Last week, when a study in The New England Journal of Medicine reported that moderate drinking can prolong life by reducing the risk of cardiovascular disease, the finding received wide press coverage. Yet 25 years ago, when Harvard epidemiologist Carl Seltzer found evidence of this effect in data from the seminal Framingham Study, no one heard about it.
As he explains in the May 1997 Journal of Clinical Epidemiology, Seltzer did write an article summarizing his findings. But the National Heart and Lung Institute, which was overseeing the study, told him not to submit the report for publication. "An article which openly invites the encouragement of undertaking drinking with the implication of prevention of coronary heart disease," wrote an NHLI official, "would be scientifically misleading and socially undesirable in view of the major health problem of alcoholism that already exists in the country."
Since then, Seltzer's discovery has been confirmed in dozens of epidemiological studies. The most recent one, conducted by researchers from the American Cancer Society, the World Health Organization, and Oxford University, is the largest so far. It followed a group of 490,000 people over a nine-year period and found that, compared to teetotalers, subjects who had a drink a day were 30 to 40 percent less likely to die of cardiovascular diseases. Their overall death rate was 20 percent lower.
Although the connection between moderate drinking and a reduced risk of cardiovascular disease is now generally acknowledged by scientists, the attitude that blocked publication of Seltzer's article still prevails in certain quarters. The Bureau of Alcohol, Tobacco, and Firearms, for example, will not allow brewers, vintners, and distillers to tell their customers about the health benefits of moderate drinking. The BATF's explanation is eerily similar to the one Seltzer got from the NHLI bureaucrat in 1972.
Federal regulations for the marketing of alcoholic beverages bar any statement about "curative or therapeutic effects if such statement is untrue in any particular or tends to create a misleading impression." The BATF interprets this rule as forbidding "all therapeutic claims, regardless of their truthfulness." It argues that such claims are inherently misleading, given the "harmful societal effects arising from the consumption of alcohol" and the danger to "those who for psychological or physical reasons are adversely affected thereby."
In other words, consumers should be kept in the dark about the benefits of moderate consumption, because a certain percentage of them will become alcoholics. By the same logic, consumers should not be informed about automobile safety features, because a certain percentage of them will drive recklessly and get into accidents.
It hardly seems plausible that accurately summarizing research on the health effects of drinking--research that also clearly shows the dangers of excessiv consumption--will create the impression that habitual drunkenness is good for you. If anyone is presenting an unbalanced picture of alcohol's impact, it's the federal government, which mandates warning labels about the hazards of drinking but forbids manufacturers to tell the other side of the story.
Under this policy, the BATF has nixed newsletter articles, wine bottle neck-hangers, even a label quoting Thomas Jefferson. The Competitive Enterprise Institute, a free-market think tank, has challenged the BATF's censorship in federal court on First Amendment and statutory grounds. Recent Supreme Court rulings upholding the right of liquor stores to advertise prices and the right of brewers to tell customers the alcohol content of their beer suggest the BATF's policy may be overturned.
The Wine Institute has taken a more timid approach, asking the BATF to approve a label saying, "To learn about the health benefits of moderate wine consumption, write for the Federal Government's Dietary Guidelines for Americans." (The guidelines note, "Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals.") The BATF insisted that "health benefits" be replaced by "health effects," but it still hasn't approved the label.
The closest the bureau has come to lifting its gag order is a decision to let wineries reprint and distribute a four-page pamphlet from the National Institute on Alcohol Abuse and Alcoholism that includes three paragraphs on the evidence concerning moderate drinking and heart disease. "It's a little large for a label," a winery spokesman once told me, but maybe "you could make a paper bag out of it and put a bottle of Fumé Blanc in there."