UCL News


The ideas interview: Annie Britton

15 August 2006

Epidemiologists … look at the nation's drinking habits from a distant viewpoint and over long periods: as an astronomer might look at windstorms on Mars.

Not for them the pools of vomit on the pavement, or the blood in A&E. The epidemiologists' is a peculiar kind of clarity - and valuable if we want to make real sense of our nation's love affair with the bottle.

[Dr] Annie Britton [UCL Epidemiology & Public Health] has been tracking the health of a large group (some 10,000) of civil servants working in London, since 1985. "You can apply the techniques of epidemiology," she explains, "only where you've got a cohort with very big numbers. It throws up different, and differently useful, data from small-scale, anecdotal, surveys, or personal experience."

But doesn't "sampling" work equally well as a technique? Surely she can extrapolate from small, representative groups of drinkers. "When you do a cohort study like ours you have to work out at the start who's going to be in your cohort. So you do, in a sense, sample. But with something sufficiently large you can look more objectively at all the extremes. With 10,000 people, for example, you'll get a whole range of drinking behaviours. I say that but, of course, if you're looking, as we are, at London civil servants, the cohort is by definition skewed towards white, middle-class people. In some ways they're not a very exciting class of drinker." …

"Our cohort study wasn't designed specifically for alcohol study. It's just one of many things we're looking at. There are, of course, other cohort studies which do focus specifically on alcohol consumption. In America, for example, there are ones in the order of hundreds of thousands of people. The results coming back from those cohort studies are highly interesting. What, for example, are the long-term patterns? Do drinking habits formed in a person's 20s change when they marry and have kids? Or grow older? Or have more money?"

Do you work by questionnaire, I ask her - or is it observational? "It's mixed. Our team has a questionnaire which we give to the subjects every two years. And we also take lots of biological measurements when they come into our clinics every five years." …

So are you in any position, after 20 odd years, to offer tentative conclusions about it? Epidemiology relates to epidemics - is Britain in the grip of a booze epidemic? Or is it just a national characteristic that we like our tipple?

"I think it's certainly a national characteristic. Other countries, for example, tend to be ashamed or mortified by drunkenness. The UK is unique in glorifying it with programmes such as the appalling Booze Britain. And our drinking habits have got worse.

"Since 1970, for example, we in Britain have increased our per-capita annual drinking consumption by 50%. Whereas in France it's coming down. The French have cut their intake by more than half. The government should do something about it. But the approach the government won't take is to use taxation to put up prices. That is what surveys show would have the most effect - particularly with younger drinkers who one has to be most worried about." …

Professor John Sutherland, 'The Guardian'