How can there possibly be more bad news about alcohol? Booze, that is. Beer, wine, hard liquor. We all know about its devilish effects -- bad behavior, embarrassment at parties, an occasional fistfight, hangovers and the like.

We know alcohol is a leading cause of automobile accidents. That's well documented. The National Highway Traffic Safety Administration estimates some 40% of U.S. auto collisions are due to alcohol impairment. Deaths are much lower thanks to seat belts and airbags.

We also know alcohol can lead to addiction and, in turn, divorce, loss of employment and homelessness. Some of us have seen it up close and personal. Locally, the David Lawrence Centers in Naples -- a mental health leader -- specializes in treating alcohol addiction.

As if highway crashes and addiction weren't enough, we are now told alcohol can also cause cancer. That's right. U.S. Surgeon General Vivek Murthy wants warning labels mandated. The Siteman Cancer Center's Graham Colditz was quoted as saying, "Even very small levels can lead to cancer. This ... has been ignored by health recommendations historically."

Alcohol presumably damages DNA and alters hormone levels, making it easier for the body to absorb other carcinogens, like tobacco smoke.

Bad news, for sure. Yet, for three decades, dietary guidelines have said it was safe for men to have two drinks per day and women one per day. Not only safe, but beneficial (antioxidants in red wine). Now, boom, everything is turned upside down. And this is occurring at a time when overall consumption is down in the United States, when young people in particular are turning to non-alcoholic drinks, when use of GLP-1 drugs like Ozempic is shown to reduce cravings for alcohol.

So, what are we saying here? Cut out booze altogether? That's a tough ask.

Alcohol is part of our culture. It accompanies meals and anchors celebrations, weddings, bar or bat mitzvahs. I'm terrible with foreign languages, but even I know many of the toasts - cheers, prost, santé, skal, zivjeli, nazdrovia.

How strong is the evidence against alcohol? Let's look at some numbers.

The surgeon general tells us that for men, going from less than a drink per week to two drinks a day increases the risk for developing cancer from 10% to 13%. But what's the risk for a teetotaler? What's the baseline? For women, the numbers are 17% and 22%. Again, no baseline. That won't keep most people off the bottle.

What if you start and stop? A study in 2023 showed that 83% of alcohol-related cancer deaths could be prevented if consumption was cut to 1-2 drinks a day. OK, that sounds hopeful. Cutting back helps.

But what's the bottom line? What's an estimate of the overall danger? It's hard to draw conclusions from observational studies, but here's a guess.

There were over 600,000 total deaths from cancer in 2021 (American Cancer Society.) There are 20,000 annual alcohol-related cancer deaths, as reported by the surgeon general. That means -- ballpark -- less than 3.5% of cancer deaths are caused by alcohol consumption. Less than 3.5%.

That's not going to convince many people to stop drinking.

But labels do have value in that they promote awareness. It took decades and many warnings to drive home that smoking was extremely risky and should be avoided. And it's claimed health warnings in general discourage 26% of consumers from using a product. Some people heed warnings.

For us old-timers, none of this matters much. We're already damaged goods. So I'm going to have some scotch before dinner tonight. Maybe an 18-year-old McCallum. My wife has already started on the red wine. |