Is Christmas Cost-Effective?

David J. Kerr, CBE, MD, DSc


December 16, 2021

This transcript has been edited for clarity.

I'm David Kerr, professor of cancer medicine from University of Oxford. With the festive season fast approaching, I thought it might be interesting to consider a paper that was published last year in the Christmas edition of our British Medical Journal, a venerable institution, if ever there was one. At Christmas time, they open the gates to rather more interesting and inspired papers than is usually the case.

This one is called "Harms and the Xmas Factor." Two friends of mine from the old days, Robin Ferner and Jeff Aronson, both clinical pharmacologists who are well known, present a rather compelling case for the fact that given the balance of benefits and harms, Christmas may not be cost-effective. Yep, you heard it here.

They highlight a whole range of areas in which we might run into significant problems. There are many of them, starting at Christmas cards, a source of potential harm. In 1876, a young man painted large, festive cards "with colours chiefly of a bright green." He developed acute arsenic poisoning. The paint he used was Scheele's Green, which is based on copper hydrogen arsenide.

What about those hanging up their Christmas decorations? Obviously, there is the potential for falling off ladders or roofs as we decorate with our fantastic Christmas light display. Every year, light-emitting diode bulbs, sharp-pointed confetti stars, Christmas tree–shaped decorations, and metal clips to hold them have all found their way into toddlers' bronchi and pharynges. Watch those toddlers when they're out and moving around. We know that Christmas trees, pine trees, can cause contact dermatitis — a further source of particular problems.

What about overeating and overdrinking? I found a recipe in BMJ — this is post-war BMJ, 1946. Rationing was still in place at that time, but the BMJ published a recipe for a Christmas pudding. That's the most awful of Christmas festive fear. The recipe for this pudding, to feed six, accounted for 58,000 calories. In those days, they commented, " the mind is enriched in tranquil after such a meal" — presumably because that's because we've diverted all the blood flow that we can away from the brain toward the digestive tract, leaving people semi-comatose. This is the sort of diet promulgated in those days by the BMJ.

There are other elements of feasting. One of the most interesting examples that they give: 97 people who ate at a reception of the National Institute of Public Health combined with the National Institute of Hygiene in Warsaw developed novel gastroenteritis from a Christmas salad.

Drinking too much alcohol. All of us know about the concept of the holiday heart syndrome. Too much alcohol is associated with developing acute, sudden-onset atrial fibrillation. Is it worth it?

What about presents? Clearly, you can get weird presents, such as hamsters that you become allergic to.

In 2002, two noted health economists, Isaacs and Fitzgerald, undertook an economic investigation of Christmas derived by inspired guesswork. They came to the absolutely firm conclusion that there are just no data supporting any sort of economic benefits from Christmas whatsoever. However, they ignored the value of eternal life. They're putting that to one side.

I hope this serves as a warning. I want you to eat, drink, and be merry, but take care out there on those mean festive season streets.

Thanks for listening. Medscapers, over and out. I'd be very interested in your own stories of Christmas disbenefits when we enter those into the equation.

For the time being, over and out. I wish you all a very, very happy holiday season.

David J. Kerr, CBE, MD, DSc, is a professor of cancer medicine at the University of Oxford. He is recognized internationally for his work in the research and treatment of colorectal cancer and has founded three university spin-out companies: COBRA Therapeutics, Celleron Therapeutics, and Oxford Cancer Biomarkers. In 2002, he was appointed Commander of the British Empire by Queen Elizabeth II.

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