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Health warnings about alcohol give only half the story

The Economist
Jan 18, 2025 08:00 AM IST

Enjoyment matters as well as risk

For many people, the new year brings both a banging hangover and a solemn resolution never to get drunk again. More than a decade ago Alcohol Change UK, which campaigns to cut drinking, launched its “Dry January” campaign. This year it reckons a third of British men will try to stick to it.

Drinking a lot is indisputably bad for you(Pixabay) PREMIUM
Drinking a lot is indisputably bad for you(Pixabay)

In America Vivek Murthy, the surgeon-general, is also keen to discourage drinking. Dr Murthy has recommended placing warnings on alcohol to highlight the fact that it raises the risk of some cancers, including breast and bowel cancer. If so, America could become the third country, after South Korea and Ireland, to require labels.

Drinking a lot is indisputably bad for you. Boozing has long been associated with heart attacks, liver disease, stroke and obesity. Drunks are more likely to get into fights or accidents. Alcohol is addictive, and the World Health Organisation (WHO) blames it for about one death in 20 around the world. The link with cancer is less familiar to most people. Dr Murthy’s statistics suggest that women who drink occasionally have about a 16.5% lifetime risk of several common cancers, whereas those who have one drink a day—America’s recommended maximum—have about a 19% chance.

As the evidence of alcohol’s harms has piled up, the public-health messages have become starker. The WHO says flatly that there is “no safe level” of alcohol consumption. America’s guidelines say that those who do not drink should not start “for any reason”. In 2023 Canada published guidelines recommending two drinks (roughly two cans of beer) a week for those who want to remain in the “low risk” category, down from 15 a week for men and ten for women.

It is all very sobering. But over-zealousness can be counter-productive. Taken literally, the WHO implies that it is unsafe to have even a sip of communion wine. If one bit of public-health advice seems absurd, people may start to doubt other bits, too.

And although there is unanimity that heavy drinking is very bad for you, there is less agreement around light indulgence. In December America’s National Academies of Science, Engineering and Medicine concluded, with “moderate certainty”, that moderate drinking (up to two cans of beer a day for men or one for women, as per official American advice) was associated with benefits rather than harms. Benefits in heart health appeared to outweigh the risks from cancer and other ailments, though the effect disappeared quickly with extra quaffing.

Many scientists think that the benefits of light drinking are a statistical mirage. But even if the WHO is right, and no amount of alcohol is safe, that is only half the picture. After all, there is no completely safe level of almost anything, from flying to going on a date. Walking is good for you, and touted at book length by the surgeon-general (“Step It Up!”). But 7,500 American pedestrians were killed by cars in 2022.

People balance the dangers of an activity against the benefits it brings. These days, suggesting that drinking might have any benefits at all feels faintly heretical. But many enjoy the taste of a good beer or wine, appreciate the buzz it provides, or take pleasure in the social rituals, like a pub visit or a dinner party, which it lubricates. That is why the world is willing to spend $1.8trn a year on drink. All that enjoyment belongs on the scales with the (equally real) harm.

Some perspective: Canada’s new guidelines define “low risk” as a one-in-1,000 chance of premature death owing to alcohol. Boosting consumption from two to six drinks a week raises the odds to one in 100. With walking, the lifetime risk of being run over in America is about 1 in 470.

What to do in 2025? If you are a heavy drinker, almost everyone would agree that it would be wise to cut down. For all but the most risk-tolerant, the middle-class habit of downing half a bottle of wine with dinner is worth examining. But if you fancy a pint or two with friends every now and then, you will be trading a tiny risk of harm for an evening of warmth and good company. That is a trade many rational people will be happy to make—especially amid the cold and gloom of January.

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