Alcohol and tobacco.

The Lancet (2007;369:1047-1053) recently published a paper on
"Development of a rational scale to assess the harm of drugsof potential misuse." I know, sounds a riveting read, does it not?

The authors developed a nine category matrix of harm, to assess the harms of a range of illicit drugs in an evidence-based fashion. This was based on the likelihood of physical harm, social harm and dependence. As well as illegal drugs, five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified in the United Kingdom (ketamine) for reference.

The graph that illustates the results of this study (which you can just about make out if you squint) is below.

No surprises to anybody that works in a retail setting that alcohol and tobacco come a lot higher up the "harm scale" than drugs that are illegal in the United Kingdom. I am surprised constantly by how many people smell of alcohol and are obviously inebriated at 10am (and that's customers, not my colleagues!) Perhaps more surprising is how low tabloid-favourites Ecstasy and GHB are.