Q&A with Dr Aric Sigman

AricDr Aric Sigman joined us in June 2011 to answer your questions on British drinking culture, the best way to discuss alcohol with your children and if there's any harm in indulging in the odd glass of wine around young children. 

Dr Aric Sigman is a father of four and author of Remotely Controlled and The Spoilt Generation. Dr Aric's new book Alcohol Nationlooks at how the way we view alcohol impacts directly upon on our children's present and future health, wellbeing and academic success. British drinking culture | Curbing binge drinkingEffects on children | Alcohol abuse   

 

British drinking culture

Q. scottishmummy: What influences do you think cultural factors brings to alcohol consumption? Certainly, the Glasgow Ripple Effect study showed the ramification of alcohol upon individual and community.

A. Dr Aric Sigman: In the way that petrol, chocolate, or salt and vinegar crisp consumption is strongly influenced by culture, so too is alcohol - you don't need me to tell you that. The Ripple Effect was commissioned by the Communities Sub-Group of the Glasgow Drugs and Alcohol Partnership. The report found that like the ripple effect created by a pebble in a pond the 'ripple effect' of alcohol was found to go far beyond the individual and their immediate family. Ninety-nine per cent of people felt alcohol affected their community and 95% of the examples they cited were 'negative effects' ranging from 'sense of safety', 'antisocial behaviour', parks are 'no-go areas at night', abuse/intimidation, 'vandalism' etc etc. I suppose it's a documented example that getting smashed isn't only a personal phenomenon, it frequently has collective effects - we've simply become punch drunk to.

Britain often seems to shrug its shoulders, uttering a collective acquiescent sigh of: "Well, that's what Britain's always been like, you're not going to change it." I don't agree, and I believe that changing the way we introduce our children to alcohol and how we consume and behave under its influence will make a difference later on.

Q. MavisEnderby: Why do you think that people in the UK feel the need to binge drink? In southern Europe it seems that alcohol can be enjoyed in a sensible manner.Book

A. Dr Aric Sigman: We often confuse binge drinking with alcoholism and health damage. The two are not the same thing. I used to live in Paris where the British are led to believe children learn how to handle their alcohol early and often to avoid disappointment, while actually the French die at nearly twice the rate that we do of cirrhosis of the liver.

They have terrible problems with alcoholism yet the main difference is that when they get drunk, they tend not to headbutt one another and pull each other's hair out on a Saturday night on the High Street in the way that Brits are so accomplished at. We are confusing the pattern of drinking and its associated antisocial behaviour with alcohol dependence and health damage.

British binge drinking may be partly the result of traditional pub hours, which conditioned people to get it down 'em in a three-hour period before last orders. Coupled with that has been a cultural imperative to get drunk and quick because it's the thing we all do. 

Binge drinking is also the result, perhaps inadvertent, of stronger drinks consumed by a generation that has little understanding of percentage proof. And, of course, the price and availability has never been so good if you want to get hammered.

At a deeper level, I believe that younger people have never been bored so easily and have grown up being used to having stimulation of all sorts on tap and so whether it's high use of action-packed computer games or high-volume MP3 earphone entertainment or stimulant-based energy drinks, young people need the buzz early and often to avoid disappointment. Changing your mood by drinking is simply one more thing on the list. 

I've always thought that one of the greatest things we can give our children early on is the gift of boredom, which allows them to generate their own stimulation and entertainment without it being supplied externally. But that is a much bigger issue and question, which will require us to think outside the bottle.

Q. Missingfriendsandsad: I think that value for money distorts our drinking habits - at £3-£4 a pint many of my group of friends, both men and women, think that it's poor value to have weaker beers so plump for beer at 5%-plus I also hear younger people saying that if they are going to spend so much they want to ensure they are drunk when they go home. How much of alcohol's relatively high cost in Britain accounts for our funny attitude to it?

"If Britain uses high enough minimum pricing, the greatest impact will be on those who drink cheap alcohol, in particular young binge drinkers and low-income heavy drinkers who are at greatest risk of liver disease."

A. Dr Aric Sigman: The House of Commons health committee clearly believes that raising the price of alcohol actually reduces binge drinking and alcoholism. In New Zealand, too, a new report from the prime minister's chief science adviser declared that increasing alcohol price is among the most effective ways to address youth drinking problems.

The alcohol industry, of course, claims that raising prices won't change a nation's harmful drinking habits. But their claims have been dismissed by the House of Commons health committee as "economic illiteracy". In a recent report, the committee described increasing alcohol prices as "the most powerful tool at the disposal of a government".

As for the notion that raising prices would unfairly affect the majority of moderate drinkers, this is dismissed by the report as "a myth widely propagated by parts of the drinks industry and politicians". If Britain uses high enough minimum pricing, the greatest impact will be on those who drink cheap alcohol, in particular young binge drinkers and low-income heavy drinkers who are at greatest risk of liver disease.  Also I think our culture has an effect. We don't easily enjoy ourselves and often see enjoyment as unseemly unless we can excuse it under 'being drunk'. 

Q. Missingfriendsandsad: An Italian friend of mine is always astonished how English people going for a meal can enter a restaurant not talking, not smiling, sit eating good food with only polite conversation, and then leave in silence, still unsmiling. Italians come in chatting, and leave smiling and chatting whether drinking or not. We seem to be obsessed with two versions of ourselves - the sober one where self-control and reticence is the highest quality, and the drunk one where the opposite is true. Why do we still feel so affronted by emotion in our sober life, and so keen to be overwhelmed by our emotional selves that we take massive hits of a powerful drug to try to quicken the process, but also keep it in a temporary window?

"Allowing British people to express emotions more easily and healthily is not something that will happen overnight and alcohol has been the grand disinhibitor allowing the nation to do so. But unfortunately it has come at a terrible cost for many people. "

A. Dr Aric Sigman: I've lived in the UK for many years and still don't have the answer. Many of my British friends of a certain age tell me: "It's all right for you with your beach-boy upbringing, but you really have no idea what it was like over here until recently: the conformity, the emotional repression. You were a citizen, we were Her Majesty's subjects; and while you had doughnuts, we had duties; you had a life, we had a station in life." Coming from a culture (the US) in which self-adoring loudmouths and show-offs are commonplace, your social and emotional history is still a revelation to me. On a personal note, I like a lot of your contained behaviour.

I can say that while it may be 'modern' to let it all hang out like some other cultures and loosen up and chill, while it's uncool to have a stiff upper lip while being anally retentive at the same time, it is precisely these characteristics which have produced some of your greatest art and thinking but also some of your greatest drinking. Hogarth's Gin Lane and the gin riots of the 18th century provide a useful perspective.

Allowing British people to express emotions more easily and healthily is not something that will happen overnight and alcohol has been the grand disinhibitor allowing the nation to do so. But unfortunately it has come at a terrible cost for many people. 

I must point out that I have no moral or ethical objections whatsoever to adults drinking alcohol, nor would I like to be part of a neo-temperance initiative. I am not an 'uptight, puritanical American' preoccupied with ridding Britain of the demon drink. My only concern is a health concern for children and young people based on a new understanding of alcohol's effects on them.

Q. Tee: As an American in Belfast, I find the UK attitude to drinking fascinating. In the US, for instance, you would never have a Christmas dinner that included more than a glass or two of wine, whereas here it is expect that you'll get legless, even with the CEO of your company right there. What do you think led to this attitude and what can we do to end it, and educate our children that you don't have to be falling down drunk to have fun?

A. Dr Aric Sigman: I too have been enlightened by the Romanesque orgiastic nature of the British office Christmas party. People having sex on the photocopier and then straightening their tie, pulling up their tights and then getting back to work the next morning and discussing the beancounter's figures as if nothing's happened - it's cultural and I'm not in a position to demand any change. However, not getting hammered in front of our children and not approving of them getting hammered will reduce the likelihood - surprise, surprise - of them getting hammered as much when they are adults. 

Q. Missingfriendsandsad: English-speaking cultures have dominated the world in so many different ways. Amerians drink as a pastime in itself and have the idea of a 'bar' where drink is the focus rather than interaction, and Australians drink with the 'would you like a tinny' invitation being welcome in most homes. Additionally, the Japanese drink heavily in order to get drunk too. The world is culturally dominated by successful UK/American/Japanese businesses and the changes they have facilitated. Not to mention our drink-fuelled City and Parliament making the UK contribution to the world disproportionate (perhaps grandiose thinking is better done when tipsy?) Could it be, in fact, drink is good for us - the casualties being a small relative risk? 

A. Dr Aric Sigman: It's true that the discovery of distant lands that Britain would eventually colonise was virtually dependent on drunkenness. Captain James Cook lived in fear of uprisings on board if liquor provisions ran low, meaning that sailors had to be asked to accept a temporarily reduced allowance. In fact, Cook actually planned and co-ordinated his expeditions according to the state of the liquor reserves. The daily ration of grog was one imperial pint (20 fluid ounces or over half a litre of 94% proof liquor). Cook would not cruise for longer than the liquor lasted.

Yet, seriously, today I can't see that alcohol is the common denominator of global business success. Medically, on the whole, drink isn't good for us but that shouldn't stop us from drinking. Chocolate ice cream isn't good for us but I eat it and am quite happy to take the risk, knowing it's full of saturated fat and sucrose. Ten per cent of male cancers appear to be caused by alcohol consumption. Philosophically, if you're asking whether on the whole alcohol is a benefit or a cost to our society, at the moment, it seems to be more of a cost because of the way and the age at which we start using it. But this is really a value judgment that only you can make. 

 

Curbing binge drinking

Q. bethelbeth: What exactly do you think that the distilleries and breweries should be doing in order to better the current situation, if anything?

A. Dr Aric Sigman: Their raison d'etre is to sell alcohol and make as big a profit as possible. The main thing we can demand is that our politicians exclude this exceedingly powerful lobby group from all policy making, especially those that relate in any way to child health. Drinks industry representatives currently sit on policy formulating bodies and the British Medical Association and Royal College of Physicians have, to their great credit, complained and refused to work with them.

"I've always thought that one of the greatest things we can give our children early on is the gift of boredom, which allows them to generate their own stimulation and entertainment without it being supplied externally."

Q. Missingfriendsandsad: I live in a small, relatively well-heeled town where apart from one cinema and intermittent amateur theatre, the only options in the evening are drinking in the pub or going to a restaurant, which would typically include drinking. Often I find the home alternative means more drinking with friends. I can't help thinking that if we had a choice of drugs like mild, legalised cannabis we would be more healthy and more interesting. Plus, if we had more options, we might not resort to drinking to fill the gap and make boredom more bearable. What are your thoughts?

A. Dr Aric Sigman: Every society I've visited picks its poison and makes it legal. Yes, two studies in The Lancet have concluded that alcohol is society's most harmful drug, which just happens to be legal. But that doesn't mean the other 19 recreational drugs on their list don't pose big risks and problems. In the case of adolescents, whose brains and bodies are still developing, all of these things can affect them to a greater or lesser extent.

In the case of cannabis, there seem to be particular risks for teenagers in that they may not become addicted and won't die from it yet may develop schizophrenia, which won't go away. But I certainly agree that we've refused to see alcohol as a heavy-duty drug with a capital D... and our society has been very hypocritical as a result. 

 

Effects on children

"If we overindulge in sausages and chips, our children are more likely to overindulge in sausages and chips. They absorb many of our behaviours and values without thinking consciously about it and heavy drinking is simply one more of those things. "

Q. Rhubarb: Drinking is part of our culture the way it is in other European cultures, however it's the way we have embraced it that is different. We have pubs, whereas France, Italy and to some extent, Spain, do not. There is it unheard of for people to get together merely for the purpose of getting drunk. Alcohol is drunk with meals that are shared with family and friends. They would never consider just drinking for the sake of it.

Again in European cultures they go out for the night as a family - babysitters are not needed. I drink at the weekends usually with a meal, but often we'll have a family walk and then a drink or two at the pub afterwards. I never hide it from the kids and we do talk to them about the dangers not only of alcohol but of being drunk. I once drank too much home-made wine, which was stronger than I thought, and when my 10-year-old realised I was drunk, she was terrified. But in a way I'm glad she can see how terrible it is to be drunk and how quickly you can lose control. I think it's when you incorporate drinking into your daily lives that it becomes dangerous because you are telling your kids that you cannot have a good time without drink, that it's normal to drink every day and that getting drunk is a good laugh that results in funny pics being posted on Facebook. 

A. Dr Aric Sigman: It would be nice to think that being drunk in front of our children will turn them off the idea of wanting to get drunk themselves, but this does not seem to be the case at all. And it's not surprising. If we overindulge in sausages and chips, our children are more likely to overindulge in sausages and chips. They absorb many of our behaviours and values without thinking consciously about it and heavy drinking is simply one more of those things. I agree that we mustn't demonstrate to our children that you can't get through the day without a good couple of drinks to be able to cope.

Q. fuzzpigFriday: I have always been of the view that it's important to let children see alcohol as just a normal thing - no importance, but no mystery either. Letting them taste it if they ask, rather than making it into 'forbidden fruit'. However, we don't drink - not for any moral or health reason, we just don't enjoy it that much. How do we get round it? I worry that even though we aren't overtly banning it, it will still hold a great fascination to our children if they never see it at home, and the first time they encounter it is at teenage parties where it is seen as the bestthing ever. What do you think?

"There is no reason why you cannot drink at the dinner table in front of your children while at the same time making it clear that you are an adult and the effects on your brain and body are entirely different to the effect on their developing brains and body."

A. Dr Aric Sigman: There is no reason why you cannot drink at the dinner table in front of your children while at the same time making it clear that you are an adult and the effects on your brain and body are entirely different to the effect on their developing brains and body.

Few parents who smoke would hand over a fag to their 14-year-old just because he asked for one. Yet they worry that by doing the same thing with alcohol they'll cause a backlash effect.

The good news - and I've given some examples of research in my book - is that there is a prevailing myth about alcohol being elevated to a forbidden fruit. In the first place, this is Britain. Alcohol is not, has not been and never will be a forbidden fruit. Children are exposed to it all the time, so let's trash that misconception, which is furthered by the drinks industry.

The best thing we can do is to drink responsibly and tell our children you can't drink until you're old enough. Of course, they'll experiment with alcohol behind our backs anyway -  but they're less likely to abuse it or develop alcohol problems. In many ways, doing it behind the bikeshed is not a bad thing at all. We know they're going to do it, they know we know, but when they do it, they know we're not condoning it.

"A myth persists that introducing children to alcohol early prevents heavy drinking and alcoholism later. Even if it was legal, we wouldn't recommend 'early snorting' to prevent later cocaine addiction, or early cigarette smoking to prevent later nicotine addiction."

Parental disapproval is great for child sobriety and we've been bludgeoned into believing that our views about alcohol should be kept to ourselves because they are counterproductive and will produce the opposite result of the one we desire. Parental views, even if they are rejected on the surface, do seem to have an effect for the better.

Discussions about our children's introduction to alcohol always focus on the culture and parental role modelling - in other words teaching children - while ignoring the chemical effects of the alcohol.  A myth persists that introducing children to alcohol earlier prevents heavy drinking and alcoholism later. Even if it was legal we wouldn't recommend early 'sensible snorting' to prevent later cocaine addiction and abuse - or 'sensible spliffing'/dope smoking to prevent later cannabis abuse or early cigarette smoking to prevent later nicotine addiction.

There is a misguided notion of lessons in 'sensible drinking' and a misplaced belief that our positive parental role modelling and restraint displayed at the family dinner table, overrides the biochemical, epigenetic and neurological effects of our children's exposure to alcohol.

We've overlooked the most important and obvious thing: the effect of the chemical itself, irrespective of how tastefully it's introduced. Recent research is finding that exposure to alcohol at an early age is more likely to increase the chances of a child developing alcohol use disorders, while the longer our children delay alcohol use, the less likely they are to develop any problems associated with it. This seems to be that early exposure to alcohol sensitise the neurocircuitry of addiction, in other words it may 'prime' the brain to enjoy alcohol by creating a link between it and pleasurable reward: we may inadvertently be switching on genes that affect a child's susceptibility to alcohol addiction.

"Recent research is finding that exposure to alcohol at an early age is more likely to increase the chances of a child developing alcohol use disorders."

I've gone to great lengths in my book to explain all of this and how parents can use this information to make informed decisions about parenting and alcohol.

Q. FunnysInTheGarden: I'd be very interested to know whether drinking a couple of glasses of wine a night will have any impact on my children. I am never drunk, ever, and we tend to drink wine after they have gone to bed. I think that this will provide them with healthy role models as far as alcohol is concerned, as it is a normal part of daily life and quite a positive thing. Am I totally misguided? 

A. Dr Aric Sigman: You say your children never see you drinking or drunk. I can't see how this is at all a problem. If, however, you want to start drinking the two glasses a night in front of them at the dinner table, I think the main issue is: is it a non-event or do you convey a sense of 'needing' or 'craving' the wine? Children learn all kinds of things from their parents. They absorb our values and traditions. They also subliminally pick up adults' attitudes towards drinking, with potentially negative consequences. Even before their first taste, young children are learning about alcohol and about why their parents drink. They do this by seeing people drink, hearing them talk about it, even absorbing the smell of their parents' favourite tipple.

A study of children aged five to eight by the Monell Chemical Senses Center in Philadelphia demonstrated that "whether they like the odour of beer depends not just on how often their mother drinks, but on why she drinks". The scientists identified mothers who drank to "escape", for instance, to help them relax, deal with anxiety or cheer themselves up. Asked to choose between the smell of beer and rotten eggs, those mothers' children were more likely than their peers to prefer the rotten eggs. Children, concluded the researchers, "are processing the smell of alcohol with the emotional reasons their mothers, and perhaps fathers, drink".

I'm most concerned not about the alcohol per se but the lesson to children: "I've got to have a drink or I can't cope". It's the strong example of self-medication that is the main issue for me.

Q. LaVitaBellissima:  What are your views on drinking while pregnant or breastfeeding?

A. Dr Aric Sigman: Medical opinion has most definitely turned against drinking while you're pregnant. In short, alcohol is neurotoxic and can affect the development of organs and tissue. Even the degree of influence that binge-drinking peers have on our adolescent child may be partly determined by their exposure to alcohol while in the womb. Rats whose mothers were fed alcohol during pregnancy were found to be more attracted to the smell of liquor during puberty. Researchers have reported that rats exposed during gestation find the smell of alcohol on another rat's breath during adolescence more attractive than animals with no prior foetal exposure, thereby "promoting interactions with intoxicated peers".  Even before this, the eggs of mice have been found to be altered by the equivalent of one night of binge drinking.

Regarding breastfeeding and alcohol, the NHS  makes it clear that: "Anything that you put into your body while you are pregnant or breastfeeding can have an effect on your baby. This includes alcohol. However, research shows that occasional drinking, such as one or two units once or twice a week, is not harmful to your baby while you are breastfeeding. Drinking any more than this can cause problems... Alcohol clears from the mother's blood at a rate of about one unit every two hours. If you do decide to have a drink, it's a good idea to wait for a couple of hours before breastfeeding." 

 

Alcohol abuse

"It increasingly seems that alcohol dependence, formerly known as 'alcoholism', has a large genetic component. But like many problems or diseases starting with a genetic predisposition, it needs the actual trigger - alcohol - to kickstart the problem."

Q. MySweetAnnie:  I would like to know your views or findings on excessive alcohol consumption and eating disorders.

A. Dr Aric Sigman: People with eating disorders are far more likely to abuse alcohol and more alcohol abusers are likely to have eating disorders compared to the general population. This isn't surprising as both can be a way of expressing pain and quelling pain. And each behaviour heightens the damage of the other so it is vital to intervene as quickly and intensively as possible when these occur together.

Because health professionals often overlook the link between alcohol abuse and eating disorders, treatment approaches are hard to come by for these co-occurring conditions.

Q. ginbob: Do you agree that the drinking habit is a 'hereditary' disease? Do you feel that it's genetics or upbringing that makes the next generation keep this seemingly British tradition going? What's your recommendations for breaking the cycle (from an individual/family point of view) so that future generations might be less impacted by our current infamous drink culture? 

A. Dr Aric Sigman: It increasingly seems that alcohol dependence, formerly known as 'alcoholism', has a large genetic component. But like many problems or diseases starting with a genetic predisposition, it needs the actual trigger - alcohol - to kickstart the problem.

The children of alcoholics can be between four and 10 times more likely to become alcohol-dependent themselves, so one important step is to make young people and their parents aware that if parents have been alcohol-dependent, they and their children have to be particularly careful about when they start drinking, how much and how frequently.

We're often led to believe that teenagers become alcoholic because they're unhappy, while not realising that in many cases they become alcoholic by simply having too much of a good time too often and that the chemical itself interacts with their genes to cause an addiction during a critical formative stage of their development.

When I speak to groups of children or parents, I try to explain this dimension so that everyone is aware of exactly how this cycle can be broken.  

Last updated: 24-Sep-2013 at 2:26 PM