The Surgeon General Calls for New Warning Labels on Alcohol—Here’s the Truth About How It Impacts Your Health
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Giacomo Gambineri
This article is part of Dry January, Straight Up, your no-BS guide to cutting out alcohol for 31 days—or longer. SELF will be publishing new articles for this series throughout January. Read more here.
If you’re like a lot of folks, you might be kicking off the New Year with everyone’s favorite no-booze month—Dry January. And even if you aren’t, might we suggest it could be a good time to reassess your drinking habits in general? After all, while you likely know how alcohol makes you feel—wonderful while you are consuming it (at least at first…), followed by a chaser of hangovers, headaches, and grogginess galore—over the years, alcohol’s “health halo” (“It’s healthy in small doses!”) has been dimming.
Alcohol has long been known to be a carcinogen—meaning, it’s capable of causing cancer, particularly breast cancer—and on Friday, January 3, Vivek Murthy, MD, the surgeon general of the United States, issued an advisory about this link, calling alcohol consumption a “leading preventable cause of cancer” and advocating for health warning labels to be added to alcohol products. As Dr. Murthy outlines, evidence is piling up that drinking even small amounts is a problem.
At the same time, alcohol’s supposed benefit, namely a healthier heart, is turning out not to be a thing. The World Health Organization says there’s no “safe” amount of alcohol to consume. And in 2023, a review of research re-examining 107 existing studies on booze found that alcohol also has no protective health impacts whatsoever. “The mainstream view in public health and medicine is that if there are benefits [to alcohol], they’re much smaller than thought, and they may not exist at all,” Tim Stockwell, PhD, a leading alcohol researcher and director of the Canadian Institute for Substance Use Research, tells SELF.
Surprised? You’re not alone. Connecting the dots between what scientists know and how we all understand the health impacts of what we ingest is not always a…straight path. So during a popular time to temporarily press pause on drinking, SELF reports on where the research on alcohol and health stands—and how our societal views on booze have been shifting.
First things first: How does alcohol impact health?
In short, alcohol affects almost every organ and tissue in the body, including the brain, heart, lungs, liver, stomach, and more. “We observe its effects on the brain most readily because the brain is the organ of behavior,” Henry Kranzler, MD, director of the Center for Studies of Addiction at the University of Pennsylvania’s Perelman School of Medicine, tells SELF.
Because alcohol acts as a depressant, it slows down your brain activity and alters your behavior, mood, and self-control—which is why when you drink, you might act in ways you otherwise wouldn’t. Its effects on the brain also cause issues with gait, balance, and memory. Excessive alcohol use is linked to cognitive decline and neurodegenerative diseases such as Alzheimer’s, and mental health conditions such as anxiety and depression often co-occur with high levels of drinking.
When Jessica D'Argenio Waller, a 39-year-old from Niskayuna, New York, stopped drinking this summer, it was because she finally started listening to how alcohol made her feel—and because she simply couldn’t ignore the health risks. “As a health editor, I’m constantly looking at the latest research and clinical studies to support my reporting, which meant that there was mounting evidence around the health risks of alcohol, especially for women, like increasing the risk of many types of cancer, dementia, mental health conditions, and chronic disease,” she tells SELF. “Drinking started to feel counterintuitive to the other healthy lifestyle choices I make for myself.”
D’Argenio Waller is right: The current research on alcohol is grim. A 2022 study in JAMA Network Open, for example, found that drinking any amount was linked with a higher risk of heart disease. A study in Nature, co-authored by Dr. Kranzler, found that less than a drink or two a day for women was linked with a decrease in gray matter volume in the brain, white matter volume, and what’s called “white matter integrity,” which affects how well brain cells communicate with one another, Dr. Kranzler says. “Heavy drinkers had brains that were about 10 years older than similarly aged people who were not heavy drinkers.”
Of course, as you probably know, alcohol is terrible for the liver too. Drinking too much, for too long—or even heavy binge drinking that lasts weeks and months—is one of the most common causes of liver disease. And the Centers for Disease Control and Prevention (CDC) recently reported that deaths from causes fully attributable to alcohol use, like liver disease, have increased in the US over the last two decades, with a 46% increase from 2016–2017 to 2020–2021.
Some 1 in 20 new cancer cases in the US also result from alcohol use. In fact, many advancements in alcohol research are a byproduct of the investment in cancer research, Kevin Shield, PhD, senior scientist at the Centre for Addiction and Mental Health in Toronto, tells SELF. A review of research he co-authored, published at the end of November, was the first to show that less than one drink a day increased breast cancer risk. (Previous studies have connected alcohol and breast cancer but never revealed just how little booze can move the needle.) Other types of cancer that are linked to alcohol use include colorectal, liver, esophageal, stomach, and certain types of head and neck cancers.
So why did we think alcohol had health benefits for so many years?
“A glass of wine is good for your heart”; “people who drink a little bit are healthier than those who don’t drink at all.” We’ve all heard such statements—and the truth is, they do have roots in research; it’s just that they are either outdated, flawed, or the scientific understanding has evolved over time, which is how science works.
Case in point: A 1991 60 Minutes segment covered the idea that heart disease rates were higher in the United States than they were in France. “The hypothesis was that it was because of all the red wine they’re drinking in France—and that got a lot of media attention,” Dr. Shield says. Follow-up studies, though, revealed that heart disease was being “miscoded” in France, Dr. Shield says; when ill-defined deaths were reallocated, heart disease rates in the two countries looked more alike. The association between heart health and red wine didn’t exist.
Other older studies that compared drinkers and nondrinkers, or “abstainers,” included people in the latter category who previously drank but gave it up for any number of reasons. This clouded much of the research, as these “abstainers” were sometimes people who had stopped drinking for health reasons, and thus often less healthy overall than people who drank in small amounts, explains Dr. Kranzler. More recent studies that classify “abstainers” as people who have never drunk before reveal that any health benefit associated with alcohol intake shrinks or completely vanishes, says Dr. Stockwell.
As for red wine’s supposed star ingredient, the antioxidant resveratrol? Research around it is mixed, and much of it has also been conducted in animals—which isn’t exactly translatable to humans. Some research on the compound has even been marred by controversy, including some that turned out to be falsified.
Many past studies on alcohol have also been population-based studies and mainly included only people with European ancestry, says Dr. Kranzler, which means this research isn’t as detailed, comprehensive, or inclusive as it could be. (More modern research—including some of Dr. Kranzler’s—includes people with varied ancestry, hoping to reveal how genetics may play in.)
To make matters worse, there’s been a history of alcohol companies themselves funding research on alcohol and health—a move that results in inherently biased data. A glaring example: The National Institutes of Health stopped a worldwide Moderate Alcohol and Cardiovascular Health (MACH) trial in 2018, which was meant to elucidate the possible cardioprotective benefits of alcohol, after media coverage revealed that approximately two thirds of the funding came from companies that sell alcohol.
More people are “sober curious,” but the pressure to drink is still strong.
There is a clear downward trend in alcohol consumption—particularly in young adults. (Though, FWIW, there’s also a *rise* in the use of marijuana and hallucinogens.) What’s not clear is why younger people drink less—and while some data suggests younger generations are more aware of the health implications of booze, research around health harms likely isn’t the main driver of change, Dr. Stockwell suspects. (In fact, a 2023 analysis revealed that more than half of US adults weren’t even aware that drinking impacted cancer risk.) He says drinking less coincides with “a huge shift in the way young people socialize, connect, and spend their money.”
Of course, society at large is still playing catch-up to all of this in many ways, as seen through those nosy “Why aren’t you drinking?” questions you might face if you sip seltzers while out. “I still struggle with how to answer [that] question,” says D’Argenio Waller. “Drinking is still very much the social norm in our culture, and it’s considered weird or even un-fun if you're not partaking.”
It’s easier than ever to find nonalcoholic drinks—a market valued at a whopping $1.3 trillion in 2023—but for those who choose not to drink, it can be harder to replicate the social and emotional needs that alcohol can fulfill. D’Argenio Waller says it’s taken her some extra effort to find other ways to wind down. “What I liked most about alcohol was the emotional signal to relax,” she says. “I’ve started finding other ways to capture that feeling.” These include drinking tea, going for evening walks, or deep breathing.
Of course, some people SELF spoke to did stop drinking for health reasons. Kelsey Harlow, a 29-year-old from Cincinnati, went sober two years ago after having her gallbladder removed. “I decided to give up drinking and make other serious diet changes to support my body to be around as long as I could for my son,” she tells SELF. She says that she has noticed a huge difference in her GI symptoms—diarrhea, bloating, and overall discomfort—since cutting out alcohol entirely (and simultaneously focusing on eating a more balanced diet).
Amanda Woon, a 35-year-old in Hong Kong, started drinking less in 2018 after noticing how awful it made her feel. Even after one drink, she would notice flare-ups of her lupus. “If I didn’t drink, I would get fewer flare-ups, which led to an overall better quality of life,” she tells SELF.
Both Harlow and Woon say their doctors never advised them on the health impacts of alcohol.
Research on the health effects of quitting drinking is ongoing; in the meantime, policies are shifting.
We know that alcohol is bad for our brains and bodies in numerous ways, especially in large amounts, and the days of alcohol being seen as a part of a healthy diet are over. “You would never promote people to drink as part of a healthy lifestyle,” confirms Dr. Shield. He says experts usually encourage people who don’t drink not to start.
Today we have many more, much bigger, and much more accurate studies on alcohol that take into account various factors such as lifestyle choices or socioeconomic status. They all point to the idea that there is a direct linear relationship between alcohol consumption and mortality: meaning, Dr. Kranzler notes, if you don’t drink, you’re not going to have alcohol-related consequences; if you drink a little, you have a little risk; and if you drink a lot, you have a lot of risk. As much was confirmed in a 2018 study in The Lancet that found the only way to eliminate any health risks linked with drinking is to not drink at all.
But we’re not at the point that experts suggest everyone should stop drinking entirely. We do have evidence that at least some of the organs and tissues affected by even heavy alcohol use can bounce back, to some extent, if you stop drinking, Dr. Kranzler says. Even in chronic users, there’s “clear potential for reversing the adverse effects of alcohol.” But that doesn’t exactly translate to people who drink very small amounts: There really isn’t much scientific evidence to show that if you only have one to two drinks a week, going sober will improve your health in measurable ways, Dr. Shield says.
To get to that point, we’d need to know exactly *what* the health improvements would be and *how much* of a lower risk you’d be at *for what health conditions* if you cut back on booze. This is likely the next frontier of research, says Dr. Shield. “If you want to motivate people to change, you need evidence that a change can improve health.”
Big-picture changes around alcohol are underway worldwide too. In 2026, Ireland will become the first country to include a cancer warning on all alcohol products sold. The 2025 Dietary Guidelines in the United States could include changes around alcohol, and debates about cancer warnings on alcohol products in this country are also happening. In addition to the Office of the Surgeon General, the American Association for Cancer Research has called for their need. “People have a right to know what the negative impacts of a substance they’re ingesting could have on their health. Warning labels are a great way of giving them that knowledge,” adds Dr. Shield.
For D’Argenio Waller, this sort of knowledge has been empowering. Not drinking has “had positive impacts in what feels like all aspects of my life,” she says. That’s an outcome that’s pretty hard to ignore.
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Originally Appeared on Self
