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THIS TIMEUS Your browser does not support the element. of the year is when people make resolutions they may struggle to keep. One reason for that is confusion. According to Gallup, a pollster, three in five adults drink alcohol. About 45% think drinking even in moderation is bad for their health, while 43% think it has no effect. Americans drink more spirits (or hard liquor) now than during the Civil War—a time period so filled with drunkenness that some historians say it sparked the temperance movement. This is despite something that has long been known by public-health researchers.The nerds got their way on January 3rd, when Surgeon General Vivek Murthy, America’s top doctor, issued an advisory on the link between drinking alcohol and cancer. He wants the labels on alcoholic drinks to carry a cancer warning. Alcohol, the advisory notes, is the third leading preventable cause of cancer in America, after tobacco and obesity. It accounts for nearly 100,000 cancer cases a year. But while 89% of Americans know that tobacco can cause cancer, less than half are aware that alcohol does too.That is partly because the risk from alcohol is smaller, but it is not trivial. According to the surgeon-general’s report, 17% of women who drink occasionally will be diagnosed, at some point in life, with one of the seven cancers for which alcohol’s causal effect has been established. For women who have two drinks a day the cancer rate goes up to 22%. Among men, the cancer rate goes up from 10% among occasional drinkers to 13% among those having two drinks a day.The link between alcohol and cancer is not scientific news. The World Health Organisation classified alcohol as a carcinogen in 1988. Yet nearly 10% of Americans today say that drinking is good for health. Some of the confusion stems from studies that have found, over the years, that moderate drinkers live longer than non-drinkers. This result is explained mostly by a seemingly protective effect of moderate drinking against heart disease.But what scientists have learned over the years is that plain comparisons of drinkers and non-drinkers make alcohol seem healthier than it may be. Many abstainers have given up alcohol because they are too unwell; some are former alcoholics. How researchers account for these “sick quitters” matters. Some exclude all non-drinkers from the analyses and only measure how risks of disease change with the amount of drinking; others group ex-drinkers with current drinkers. With such adjustments, the protective effect of moderate drinking on longevity and heart disease nearly disappears; the increased cancer risk chalked up to drinking goes up.Newer studies that use genetic tolerance to alcohol to mimic randomised trials of drinking have found no health benefits from alcohol. This study method mitigates biases: people who drink are richer, more educated and healthier than those who do not. That may explain why red wine, rich people’s drink of choice, has seemed particularly heart-healthy. Most scientists now see the idea of alcohol being beneficial in moderation as “either exaggerated or completely false”, says Tim Stockwell from the University of Victoria in Canada.Americans are bombarded with headlines about the benefits of alcohol (“Wine may be good for the heart, new study says”). Occasionally, a headline gives them pause (“Even a little alcohol can harm your health”). The surgeon-general’s message may clear the air—and make resolutions to drink less stick better.
