Alcohol abuse

Licensees and barstaff are nearly four times more likely than the general population to die from liver cirrhosis, which is principally caused by drinking alcohol.

Dr Paula Franklin, the assistant medical director at BUPA investigates.​

To many customers, publicans seem to have the best job in the world; propping up the bar all day with unlimited access to all that booze. In reality, of course, anyone working in the trade needs to be pretty disciplined about drinking. The fact that publicans and barstaff are nearly four times more likely than the general population to die from liver cirrhosis, which is principally caused by drinking alcohol, shows not everyone succeeds.

It's easy to see how it happens. You're obliged to be a jovial host; the anti-social hours can strain relationships; sales targets must be met; you don't want to offend customers pressing to buy you a drink.

The medically recommended maximum daily limit is three units a day for men and two units for women. You may think you're well below that - but make a note of every single drink for a week and you may be surprised. Regular over-indulgence eats into your profits in more ways than one. It increases the risk of raised blood pressure (hypertension), weight gain, liver damage, digestive problems, mouth and throat cancer and depression. You won't be in control of the bar or cash flow and you are more likely to have an accident.

So what are the danger signs? Take stock if you or your partner:

• Feel you "need a drink" to get going in the morning or get through opening hours
• Regularly reach for the top shelf spirits
• Drink after hours and/or drink alone in the bar
• Hide how much you drink
• Get annoyed if someone raises the subject
• Regret the way you handled an incident in the bar once you've sobered up
• Feel that your appearance/diet/sex life is suffering
• Become moody, violent, suffer memory blackouts, the shakes, sweating or morning vomits.

Admitting that you have a drinking problem is a major step towards getting it under control.

Equally important is sitting down with your partner or a close friend and talking it through with them.

If he or she is on hand to nudge you towards the soft drinks, or bring you a mug of tea at danger times, you'll be far stronger for it. If you need outside help, most pub operators provide access to an advice or counselling network. You could also contact your local branch of Alcoholics Anonymous.

If you simply want to cut down the amount you drink, first decide on your alcohol limit - and stick to it. Have long drinks instead of shorts, try no and low-alcohol versions, alternate soft drinks, and have a completely dry day once a week. Also:

• Drink a pint of soft drink before you start work so that you are not thirsty
• Make yourself - or arrange for someone else to bring you - mugs of tea or coffee regularly
• Sip on a soft drink to look sociable and avoid thirst
• When a customer wants to buy you a drink, try telling them you are taking the car out later, you already have one - your soft drink - or simply put the cash in the charity jar.

Your occupation makes you vulnerable to drink related problems and they can often creep up on you unawares. But, looking for the signs and making a regular note of your drinking will help you manage the temptation for "just one more".