With a new year comes Dry January and a new recommendation from the Surgeon General on alcohol and cancer risk. Moderate alcohol consumption was once believed to be good for the heart, but the best research methods have thrown cold water on that. “Drinking less is a great way to be healthy,” said Dr. Timothy Naimi, who directs the Canadian Institute for Research on Substance Use at the University of Victoria in British Columbia.
On Friday, US Surgeon General Dr. Vivek Murthy called for an update to the existing health warning label on alcoholic beverages to include cancer risk. His proposal requires congressional approval.
What is the harm of drinking alcohol?
Alcohol consumption increases the risk of developing several types of cancer, including colon, liver, breast, mouth, and throat cancers. Alcohol breaks down in the body into a substance called acetaldehyde, which can damage your cells and stop them from repairing themselves. This creates conditions for cancer to grow. Thousands of deaths in the U.S. could be prevented each year if people followed the government’s dietary guidelines, Naimi said.
These guidelines advise men to limit themselves to two or fewer drinks per day and women to one or fewer drinks per day. One drink is equivalent to about one 12-ounce can of beer, a 5-ounce glass of wine, or a shot of liquor. According to Murthy’s guidelines, there are about 100,000 alcohol-related cancers and about 20,000 alcohol-related cancer deaths in the United States each year.
“When considering whether or not to drink and how much, remember that less is better when it comes to cancer risk,” Murthy wrote on social media platform X on Friday.
What about moderate drinking?
The idea that moderate drinking has health benefits came from flawed studies that compared groups of people based on how much they drank. It was usually measured at a single point in time. And none of the studies randomly assigned people to drink or not, so they couldn’t prove cause and effect.
People who report moderate drinking tend to have higher levels of education, higher incomes and better access to health care, Naimi said. “It turns out that when you adapt to these things, the benefits tend to disappear,” he said. Another problem is that most of the studies did not include young adults. Almost half of people who die from alcohol-related causes die before the age of 50.
“If you study people who make it to middle age and don’t stop drinking because of a problem and don’t become heavy drinkers, that’s a very select group,” Naimi said. “This creates the appearance of a benefit for moderate drinkers, which is actually a statistical illusion.”
Other studies challenge the idea of alcohol’s benefits. These studies compare people with a gene variant that makes drinking unpleasant to people without the gene variant. People with this variant tend to drink very little or not at all. One of those studies found that people with the gene variant had a lower risk of heart disease — another blow to the idea that alcohol protects people from heart problems.
What do the guidelines say?
Recommendations vary widely from country to country, but the general trend is to drink less. The United Kingdom, France, Denmark, the Netherlands and Australia recently reviewed the new data and lowered their drinking recommendations. From 2026, alcohol will be labeled with cancer warnings in Ireland.
“The scientific consensus has shifted because of compelling evidence linking alcohol to more than 200 health conditions, including cancer, cardiovascular disease and injury,” said Karina Ferreira-Borges, Regional Advisor on Alcohol at the World Health Organization’s Regional Office for Europe.
Naimi served on an advisory committee that wanted to lower the recommendation for men in the US to one drink a day. That advice was reviewed and rejected when the federal guidelines came out in 2020. “The simple message that is best supported by the evidence is that if you drink, less is better when it comes to health,” Naimi said.
