The Messaging Battle Over Alcohol’s Health Risks

Jon Gingerich

The U.S. Surgeon General in January issued an advisory calling for alcoholic beverages to contain a warning label addressing the cancer risks associated with drinking. In a statement, outgoing Surgeon General Dr. Vivek Murthy referred to alcohol as a “well-established, preventable cause of cancer” that contributes to 100,000 cancer cases in the U.S. each year, although a majority of Americans remain “unaware of this risk.”

This shouldn’t be a controversial statement—health experts have known about the link between alcohol and cancer since the 1980s. Yet, the Surgeon General’s suggestion that even moderate drinking may pose health risks resulted in pushback from alcohol industry advocates, who’ve responded with inconsistent messaging that could mislead Americans regarding the risks associated with alcohol consumption.

The scientific consensus surrounding the dangers of alcohol has evolved significantly in recent years. A spate of well-publicized studies has suggested that alcohol has no health benefits, that the methodology behind previous studies suggesting moderate drinking provides health benefits was flawed and that a direct link exists between alcohol consumption and a variety of serious health risks, including seven different types of cancer.

These findings suggest our current health messaging isn’t giving Americans the full picture regarding the potential dangers of drinking. But if there is a causal relationship between alcohol and cancer, why aren’t U.S. health authorities telling us about it?

It’s worth noting that the World Health Organization currently identifies alcohol as a “toxic substance” and “an established carcinogen” that is “associated with risks of developing noncommunicable diseases such as liver diseases, heart diseases, and different types of cancers.”

The Surgeon General’s advisory comes as the nation awaits the latest updates to the Dietary Guidelines for Americans, the influential USDA/HHS policy statement issued every five years that provides recommendations for a healthy diet. When it comes to alcohol, the DGA’s recommendations are informed by two separate scientific reviews. One comes from the National Academies of Sciences, Engineering, and Medicine (NASEM), which concluded in its December report the decades-held belief that moderate drinkers have a lower risk of cardiovascular disease. (Cardiovascular disease remains the leading cause of death in the U.S.) Alcohol trade groups such as the Distilled Spirits Council have repeated these findings in press statements ever since the Surgeon General’s advisory was released in January. This reporter was sent at least one email from a PR firm representing wine brands, which stated that the Surgeon General’s recent push for cancer-warning labels is “contradicting key findings” from NASEM and concluded that “Americans deserve evidence-based guidance, not fear-driven narratives.”

It’s a logical stretch to conclude that moderate drinking is safe simply because it’s linked to reduced cardiovascular risk, as though a reduced risk of heart disease somehow cancels out increased cancer risks. It seems discreetly reasonable that two things can be true at once: that alcohol may lower the risk of heart attack while heightening the risk for cancer. Indeed, the NASEM report also noted that moderate alcohol consumption was associated with an increased risk of breast cancer.

Current DGA guidelines also state that “emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease.” So, why not put that on a warning label?

Marion Nestle, a nutritionist, author and professor at New York University, told O’Dwyer’s that the DGA committee had previously recommended revising current guidelines for daily alcohol intake, calling for only one drink per day for men. Those suggestions, however, never made it into the final guidelines, and the DGA continued with its longstanding recommendation of two alcoholic drinks per day for men and one for women, which is the same recommendation it has had in place since 1990.

Why are we using 35-year-old science to guide healthy alcohol practices? Here’s a clue. Despite the Surgeon General’s suggestions, revising the current warning labels on alcohol would require an act by Congress, which seems unlikely. Politico in January reported that more than 100 U.S. House reps. in October reached out to the HHS and USDA secretaries, “asking them to suspend a study on alcohol consumption overseen by HHS that figures to undergird the new dietary guidelines.” According to Open Secrets, the D.C.-based nonprofit that publishes lobbying data, more than $29 million was spent on beer, wine and liquor lobbying in 2024.

South Korea is currently the only country in the world requiring a warning label stating that drinking alcohol can lead to liver cancer. In 2023, Ireland became the first EU nation to mandate a warning label regarding alcohol’s cancer risks, which is set to take effect in 2026. Lawmakers in Canada had proposed a similar labeling initiative before alcohol-industry lobbyists successfully shut that proposal down. Call me crazy, but I don’t think Canada is alone.

“In the face of inconsistent interpretations of the evidence on alcohol and health, you need to decide whether to take precautions—‘I will drink as little as possible’—or continue drinking as much as you like and take your chances on the consequences,” Nestle said.