Slightly more dead
The Herald’s story (via Medical Daily) about a report in the BMJ slightly misses the point. The lead says
A new report, published in the British Medical Journal, claims activities like having a couple of drinks, smoking, eating red meat and sitting in front of the TV can cut at least 30 minutes off a person’s life for every day that do it.
None of this is new. What’s new, and the point of the report, is the idea of quoting all these risks in terms of expected life lost, denominated in ‘microlives‘. David Spiegelhalter, who is Professor for the Public Understanding of Risk, writes in the report:
We are bombarded by advice about the benefit and harms of our behaviours, but how do we decide what is important? I suggest a simple way of communicating the impact of a lifestyle or environmental risk factor, based on the associated daily pro rata effect on expected length of life. A daily loss or gain of 30 minutes can be termed a microlife, because 1 000 000 half hours (57 years) roughly corresponds to a lifetime of adult exposure. From recent epidemiological studies of long term habits the loss of a microlife can be associated, for example, with smoking two cigarettes, taking two extra alcoholic drinks, eating a portion of red meat, being 5 kg overweight, or watching two hours of television a day. Gains are associated with taking a statin daily (1 microlife), taking just one alcoholic drink a day (1 microlife), 20 minutes of moderate exercise daily (2 microlives), and a diet including fresh fruit and vegetables daily (4 microlives). Demographic associations can also be expressed in these units—for example, being female rather than male (4 microlives a day), being Swedish rather than Russian (21 a day for men) and living in 2010 rather than 1910 (15 a day). This form of communication allows a general, non-academic audience to make rough but fair comparisons between the sizes of chronic risks, and is based on a metaphor of “speed of ageing,” which has been effective in encouraging cessation of smoking.
There was a BBC documentary on this subject back in October (a 5-minute clip is available).
Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »