Thursday 29 November 2018

Is Cold and Dark Weather a Trigger for Heavy Drinking?

There is a commonly held belief that winter conditions — that are characterized by extreme cold and low sunlight — are connected to heavy drinking.

Whenever we think of countries in Northern Europe we instantly think of sub-zero temperatures, dark clouds and polar landscapes. We also imagine its inhabitants tucked in a bar drinking their sorrows away. What creates this image is the perception that strong spirits and binge drinking are a staple of many Northern countries.

However, scientific and factual evidence shows a more nuanced picture.

Statistical Verdict

The argument that countries with a colder climate experience a larger intake of alcohol is not by any means clear. A study released by the World Health Organization (WHO) in 2014, suggests that this is not necessarily the case.1

While the top four places are occupied by Belarus, Russia, Moldova and Ukraine, we also find the very warm Southern European countries of Andorra and Portugal occupying the number seven and ten spots respectively, ahead of Germany and all Scandinavian countries. In fact, other top ten entrants such as the Czech Republic and Romania experience quite temperate climates.

The cold weather argument fails to explain why Uganda, South Africa and Brazil have some of the highest alcohol intakes in the world, also surpassing that of any Scandinavian country.

Research also suggests that alcohol consumption is no longer culturally predetermined, as drinking patterns seem to converge, throughout Europe at least; binge drinking is becoming more and more common in Southern Europe while the “booze gap” (the difference in consumption levels) between North and South keeps narrowing.2

What is clear is that cold weather isn’t the only determining factor in levels of alcohol consumption. For those countries that receive more sunlight and warmer weather, there will be other factors at play that lead the residents to drink more heavily. Likewise, in colder countries, there may be other elements in their environment that add to or exacerbate heavy drinking patterns.

For example, given the prevalence of East European countries in the top 20, Tom Donaldson, president of the National Organization on Fetal Alcohol Syndrome (NOFAS), suggests that these high consumption levels are motivated by these states’ underlying social context. He blames the high rates on the fact that “there are no public health awareness efforts whatsoever about the effects of alcohol consumption.”3 This assertion is certainly credible given that eight of the top offenders lack rigorous information campaigns on the hazards of heavy drinking.

Science Verdict

The popular belief that heavy drinking is a response to cold and miserable weather may actually be rooted in truth. The available statistical and medical evidence doesn’t give us any clear-cut answers here, but the newest study on the subject does suggest there is a link.4

This new study — the first of its kind — paints a bigger picture, and may provide us with more answers. It indicates that there is a direct relationship between the amount of sunlight a country gets and its inhabitants’ intake of alcohol. In colder climates with fewer hours of sunlight, alcohol consumption is increased — and sadly predictably, they also see an increase in levels of alcohol cirrhosis. This new evidence is only one study, so it can’t be conclusive, but it is certainly persuasive.

One thing that may also add to the increase of alcohol intake in these colder, darker regions is a well-known misconception that drinking alcohol keeps you warm.

Medical research points out the opposite; alcohol actually lowers your overall body temperature and can increase the risk of hypothermia. This is because alcohol dilates the blood vessels, increasing the amount of blood that is pumped to the skin, creating a feeling of body warmth on the surface while overall the core body temperature decreases. Summarized by Dr. William Hayes, Director of Clinical Pharmacology at the University of Iowa, “Consumption of alcohol undoes many of the human body’s healthy reflexes, one of which is keeping the core body temperature warm in cold weather.”5

In addition, research shows that lower temperatures cause people to consume less fluids overall. As professor Robert Kenefick of the University of New Hampshire US explains: “people just don’t feel as thirsty when the weather is cold”, which in turn leads to less consumption of fluids and a higher risk of dehydration. Kenefick conducted research that showed cold temperature actually reduces the feeling of thirst by suppressing the secretion of fluid-mediating hormones that ignite thirst in case of dehydration.6

The Final Verdict

With many countries with sunnier climates ranking high on alcohol intake there is an argument to made that it is countries without public health policies to address drinking in general that is the biggest factor in high alcohol use per country. However, the nascent evidence provided by the recent study about the positive correlation between longer nights, higher alcohol intake, and rapidly rising cases of liver disease has begun adding external factors (weather, geography, etc.) to the important discussion on how to mitigate alcohol related harm from a public health perspective. What is undoubtedly true is that there is more to be uncovered on the factors that contribute to a countries levels of alcohol intake.

In the end, a truly effective public health campaign will involve a deep understanding of both statistical and scientific evidence to support comprehensive policies and programs for healthier societies.

References:

  1. World Health Organization. (2014). Global status report on alcohol and health 2014. Retrieved from https://ift.tt/1lc7Wpj
  2. Bloomfield, K., Stockwell, T., Gmel, G., & Rehn, N. (2003, December) International comparisons of alcohol consumption. Alcohol Reserach and Health, 27(1):95-109. Retrieved from https://ift.tt/2uLIzqG
  3. Hess, A.E.M., Frohlich, T.C., & Calio, V. (2014, May 15). The heaviest-drinking countries in the world [blog post]. Retrieved from https://ift.tt/2KHrpDT
  4. Ventura-Cots, M., Watts, A., Cruz-Lemini, M., Shah, N.D., Ndugga, N., McCann, P., Sidney Barritt IV, A., Jain, A., Ravi, S., Fernandez-Carrillo, C., Abraldes, J.G., Altamirano, J., & Bataller, R. (2018, October 16). Colder weather and fewer sunlight hours increase alcohol consumption and alcoholic cirrhosis worldwide. Hepatology. https://ift.tt/2BGziqg
  5. Hiskey, D. (2012, October 9). Alcohol does not help prevent hypothermia, it actually makes it more likely [blog post]. Retrieved from https://ift.tt/1kRkowR
  6. Cold weather increases risk of dehydration [press release]. (2006, January 28). Retrieved from https://ift.tt/2BgYAbW


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