Public Opinion Turns Against Alcohol, And Yet...
The science has not shifted nearly as much as the attitudes reflected in Gallup’s findings.
Welcome to Friday Drinks!
This is where I look at the top news stories of the week, assuming there is any news worth talking about.
Of course, there was a massive story this week. Gallup published the results of its latest polls, showing that alcohol consumption among US adults has fallen to its lowest levels in 90 years of polling. Not only that, but:
“This coincides with a growing belief among Americans that moderate alcohol consumption is bad for one’s health, now the majority view for the first time.”
It’s an extraordinary social change in a very short period. What’s driving it is a long and complicated story — but it’s not because “the evidence has changed” as the media keeps reporting, as you’ll see below.
So what is the actual risk of moderate drinking? I’ve compiled three recent documents, so you can see for yourself. The last one is particularly interesting.
The Big Picture
Laura Catena, a Stanford- and Harvard-educated medical doctor, who is also the owner of Catena Zapata in Argentina, has created a handy infographic.
The main takeaway here is: don’t do cocaine, kids. It’s really bad for you.
The NASEM report
This came out in December 2024. Fourteen scientists from the National Academies of Science, Engineering and Medicine evaluated the most recent evidence on the impact of alcohol and health. They concluded, in line with decades of epidemiological findings:
“Based on data from the eight eligible studies from 2019 to 2023, the committee concludes that compared with never consuming alcohol, moderate alcohol consumption is associated with lower all-cause mortality (moderate certainty).” (My emphasis.)
They also concluded there was moderate certainty that moderate drinking raised the risk of both breast and colorectal cancers.
Their work was reviewed by another 11 scientists, including alcohol sceptic Professor Tim Stockwell. If you want to know more about how the report was compiled and why it’s worth taking seriously, I interviewed the study’s lead, Professor Calonge, and wrote about it here.
The IARD Report
Never heard of IARD? Then go and listen to this Drinks Insider episode, where I interview CEO Julian Braithwaite.
The International Alliance for Responsible Drinking (IARD), funded by 13 of the world’s largest alcohol companies, has a scientific team, a librarian, and a research database. They review and summarise the published literature on alcohol and health, producing reports and compilations of existing research.
The process involves at least three researchers, a year of drafting, and then external reviewers. IARD’s created a short video on their process.
They’ve just updated their review of existing meta-analyses that look at alcohol consumption and all-cause mortality.
It shows that 19 out of 23 relevant studies affirmed the J-curve, meaning they found that light-to-moderate drinkers had a statistically significant lower risk of all-cause mortality compared with abstainers.
In other words, the studies suggest that people who drink light to moderately tend to have a lower risk of dying from any cause.
But take a look at the authors of the four dissenting studies, which didn’t find this lower risk — they’re the sceptics, whose work is constantly quoted in the media.
By the way, I will be publishing the interview with Julian in the newsletter next week.
Their report is here:
A new study aims to answer the big questions
One of the reasons there are competing narratives over alcohol and health is because the existing scientific thinking is based on observational studies — researchers rely on what people tell them about their alcohol intake, a topic on which people tend to lie.
Researchers can correct somewhat for this; they sometimes look at tax receipts, to see how much alcohol was actually bought and then extrapolate from that, but it’s not perfect.
Other problems include researchers, both for and against alcohol, drawing on the same data sets, and the fact that studies rarely take drinking patterns into account. As for distinguishing between the effects of beer, wine and spirits, forget it.
These problems are well known, and some Spanish researchers have decided to tackle them. They’re currently running a trial, called UNATI, which will compare wine drinkers with non drinkers. What they’re doing is clever — they will check participants for biomarkers associated with alcohol consumption, to correct for the self-reporting problem. I wrote about it here.
The trial finishes in 2029 and the results will be out some time after that. But until then, be aware that the “all alcohol consumption is bad from the first drop,” mantra is not settled science.