink alcohol quit? Based on the same evidence, unequivocally yes!
 
“You are not your own; you were bought at a price. Therefore honor God with your body” (1 Cor. 6:19, 20, NIV).
 
To whom do we belong?

_____________
1 www.who.int/substance_abuse/publications/global_alcohol_report/en.
2 www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles.pdf.
3 Ibid.
4 Thomas Babor, Alcohol: No Ordinary Commodity, second edition (New York: Oxford Press, 2010), p. 70.
5 Richard K. Ries, et al., Principles of Addiction Medicine, fourth edition (Philadelphia: Wolters Kluwer, 2009).
6 www.eurocare.org/library/latest_news/alcohol_and_cancer_the_forgotten_link.
7 www.wcrf.org.
8 David Nutt, et al., “Drug Harms in the UK: A Multicriteria Analysis,” The Lancet, Nov. 1, 2010.
9 Alcohol: No Ordinary Commodity, p. 1,393.
10 Timothy S. Naimi, et al., “Cardiovascular Risk Factors and Confounders Among Nondrinking and Moderate-Drinking U.S. Adults,” American Journal of Preventive Medicine, 28, no. 4 (2005) p. 369.
11 Kaye Middleton Fillmore, et al., “Moderate Alcohol Use and Reduced Mortality Risk: Systematic Error in Prospective Studies and New Hypotheses,” Addiction Research and Theory.
12 Boris Hansel, et al., “Relationship Between Alcohol Intake, Health and Social Studies, and Cardiovascular Risk Factors in the Urban Paris-Ile-De-France Cohort,” European Journal of Clinical Nutrition 64:561-568.


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Peter N. Landless, a board-certified nuclear cardiologist, is an associate director of the General Conference Health Ministries Department in Silver Spring, Maryland, United States.





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