Most Americans still don't know that alcohol can cause cancer — and the alcohol industry is working hard to make sure it stays that way.
For the past three years, the industry, aided by its allies in Congress and later the Trump administration, has sought to discredit and eventually bury a major analysis that offers new evidence of the link between drinking alcohol and getting sick and dying from various causes, including cancer.
It appears their campaign has succeeded. Three co-authors on the Alcohol Intake and Health Study, which was commissioned in early 2022 by the US Department of Health and Human Services under President Joe Biden, told Vox that they were informed last month that the Trump administration did not intend to publish the final draft of the study or its findings.
"The thing that the alcohol industry fears more than increased taxes is increased knowledge about the risks associated with drinking alcohol, particularly around cancer," Mike Marshall, CEO of a group dedicated to reducing alcohol's harms called the Alcohol Policy Alliance, who was not involved with the study, told me. "Like the tobacco industry, like the opioid industry, they are working hard to prevent the American people from gaining the knowledge that they need to make the best decisions for themselves."
Why assert so much pressure? It makes sense if you look at the headwinds the alcohol industry faces. Americans today are drinking less. This year, Gallup recorded a historic low in the percentage of US adults who drink: 54 percent, down from 67 percent in 2022.
Though the vibes around alcohol are shifting, a lot of people still don't fully understand alcohol's health consequences. Surveys have found that while the percentage of Americans who know that alcohol is a carcinogen has been rising, it is still below 50 percent.
By the end of the year, the federal government will issue new dietary guidelines — something that happens every five years — which include recommended limits on alcohol consumption. The alcohol study's results were intended to inform those guidelines.
"I was hopeful. … Look at all this evidence we have," Priscilla Martinez, deputy scientific director of the Alcohol Research Group at the Public Health Institute and one of the co-authors, told me in an interview. "This is when the change is going to happen."
But after the authors submitted their final report to Trump's health department in March and never saw it again, Reuters reported in June, citing anonymous sources, that the new dietary guidelines would eliminate any specific recommended limits on alcohol consumption.
"I think it's a shame," said Katherine Keyes, an epidemiologist at Columbia University and another co-author. "Anyone who is a decision-making authority, you want them to have all of the information."
It is another example of the Trump administration seeming to work against the best interest of public health — despite allying itself closely with Health Secretary Robert F. Kennedy Jr. and his Make America Healthy Again movement.
Kennedy and MAHA are fixated on harmful toxins and the corrupting influence of corporate interests. But neither Kennedy, who has been in addiction recovery himself for decades, nor the broader movement has seemed to make reducing alcohol consumption a priority. Instead, the Trump administration will not release a report that would actually show just how harmful to people's health drinking alcohol can be, the latest in a series of decisions that could actually leave Americans less healthy.
"People are going to get sick who might have avoided getting sick, because they might have decreased their drinking," Martinez said.
The Alcohol Intake and Health Study's conclusions, explained
For this story, I spoke with three of the six authors of the study: Martinez, Keyes, and co-author Tim Naimi, an alcohol researcher affiliated with the University of Victoria and Boston University. They all emphasized that they had sought to conduct a study that would fairly represent America's alcohol consumption. They not only reviewed a wide range of observational studies, but they also ran data through a statistical model based on the US population, specifically to estimate the mortality effects of alcohol for Americans.
Martinez said the thinking was: "We've got to make this relevant to Americans."
They broke out their findings by different drinking levels — from one drink per day to three — and focused on health outcomes that have been proven to be associated with alcohol use. Their big-picture conclusion: Among the US population, the negative health effects of drinking alcohol start at low levels of consumption and begin to increase sharply the more a person drinks. A man drinking one drink per day has roughly a one in 1,000 chance of dying from any alcohol-related cause, whether an alcohol-associated cancer or liver disease or a drunk driving accident. Increase that to two drinks per day, and the odds increase to one in 25.
The general finding that the health risks from alcohol start at low levels of drinking and increase significantly for people who drink more is consistent with previous research, as I covered in a story earlier this year. Public health experts broadly agree that heavy drinking is bad for your health; the debate has been over moderate amounts of drinking. There is another issue that continues to complicate the debate: Lay people may have an inflated definition of what "moderate" drinking means compared to their doctor or a scientist, which could lead to people putting their health at risk even if they don't think of themselves as heavy drinkers.
In that context, the report is a harrowing read: Alcohol use is associated with increased mortality for seven types of cancer — colorectal, breast cancer in women, liver, oral, pharynx, larynx, and esophagus. Risk for these cancers increases with any alcohol use and continues to grow with higher levels of use, the study's authors concluded. Women experience a higher risk of an alcohol-attributable cancer per drink consumed than men. Men and women who die from an alcohol-attributable cause die 15 years earlier on average.
Amid all of the public discourse about alcohol and its health effects, here was a clear and authoritative summary of the evidence that would be most relevant to Americans. It was, its authors told me, consistent with the scientific consensus at this time.
"Nothing we're saying is all that surprising or controversial to those of us who know the field," Keyes said.
You can click here to read the rest of my piece on Vox.com.
