Instead, this government has chosen to allow the lie to continue for a while longer, writes Terence Cosgrave<\/p>\n<\/p><\/div>\n
T<\/span>ruth, as we have learned recently from the American experience, is a remarkably fragile thing. It can be bent by money, softened by convenience, delayed by politics, and strangled entirely by public relations departments wearing reassuring smiles. If you were to chart the history of modern health advice, it would look less like a straight line toward enlightenment, and more like a drunken tourist wandering through Temple Bar in search of a sophisticated take on Irish music.<\/p>\n Terence Cosgrave and pup<\/p>\n<\/div>\n We like to imagine that science advances nobly and steadily, with white-coated researchers pursuing truth wherever it leads, but the reality is rather more human. Scientists need grants. Universities need donors. Governments dislike panic. Industries dislike regulation. Consumers dislike hearing that the thing they enjoy might kill them. And so the truth, inconveniently enough, often spends decades waiting outside in the rain while everyone inside insists the weather is perfectly fine.<\/p>\n One of the most extraordinary examples emerged from the sugar wars of the 1960s, though \u2018war\u2019 suggests a degree of honesty which was absent from the affair. In 1967, researchers at Harvard University published a hugely influential review in the New England Journal of Medicine<\/em> that effectively shifted blame for heart disease away from sugar, \u2026 and on to saturated fat. For decades afterward, fat became the villain of the Western diet. Eggs were suspicious yolks. Our old friend, Butter, was shamed like a former criminal acquaintance. Entire supermarket aisles swelled with \u2018low-fat\u2019 products that tasted like damp yellow cardboard.<\/p>\n The small detail not mentioned in the published paper was that the Sugar Research Foundation \u2013 an industry group representing sugar producers \u2013 had secretly funded the research and influenced its conclusions. This only came fully to light nearly fifty years later, when historians uncovered internal correspondence showing that the sugar industry had carefully guided the narrative. The scientists involved were not cartoon villains cackling over sacks of sucrose. They were respected academics operating in a system already comfortable with compromise. But the effect was enormous. Americans spent decades fearing fat while consuming extraordinary quantities of sugar disguised in yogurts, cereals, sauces, breads, and individual drinks large enough to irrigate a small farm.<\/p>\n What makes the episode so revealing is not merely the deception itself, but how ordinary it was. Industries have always understood that the best way to avoid regulation is not<\/em> to prove yourself innocent\u2026 but to make the truth seem uncertain. To, eh, muddy the waters, as some UK water companies might have put it. \u00a0If you can persuade the public that the experts disagree, you buy time. Time means profit.<\/p>\n No industry perfected this strategy more spectacularly than tobacco.<\/p>\n The cigarette companies performed perhaps the greatest public relations sleight-of-hand in history. By the 1950s, internal research already showed strong links between smoking and lung cancer. Scientists inside tobacco firms knew it. Executives knew it. Yet the public was told, repeatedly and confidently, that the evidence remained inconclusive.<\/p>\n Advertisements featured doctors cheerfully recommending particular cigarette brands, which today seems about as sensible as having cardiologists endorse chainsaws for neck massages. One famous campaign proclaimed: \u201cMore doctors smoke Camels.\u201d Whether they actually did or not is almost beside the point. The genius lay in associating cigarettes with authority and reassurance. People know that industry people lie, but they trust doctors.<\/p>\n For decades, the industry funded studies designed not necessarily to prove smoking safe, but merely to confuse and distract. If one scientist said smoking caused cancer, another would appear saying perhaps air pollution was the real culprit. Or stress. Or genetics. Or city living. The objective was confusion. People tolerate danger surprisingly well; uncertainty they practically embrace. Soldiers go to war because they think it\u2019s the guy beside them that will be killed.<\/p>\n And this is the curious thing about human beings: we do not merely accept comforting lies, we often demand them. The smoker in 1963 did not truly want to hear that his daily habit was lethal, any more than the modern drinker wishes to hear awkward truths about alcohol. Back in the 80s I can assure you that young people did not want to deal with the fact that sex could lead to death via HIV and AIDS. Some did, certainly. But many lived with the dichotomy that sex could thrill but also kill. We enjoy narratives that allow pleasure without consequence. Civilization itself may largely depend upon this arrangement.<\/p>\n Alcohol occupies a fascinating position because it combines enormous cultural prestige with devastating medical effects. Cigarettes became socially radioactive because smoking is easy to isolate visually. A cigarette looks unhealthy even before it kills you. Alcohol, by contrast, is wrapped in conviviality and secrecy. It appears at weddings, holidays, business lunches, funerals, first dates, literary festivals, rugby matches, and awkward Christmas parties where someone eventually explains cryptocurrency to a trapped accountant.<\/p>\n We speak of wine as sophisticated and whisky as refined. We describe beer with terms usually reserved for medieval poetry. Yet alcohol contributes to cancers of the breast, liver, bowel, mouth, throat and oesophagus. According to the World Health Organization, no level of alcohol consumption can be considered completely safe when it comes to cancer risk. This is not fringe science. It is mainstream evidence.<\/p>\n And yet the public understanding remains strangely foggy \u2013 hungover, as it were, from the giddy heights of wonderful drunkenness and conviviality.<\/p>\n Ask the average person whether smoking causes cancer and they will answer instantly, \u2018yes\u2019. Ask whether alcohol is carcinogenic, and many will hesitate. Some will suspect you are exaggerating. Others will assume the danger applies only to alcoholics who begin Tuesdays with vodka and regret. Few realize that even moderate drinking increases certain cancer risks.<\/p>\n We call this river of booze \u2018Denial\u2019.<\/p>\n Partly this is because alcohol has been protected by precisely the same machinery that once defended tobacco. Industry-funded studies have repeatedly emphasized potential cardiovascular benefits of moderate drinking while minimizing risks. News headlines delighted for years in announcing that red wine was somehow equivalent to liquid yoga. Every few months a study would emerge suggesting a nightly glass of Pinot Noir might extend life, sharpen intellect, improve romance, and possibly teach French to the family dog.<\/p>\n The science, however, was often deeply flawed. Moderate drinkers tended to also be wealthier, healthier, better educated, and more socially connected than non-drinkers. Many abstainers included former heavy drinkers already in poor health. Comparing the two groups produced misleading conclusions. When researchers corrected for these biases, the miraculous protective effects of alcohol began evaporating faster than gin at a garden party.<\/p>\n Still, governments remain cautious. Warning labels on cigarettes became progressively harsher because the political battle was eventually won. Tobacco lost cultural legitimacy. Alcohol has not. The drinks industry is economically powerful, politically connected, and socially embedded in ways tobacco no longer is.<\/p>\n There is also the awkward fact that many politicians, journalists, academics and doctors drink alcohol. Quite a lot, in some cases. It is difficult to create moral panic around behaviour shared enthusiastically by the professional classes.<\/p>\n And here we arrive at the deeper issue of truth itself. Truth is rarely just data. If it were, humanity would have settled most arguments centuries ago. Truth competes against desire, identity, economics, habit and fear. We often think people reject scientific evidence because they are ignorant, but frequently they reject it because the evidence threatens something emotionally valuable.<\/p>\n A person who enjoys drinking does not hear \u2018alcohol is carcinogenic\u2019 as a neutral medical statement. They hear: your Friday evenings, your celebrations, your friendships, your rituals, your coping mechanisms, your pleasures \u2013 these may carry hidden costs. That is not merely information. It is an intrusion. It is an attack. This person is trained in denial as a self-protecting mechanism.<\/p>\n This explains why health messaging has so often failed historically. Authorities oscillate between alarmism and reassurance, seldom trusting the public with nuanced truth. During the twentieth century, officials sometimes concealed risks to avoid panic. At other times they exaggerated certainty to compel behavioural change. Neither approach builds trust for long.<\/p>\n Consider how dietary advice has pinballed over decades. Eggs were dangerous, then nutritious, then dangerous again, then redeemed. Coffee oscillated between poison and miracle tonic often enough to induce whiplash. Margarine replaced butter as the virtuous option before eventually acquiring the nutritional reputation of industrial lubricant. Each reversal leaves the public more cynical.<\/p>\n Into this confusion steps industry, eager to present itself as the calm and reasonable voice amid scientific \u2018uncertainty\u2019.<\/p>\n What is remarkable is how predictable the pattern always is. First comes denial. Then doubt. Then strategic delay. Then finally reluctant admission once the evidence becomes overwhelming and public opinion shifts irreversibly. We saw it with asbestos, leaded petrol, tobacco, opioids and climate change. One could almost automate the process.<\/p>\n Aside from the current madness in the U.S., the arc of public health only goes in one direction.<\/p>\n So can we finally tell the truth about alcohol?<\/p>\n Technically, yes. Scientifically, the evidence is increasingly robust. Public health agencies in several countries now explicitly describe alcohol as a carcinogen. Ireland, fittingly enough for a nation with a historically dysfunctional relationship toward drink, is set to become the first country to require cancer warning labels on alcoholic beverages. One imagines this has caused deep unease in pubs where Guinness is discussed less as a beverage than as a constitutional right and \u2018part of what we are\u2019.<\/p>\n But telling the truth and changing behaviour are not the same thing.<\/p>\n Smoking declined not only because people learned cigarettes were deadly, but because laws, taxes, advertising bans, social pressure, and cultural norms all changed simultaneously. Smoking became inconvenient, expensive, and socially embarrassing. Alcohol occupies a far more entrenched position. It lubricates social life. It is tied to celebration and identity.<\/p>\n The challenge, then, is not whether we can state the truth, but whether society can tolerate it honestly without collapsing into denial or puritanism.<\/p>\n Perhaps the most sensible approach is also the least dramatic: treating adults like adults. Not banning alcohol. Not demonizing drinkers. Simply stating clearly what the evidence shows. Alcohol is enjoyable for many people. It is also a carcinogen. Both statements can co-exist.<\/p>\n Indeed, maturity may consist precisely in accepting that many pleasures carry risks. Sunshine causes cancer. Cars kill people. Bacon appears determined to assassinate us slowly. Life has never been a perfectly safe enterprise. The problem begins when industries deliberately obscure risks while governments hesitate to confront them.<\/p>\n It\u2019s the job of government to stop companies from lying to us \u2013 instead, this government has chosen to allow the lie to continue for a while longer. That is to their collective shame, if such a thing exists in politics. Instead, this government has chosen to allow the lie to continue for a while longer, writes Terence Cosgrave Truth, as we have learned recently from the American experience, is a remarkably fragile thing. It can be bent by money, softened by convenience, delayed by politics, and strangled entirely by public relations departments wearing reassuring smiles. 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