Costs. Smoking vs Alcohol

Yesterday, I saw that the latest protection and prevention measures from the anti-smoking lobby was that not only is smoking to be banned in cars, but also there will be plain packaging on cartons of cigarettes. Someone quoted thousands of deaths and billions per year can still be attributed to smoking, and that these measures will stop young people starting.

Smoking has now become, unfashionable, unacceptable, harmful and very non PC. Drinking, however, and generally more than the safe guidelines, seems to have gone in reverse, most especially wine. It is fashionable, acceptable, normal, and everywhere. As a long term non-drinker, I feel more and more stigmatised for not being on the sauce than I do for once drinking too much of it.
But I am at a loss to understand why there is not more comparison between the costs to both the NHS and productivity, let alone the emotional cost caused by alcohol misuse? I know that cigarettes and tobacco wreak havoc, and that one cigarette can be potentially harmful, but so can one glass of wine for many millions too, because it rarely stops there.

There are plenty of statistics which if they are to be believed, show that alcohol harms, to oneself and others is dramatically more costly.

For example, the BMA quote that smoking costs the NHS 2.7 billion, and 2.5 billion to the wider economy, sick leave and lost productivity. There are no quotes for any crime costs because you are highly unlikely smash someone’s face in after smoking 20 Silk Cut.

Alcohol Concern quote that alcohol costs the NHS 3.5 billion, crime 11 billion, lost productivity, 10 billion. These I know are under estimated, because the majority of women that I see have never been seen by a GP as a direct result of their drinking, only the symptoms of it, for they are too frightened to tell the real facts about their drinking habits. 90% of these women are Mothers, wives, partners, professionals, and all admit to me in some way being irresponsible because of their previous routines with the ugly juice. 27% of them came from the health sector last year.
I loathe the nanny state, love the idea of all of us being able to make our own choices, but when there is so much skewed propaganda there is a real sense of unfairness to me. I think it would be madness to un brand cigarettes, a step way too far, but by the same token there are so few steps being taken to address the way we use alcohol, or at least the potential harms that are hidden in the cheeky little numbers so adeptly lined up in big supermarkets or casually placed on counter tops of virtually every corner shop or garage. There is no listing of ingredients, no warnings of big ugly diseased livers, cancerous breasts, not a hint of harm.
If I was unable to care for myself, I would far rather trust a smoker than a drinker to look after me, and that goes for my loved ones too.

To add to the madness, all smokers who quit are congratulated, and giving a huge pat on the back, whereas for most of us who call time on wine o’clock, are accused of being dull, boring, and weak willed, just because we have decided that alcohol doesn’t suit us anymore.
No matter how defensive of, or in love with alcohol this country may be, surely this must be the time to strike a fair balance.

Over Age Drinkers

Older drinkers

Most of the publicity that surrounds alcohol misuse, had always been directed at the young, under-age drinkers. With images of reckless binge drinkers outside nightclubs and vomiting in the street, fighting and anti-social behaviour, that puts fear and dread into those of us who have the misfortune of having to either witness it or walk past it.

However, there is firm evidence that it is not the young who cost the most. Both financially and emotionally it is now the middle aged drinkers who are main lining on alcohol, particularly women, and particularly wine.  Perhaps many of this demographic, are the ones who raise their glasses in horror, at the irresponsibility of these weekend revellers and are outraged by the burden put on the A & E departments and ambulances services up and down the UK.

This is what I call the Them and Us syndrome.

Us, rather than them, have nice jobs, nice clothes, a nice lifestyle, but hidden behind the interlined curtains, are drinking at least on a par with the reckless overtly boozy Brits, maintaining levels, and habitually drinking too much.  Us would have giggly conversations the morning after the night before, on how amusing it was that they had got a bit tipsy, but nowhere near as sozzled as another in their party.

Because Us appeared to be in control, articulate and reasonably intelligent, they are never really questioned about their drinking habits. The old guffaw about not being an alcoholic if you still drank less than your doctor is rolled out across a well-polished walnut dining table. It’s all a bit of a laugh, isn’t it? Not when you see the health problems it’s causing: the number of alcohol-related admissions of women to NHS hospitals in England has continually risen over the past decade, from 200,000 in 2002 to 437,000 in 2010, evidence from the Institute of Alcohol Studies claim.

Yes that is them, and this is us. Drinking is cleverly disguised, consequences are few, and as they progress down their particular River of Denial,  that is when the things start to fall apart, Us just manage, barely, to cover it up even more, terrified that someone would ever point a finger and accuse us of being alkies. In fact so bad is the bigotry that some self-harm to the point of almost killing themselves. Too frightened to confess that actually they are not just drinking three glasses of wine a night, increasing the risk of breast cancer by 50%, but pre-loading, and secretly drinking on the sly too. Hiding bottles in cupboards and Wellington boots. Re-organizing the re-cycling so that even the bin men would not suspect.

And yet Us judge others, because they are not like them. The fact is that they are just like Us, just less mature or not as good at hiding it.

The biggest cost to the NHS is not the young, it is the over 55s. The lowest cost is the under 35s. The Health & Social Care Information Centre (HSCIC) estimates the direct costs of alcohol-related harm in England to be £12.6 billion at 2008/09 prices, undoubtedly this figure will have risen since the dreadful recession hit the UK.

The indirect alcohol related deaths and harms are far more significant, two examples are that over half head and neck cancers can be attributed to alcohol misuse, costing the NHS 63.5m, Just over 13% of all malignant breast neoplasm admissions were attributable to alcohol, costing the NHS £27.1m, Alcohol Concern has told us, in fact there are over 60 medical conditions that can be related to heavy drinking.  Liver disease is now the fifth biggest killer in the UK, and on the rise. One in five of the population, 20% have liver disease, and over half can be attributed to heavy drinking, according to the British Liver Trust. Dr Carsten Grimm, Clinical Lead for the Alcohol Service in Kirklees, Yorkshire, said: “It is vital that people understand the full consequences of drinking at unsafe levels can have on their health. With almost 10 million alcohol-related hospital admissions, we can see just how serious an impact unsafe levels of alcohol consumption is having on our health system.”

There is much more financial loss involved. In a report by The Institute of Alcohol Studies the economic cost is alarming. They estimate that in real terms the cost to the country as a whole could be in the region of 55 billion.

My evidence also shows that no one is exempt from this current trend. 27% of my clients over the last three months have come from the health sector, both clinical and mental health. The average age is 47 years. Not 16. These women are the Mothers of the drinkers who are often out there on the streets getting hammered. Do you think they have perhaps learned a habit? We hear of girls of 14 taking bottles of wine to parties, because if Mummy drinks it to help her relax, then it will help us do the same. After all she isn’t a ‘drunk’.  There was a very candid interview in one Sunday paper recently that shows The percentage of women convicted of drink-driving has almost doubled in the past 15 years – from 9% in 1998 to 17% by 2012, according to a recent study by Social Research Associates (SRA) on women and alcohol. The research also notes that one in six female motorists thinks she has driven over the limit in the past year, and that with adjustments for miles driven, women are more likely to be over the legal limit than men from the age of 30 upwards. Those 50 years of anti-drink-drive campaigns featuring men in a pub downing “one for the road” suddenly seem old- fashioned in their assumptions.

If you were to also conclude from the above, that our children also are affected by parental drinking, they do take notice, and they do learn from it, as has been pointed out by Drinkwise’s latest campaign, Kids and Alcohol Don’t Mix, then surely we need to address not only the problem, but the ineffective care and handling of this hidden epidemic.

The Sanctuary Roars into 2015


Years ago, I drank too much, I worried too much, I projected too much and now I don’t. I dealt with it all, and moved on.

For me, there is no room for self-flagellation, or what if’s, my time is concentrated on the here and now, and the exciting times ahead.

In my work, naturally confidentiality has always been key, but the more empowered The Sanctuary women become the more they are now beginning to start the BIG conversation in real time, about what was once a very toxic issue for them. Without stigma or tambourine bashing, they have overcome the fear around talking openly about their reasons for not drinking to excess any more, and I hope as they do, that they will in turn encourage others who find themselves in the same concerned and worrying position to be able to do the same,  casting aside any shame or guilt.

For after all, it was never a choice that we became so dependent on such a well marketed and dangerous, legal drug.Wine is dressed up so adeptly as being very acceptable and glamorous.

It is also completely normalised, that for many of us, it was never considered ‘proper’ drinking until the wheels fall off, With the added easy edge, that it needs no prescription, just a grocery shop and a fridge.

Of course it is not the first time that we have been seduced. Gin was the craze in the first half of the 18th century, the Absinthe movement in the latter part of the 19th Century, and more recently, Mother’s little helper Valium washed down with Gin and Dubonnet in the 60s was a favourite mix for middle class Mums. My Mother was a victim of this over prescribed prescriptive drug, trusting advice that it would make all the tragedy and angst in her life disappear, sadly the reverse was the case.

65% of my clients last year were prescribed Anti depressants, Citralopram, Prozac, washed down with a cheeky little number, oblivious of the fact that their drinking totally negated the effects of the other legal drug they were taking. I am delighted to say that only 12% still take them, free of booze, a proper clinical diagnosis could be made. So in many ways history is repeating itself.

But this is a modern problem, faced by modern women, who wanted it all, and for the most part got it, except for the indisputable fact, that biologically we just are not equipped to drink like men. In everything else of course, we beat them hands down!

This BIG conversation will only start with us. Like minded women, from different backgrounds, who have had enough of the self-destruct button. Without being preachy or evangelical, by playing our wellness and clarity forward, we can make a change. We do not have a rule book, or belong to a cult, but we are very obviously, savvy, intelligent, articulate women who have now got control and choice.

Methods at the Sanctuary are not mainstream, I have no time for the depressing thought that I will be burdened with a lifetime of regret. The gold standards of care that are in place today, are antiquated and inconvenient for many. What I would love all women who are concerned about their drinking, as I once was, is to campaign for at the very least gender specific care, and at best combine that with age specific care.  To be told once you have decided to cork it, that there is a waiting list of many months is also totally unacceptable. If you broke your leg, would you allow a GP to fix it? Would you not feel safer with a specialist, most especially if there was a particular nuance to your break? There is a very laxidasical approach to alcohol misuse, borne from the legality and acceptance of this drug. There is no value in poor and ineffective care, waste of time and money. Because of the drip feed with drinking, rarely do we count the financial cost of it. We did the stats at the Sanctuary. Last year the average saving per client, was £4674.00 per annum, and that did not include, any wild on-line shopping, guilt purchases or taxi fares. I have been doing a starfish impression for many years, and it’s now time, with right attitude to make a change. We have to be proactive, vocal and concise in the inappropriate way our once problem is handled. We need to speak with the powers that be, from GPs and upwards, we need to make bars and clubs give balance to the drinks on offer, and we need too to tackle our supermarkets and get them to address this balance also. You are the consumer!

We have to banish the taboo, there is none with sexuality or smoking, so why the hell are we still frightened of talking about once drinking too much? It’s insane, and the best definition of insanity provided by Einstein, is doing the same thing over and over and expecting it to change. We have all been there! We live in the 21st century not the dark ages.

Non drinking is attractive and glamorous, I cannot remember ever being dull and boring sober, kindly my beloved never took a picture of me at the end of my drinking career, needless to say it was far from pretty, witty or wise, which were the three things that I really thought drinking gave me.  I became purely entertainment value, and then just an embarrassment. Shipwrecked on a sea of Chablis.

One of the only rules I have with my programmes, is honesty, and it’s time in real life, we all got honest. No one will judge if delivery of your decision is short sharp and to the point. No more secrets and lies.

For me to be able to survive breast cancer and alcohol dependence was a fairly bleak prospect at one time, but not anymore. I needed logic and a deep understanding of women just like me, and studied hard to be as successful as I am today. I do know that there has never been a more rewarding time and if we can keep the conversation going and growing, I’m sure you will all feel the same as I do. Empowered and inspired.  Everyone deserves to be the best they can be without ever feeling ever again an ounce of shame, guilt or remorse.

A very Happy New Year from us.