This year’s Dry January seems to be a big downer, doesn’t it? We were barely 48 hours into 2025 when the outgoing U.S. Surgeon General, Vice Admiral Vivek H. Murthy, announced that all alcohol-related products should carry a warning label clearly stating the link between all alcohol consumption and cancer. What the exact wording of this label will end up being — and whether anyone will read it — remain to be seen. Congress would have to act as a next step. (Enough said).
Nonetheless, it was the top story on only the third day of the year (scratch that, the third day of Dry January), and it’s fueling a movement that seems alcohol consumption in any amount as a societal evil.
Anyone with an ounce of common sense left knows the world is not often black and white — it is full of gray. And what’s more gray than your own individual health from day to day?
Those of us who make a living in the wine business have seen this building for months, so no one was surprised by the new Surgeon General warning on alcohol. Still, this feeling of panic … we’re all trying to figure out what to do with it.
On some levels, the Surgeon General news felt like an opening salvo toward branding alcohol as “the new tobacco” because when you hear a simple statement like “alcohol causes cancer,” you immediately think of how cigarettes cause cancer. Good luck stuffing that genie back in the bottle. Coming on the heels of lagging sales for numerous categories of wine, and a general befuddlement on how to cultivate the next generation of wine drinker, this was an awful way for the industry to start the year.
But I think it is important to take stock of a few things — both professionally and personally — because this does not have to spell doom for wine or other alcohols for that matter. It can actually be a moment for genuine, purpose-driven reform within each one of us, and within the industry.
So with that in mind, let’s dive into the gray, because the black-and-white absolutes that have dominated this media narrative for a week are completely unhelpful.
1. The Guidance on Alcohol is Just That: Guidance
There are already Surgeon General’s warnings on alcohol, and they have not been updated since 1988, a laughably long time given the amount of research that has occurred since then. Updating the labels may be warranted, however risk can also be overstated, particularly if you mandate moving the warning to the front of the product to make it scream in people’s faces.
For those in the wine business, it is important to — gulp — read the comments on these news stories. It is very clear that trust in the government and the advice it doles out is disastrously low. Most remarks I read were defiant, if not downright petulant. “Great, now do forever chemicals,” read one, which seemed to sum up the zeitgeist as good as any.
While internet commenters tend to be the most vitriolic in our population, there were several that read like “long time listener, first-time caller.” People not only don’t want this guidance, many have already rejected it, often citing Blue Zones and their 90-year-old grandmother. If others read the context behind the numbers (such as how I’ve outlined below) — as well as the stubborn fact that moderate alcohol use is still backed up by several studies — there is good reason to believe the dust will settle, especially if your are an optimist (they do still exist, don’t they?).
Of course, what to do about the structural decline of the wine industry and a massive generational divide … that’s another story for another day.
2. Public Health Guidance is For a General Population. Don’t Confuse It With Individual Risk Factors.
Public health is very different than individual health. In fact, that should be the opening sentence disclaimer on each one of these sensationalist news articles covering last weeks’ announcement (we’ll get into the evidence on moderate drinking next). As Registered Dietitian Kym Wroble and I discussed in a recent article on the WHO’s campaign against alcohol, this distinction is not very clear in the public eye. In order to influence change, guidance has to be conveyed in a simplified manner, otherwise, you won’t get the public’s attention. However, when people take this oversimplified messaging and apply it to their lives, they may not be accounting for other factors. It’s a well-known phenomenon in public health, and was front-and-center through the COVID-19 pandemic.
So take this moment to get to know your own personal risk factors both for cancer and heart disease. It is not only your age and gender, but also your family history, your unique genetic makeup, and also how you live (i.e. Eat those veggies! Move those legs!). It all plays a part. Let that guide you as much as anything.
3. Some Context on the Numbers
Alcohol abuse is the third leading preventable cause of cancer in America. It is well behind tobacco and obesity, but it is still a serious matter. The important word here is preventable.
Where this fight lies now is in moderate alcohol use, and that is where this announcement by Surgeon General has raised eyebrows. From the press release, Vice Admiral Vivek H. Murthy states:
About 83% of the estimated 20,000 U.S. alcohol-related cancer deaths per year occur at levels above the 2020‑2025 U.S. Dietary Guidelines for Americans recommended limits of two drinks daily for men and one drink daily for women. Nonetheless, the remaining 17% of the estimated 20,000 U.S. alcohol-related cancer deaths per year occur at levels within those recommended limits.
That amounts to 3,400 alcohol-related cancer deaths per year. The questions then become: which cancer is most tied to moderate alcohol consumption (it appears to be breast cancer, but the report does not get that granular)? And more importantly, how do they know moderate alcohol consumption is the culprit compared to any of a number of other potential factors?
This is where the report comes up short.
But let’s revisit those 3,400 deaths. Even if their research is sound, and they can make the link that a few drinks per week caused the cancer, that still represent 0.1% of all annual deaths in the United States, and 0.55% of all cancer-related deaths.
I think the bigger issue for public health has to be processed foods, “forever chemicals,” and the alarming state of American agriculture and food production. It would seem that if you are looking for a culprit when it comes to the startling rise in colorectal cancer cases among younger adults, moderate alcohol use would be far down the list, no?
But I guess if you were looking to target something for meaningful health outcomes — in other words, to define your legacy as a public health advocate before leaving office — alcohol is a way simpler target than white bread. Or energy drinks. Or chicken nuggets.
4. The Dataset is Incomplete at Best. Flawed at Worst.
After I published this essay, a long-time reader pointed me to this article written by Dr. Vinayak K. Prasad, professor of Epidemiology and Biostatistics at the University of California, San Francisco and a health researcher with a focus on hematology and oncology. In other words, someone who is not only well-aware of the dangers of cancer, but also capable of parsing large datasets and finding the holes.
“It is a fucking mess of confounding,” he says midway through the essay, referring to how the Global Burden of Disease Study from 2016 (the basis of the Surgeon Generals decision) confuses attributes in respondents to that point that individual traits become too difficult to distinguish. For one, the study is entirely based on self-reported drinking, which he finds fishy since people often exaggerate how much they drink, or — more likely — lose track of how much they drink. Secondly, and perhaps most problematically in his estimation, it only accounts for present-day patterns of drinking. “You could drink 30 drinks a day for years, but if you spend a year in Tibet, you get called lifetime infrequent,” he writes.
“In addition to type of alcohol, quality of alcohol, the authors don’t have a way to measure how fast or slow people drink, with or without food, with or without company, what time of day they drink, whether they sleep or eat well otherwise, whether exercise modifies the effect, and many other salient questions,” he further states. This is something our friend here at Opening a Bottle, Registered Dietitian Kym Wroble, has touted repeatedly: your cancer risk is a combination of tens, if not hundreds of factors, and yet the very study that has inspired the Neo-Prohibitionist movement fails to account for any of these variables amongst its self-reporting recipients.
5. Numerous Studies Still Say That Moderate Alcohol Intake Benefits Cardiovascular Health
Furthermore, there is this recent report from the National Academies of Sciences, Engineering and Health (NASEM) stated that a “16 percent lower risk of all-cause mortality” for moderate drinkers versus individuals who didn’t drink alcohol at all (a shout out to the always eagle-eyed W. Blake Gray of wine-searcher.com for shedding light on this report).
This is not the only report that subtly says what has been said for decades: that moderate alcohol consumption can provide some benefits by reducing risk of heart attack and stroke. And there are also numerous other studies that found the link between moderate drinking and health problems to be inconclusive.
6. Let’s Take Stock and Not Obfuscate
Wine provides the kind of deep rewards that can make life richer and more colorful. For that reason, I will accept the risks. But let’s hope that this moment makes overconsumption as unfashionable as it always should have been.
However, there is valid reason for the industry to be concerned. The Neo-Prohibitionist movement is employing a “give an inch, take a foot” strategy that requires a strong, smart and targeted counter-response from the industry. And the beverage alcohol business has very little margin for error. Its product contributes to numerous societal problems, none greater than the devastation of alcoholism. Purely on those grounds, it is a difficult product to defend, especially when you’ve personally seen the wreckage this disease can cause, as I am sure many of you have.
I would urge both wine lovers and the wine industry to tread carefully. Don’t put a lid on the risks. Don’t obfuscate. Respect those who choose not to drink, because there are many, many valid reasons to stay dry.
And lastly, perhaps this is a good moment for this industry to clean up its act, too.
This is a profession that thrives on heavy consumption and cavalier attitudes. Many people in this field drink way too much, and take pride in their know-it-all status because of all the tasting they’ve done. There is a vicious circle to this particularly with wine, which is largely seen as an opaque subject matter possessed by gatekeepers. The wine industry’s stubborn dependency on points — which stifles any curiosity among new drinkers in favor of quick, meaningless, numeric scores — is fed by this. It took me 10 years of wine reporting to overcome imposter syndrome because I hadn’t tasted enough. Then I realized: it’s never enough for most people. So to hell with them. But you can see how it promotes more and more and more tasting. Sipping and spitting is essential, but anyone in this business knows there are moments when a dump bucket is out of reach, or out of sight.
What resonates with most of us is the intimacy of wine. No other drink brings us closer to the story of the land, the people who work on it, and the history that brought it to this moment. In fact, alcohol is the least interesting thing about it.
Wine provides the kind of deep rewards that can make life richer and more colorful. For that reason, combined with my family medical history and a personal commitment to veggies and exercise, I will accept the risks.
But let’s hope that this moment makes overconsumption — at home, and within the industry — as unfashionable as it always should have been.
Note: It goes without saying, but then again, in this world it does not: please drink responsibly and consult your health provider to deem what levels of alcohol and alcohol risk you are willing to take. Opinions expressed within this article are mine and mine alone.
