Alcohol Causes Cancer. We Should Be Drinking Less.

Alcohol causes cancer, and we should be drinking less of it.

There, we said it. We realize this op-ed will make us hugely unpopular at the next professional conference reception where, chances are, alcohol will be dispensed liberally to entice attendance and promote networking.

It’s difficult to reconcile the ubiquity of alcohol at events like this with the fact that alcohol increases the risk of seven types of cancer: mouth, throat, larynx, esophagus, liver, colon and rectum, and breast cancer (in women). The science is unequivocal that alcohol is a leading preventable cause of cancer in the U.S., contributing to nearly 100,000 cases and 20,000 cancer-related deaths per year. Moreover, cancer risk increases with the amount and frequency of alcohol consumed, but exists even at “moderate” levels that are within the current dietary guidelines. Evidence shows that just one drink a day increases risk of some cancers.

Despite this evidence, we, as a society, often serve alcohol at professional events and at fundraisers, even those focused on cancer. Today, it would be unthinkable to hand out cigarettes at these events, yet we don’t question the presence of alcohol.

The link between alcohol and cancer is not well known among the public: only 45% of U.S. adults are aware that alcohol consumption increases cancer risk (as of 2019). More people think that genetically modified foods (60%), artificial sweeteners (58%), or stress (54%) are carcinogenic — despite a near total lack of evidence that they cause cancer. In contrast, decades of high-quality evidence from peer-reviewed studies conclusively indicate that drinking alcohol increases the risk of cancer. The public health and cancer research community clearly has some work to do and awareness to raise.

This is the backdrop for the Surgeon General’s 2025 Advisory Report recommendation in early January to include a cancer risk warning label on alcohol-containing beverages. We applaud this recommendation. This warning label addition is much needed and can shift social norms over time to reduce population-level exposure to a known carcinogen — as has occurred with cigarettes.

For maximum impact, warning labels should be placed prominently on the front of containers, be large with high contrast colors, contain graphic warnings, and have clear and specific wording, such as “alcohol causes cancer.”

Solid research evidence demonstrates that warning labels can be effective, as the Surgeon General’s report points out. For example, a Canadian study found that warning labels on alcohol-containing beverages, which included a cancer warning, reduced retail sales by 6%. Multiple reviews have concluded that alcohol warning labels, including warning labels focusing on cancer, show promise in raising awareness and reducing drinking behavior.

But warning labels aren’t a panacea or the only tool in the toolbox. They work best in concert with tried and tested alcohol policy strategies to make alcohol less affordable (increasing taxes), less available (decreasing the number of outlets and days and hours of sale), and less attractive (banning advertisements). Moreover, public health education campaigns should accompany health warning labels to explain the alcohol and cancer link. And, of course, clinicians can play an important role in discussing this topic with their patients. Together, these measures can have a profound impact on alcohol use and, subsequently, cancer rates.

Some have argued that ignoring the role of pleasure in alcohol consumption risks alienating the public and undermining the credibility of health messaging. It’s important to engage with this argument. These labels do not need to be presented as anti-pleasure, but rather as tools for informed choice that empower every one of us to weigh immediate enjoyment against long-term health risks. Warning labels are a tool for enabling informed consent; consumers need to know about the risks that their behavior brings.

Like other policy measures to reduce consumption, warning labels may cut into the alcohol and nightlife industries’ bottom line. In response, we expect “Big Alcohol” to take a page from Big Tobacco’s playbook — for example, it’s possible they could interfere with the implementation of these labels or launch targeted marketing campaigns to encourage drinking.

The scientific and healthcare community needs to be prepared. We should continue building a robust evidence base grounded in unbiased research without industry funding, engage key stakeholder groups (including cancer advocacy organizations and those already active, such as Mothers Against Drunk Driving), preempt industry tactics (e.g., prepare for lawsuits, monitor lobbying, and expose conflicts of interest), and empower grassroots advocacy efforts.

Finally, there are plenty of examples of entire cultures that have existed without alcohol who do not lack community or connection. As health professionals, we don’t have to wait for alcohol warning labels to materialize — we should adopt this cultural norm and lead by example. It’s time to take inventory of our own meetings and social events and the role that alcohol plays in them. We should challenge the belief that events or a life without alcohol is just not fun.

It will be a long road to dispel the pervasive notion that alcohol is a necessary ingredient for social gatherings, connection, and community. But the work to rethink our relationship starts in our own life and our immediate sphere of social and professional influence — as well as the next conference.

Johannes Thrul, PhD, MS, is an associate professor of mental health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, a member of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and an honorary research fellow at the Centre for Alcohol Policy Research at La Trobe University in Melbourne, Australia. Elizabeth A. Platz, ScD, MPH, is a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, the Martin D. Abeloff, MD Scholar in Cancer Prevention, and a member of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

The author’s views are their own and not those of Johns Hopkins University.

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