So, The Surgeon General Wants To Put Cancer Warnings on Alcohol

And I have thoughts

I want to preface this article with three points.

First, there are valid health repercussions from drinking alcohol which is why I am a big advocate for moderate drinking. Second, I have mad respect for anyone who has identified they have a problem with alcohol and are now sober. My thoughts below do not override either of those standpoints.

Third, I’m not American, I’m a Brit living in Portugal. And whilst Britain has a reasonably problematic relationship with alcohol, here in Portugal it’s much more of a glass-a-day, keep-it-chill sort of attitude.

But still, what happens in America will always influence the rest of the world. If your Surgeon General wants to put cancer warnings on alcohol, it’s no big stretch to theorise it could eventually happen in Europe too.

And I have thoughts about this.

This news is rocking the drinks industry right now — Surgeon General Dr. Vivek Murthy has called for cancer warnings on bottles of wine, beer and spirits. The reason is that alcohol has been linked to 100,000 cases of cancer cases and 20,000 deaths each year.

But there are big issues here. Issues like the validity of the studies used to make Murthy’s points. Issues like not all alcohol is made equal (more on that shortly).

And an issue that keeps rolling around in my head — why are they so hellbent on crusading against alcohol and not other, arguably bigger killers? Sugar comes to mind, as do UPFs. After all, the biggest killer in the US isn’t cancer, it’s heart disease.

This isn’t to say alcohol doesn’t play a part in heart disease. Alcoholic beverages can be packed full of sugar (think wine coolers, and sugary cocktails and a surprising amount hides in “dry” wines). And too much alcohol can mitigate healthier pursuits like exercising or eating better.

But frankly, vilifying alcohol probably isn’t going to do all that much for people who already drink it.

And should we vilify all alcohol in the same way?

I’m not so sure.

Once you’ve read this, I suggest you head over to

Jason Wilson

’s story America is in Dire Need of Drinking Literacy. He does a great job of critiquing the data used to support the Surgeon General’s recommendations.

I don’t want to repeat everything Jason says, but here are a few salient points:

• Heavy drinkers — which account for 7.2% of the drinking population — represent 75% of alcohol-related cancer diagnoses.

• Risk ratios for light drinkers can be generally easily offset.

• For women, increasing alcohol from one drink a week to two a day increases cancer risk from 17% to 23% and for men, from 10% to 13%.

• Almost every study on the effects of alcohol consumption relies on self-reported data and people often overestimate what constitutes “one drink.”

Jason’s findings give oft-lacking nuance to this controversial topic.

Speaking of nuance, there is something else at play here. Something I wrote about a couple of years ago on Medium (you can read the full story here without the paywall).

That is not all alcohol is made the same.

Alcohol is often lumped together as one amorphous blob and yet there are vast differences between different beverages. Whilst I was doing my research for that story, I tried in vain to find any study that treated different alcoholic beverages separately. Does a vodka drinker for instance have a worse time of it than a low ABV natural wine drinker? Is it so crazy to suggest they might?

And why aren’t we looking at this? After all, if it does make a difference, it could be much easier to change what a drinker drinks than to make them abstain altogether.

What I did find out was that the type of alcohol you drink could make a difference in how it affects your body. For a start, there isn’t just alcohol in your alcohol.

Some findings (all sources are in the above Medium article):

• Alcoholic drinks can contain traces of pesticides and herbicides which have been linked to all manner of issues such as Parkinson’s and yes, cancer.

• Some studies suggest sugar and alcohol don’t mix. Evidence suggests it can make hangovers worse yet there are plenty of sugary alcoholic drinks out there.

• My all-time favourite study in wine showed that the reason sulphites can affect you is not just because of allergens but because your liver breaks down sulphites AND alcohol. Thus more sulphites in your drink, the higher your blood alcohol concentration will be because your liver battles to break them both down.

Of course, no study is perfect which is why I’ve used so many qualifying words here. But that doesn’t take away from the fact that not all alcohol is the same and thus IMO, shouldn’t be treated as such. Yet when we talk about the links between alcohol and health, we seldom consider this.

Honestly, it’s fucking scary writing about this. I don’t want to come across as someone who advocates cracking on with drinking as much as you like.

But I am a realist. I know people are going to drink whether it’s healthy for them or not. In fact, this idea that wine could be healthy for you seems to be a moot point. I don’t know anyone who drinks solely for their health — that ship sailed long ago.

Alcohol drinkers know the risks associated, but it doesn’t stop them. Just as we eat cakes and ice cream. We know they’re not good for us either but still, we indulge.

The better — but much harder — thing is to accept that, in countries like the UK and US, we need a complete change in attitude and approach to alcohol. To learn how to moderate our drinking. No keggers, no binging, no drinking games. Just chilling with a glass or two.

I have no answers for how to achieve that but I do know that sticking a cancer warning on a bottle of wine isn’t it. That’s treating the symptom, not the cause. A cause that, if the Surgeon General really wants to reduce avoidable health conditions, maybe shouldn’t be so high up his list.

It’s not easy to change a whole country’s attitude to alcohol. But if we truly want to get people to moderate their intake — or as I would argue, to moderate AND drink better quality stuff — that’s what needs to happen.

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Something I rarely do — but want to do more this year — is to recommend specific wines. Seeing as I mentioned the interesting effect sulphites have in how your body metabolises alcohol, I thought we’d start there.

Below are six recommendations for low or no-sulphite wines available for my lovely paid subscribers. And FYI, all my recommendations adhere to strict criteria:

1. I have to know the wine well. That means I sold it in my store and bar, I drink it on the regular now, or both.

2. They have to be available in the US, UK and Europe because The Sauce subscribers are from everywhere.

Six of my favourite low-sulphite white wines