It's time to put cancer warning labels on alcohol, experts say (opens in new tab)

It probably has something to do with the near-universal consumption of alcohol stretching back to (check notes) the dawn of human history.

I'd like to see gambling given the same scrutiny too. We have endless ads running during sporting events in the UK these days with betting companies boasting about how many of their users are using features like bet limits and it boggles my mind. If your entire advertising budget is being spent trying to persuade people that you're not evil, then maybe you're evil.

> We agree that glorifying tobacco consumption was bad.

You're using "we" very expansively here. All of the things that we've agreed on in your comment are objectionable to many.

From what I can tell, "we" removes the "stupid" and only includes the "smarter and more enlightened" who will become stupid over time if they fail to apply the same "critical lens" to alcohol as they applied to cigarettes.

The wedge used against tobacco was second hand smoke. Unless someone can show some kind of second-hand imbibing, alcohol is really not the same.

Automotive pollution, on the other hand . . . there's a parallel.

Well, meat is also not good for health (it was defined as likely carcinogen by WHO) and it is consumed pretty much everywhere and every day. Alcohol at least is fun and people consume it more sparsely.

How long until we move past the plastic leeching into food era? Or lets burn gas and put it in the air and let's ignore cancer effects era?

How many first world countries have banned/restricted alcohol advertising already? It's already pretty heavily restricted in Australia for instance (you are still allowed to broadcast TV commercials for alcohol, but because of the limitations around when you can do it and what you can show in such commercials, they're actually relatively rare, certainly compared to what I remember in the past). What I don't know if there's been much research into how effective the restrictions have been - it's true we seem have a younger generation now that drinks less than their parents, but I believe that phenomenon has been observed in countries that haven't significant restricted alcohol advertising either. We don't have cancer warnings, though it's certainly been discussed (and appears to have broad public support). There are typically pregnancy warnings ("Alcohol can cause lifelong harm to your baby"), which have been mandatory since 2020.

There are limits to what can be done to ban alcohol. Prohibition was not a success. Bright side is that trends look like younger generations are already drinking less than older ones. They just aren't that into it.

It's 'a rite of passage', or is 'a right of passage' an American thing?

The difference is that alcohol is quite fun...

I think one key difference between tobacco and alcohol is that tobacco doesn't really have a 'safe' level of usage: every cigarette is bad for you.

However (from my understanding, could be wrong) alcohol isn't bad for you until your BAC exceeds a certain concentration, so 1-2 drinks is benign, but the 3rd one starts doing damage and damage increases in a dose dependent manner.

Most fruit juices and breads contain small amounts of ethanol - and I don't think there is any suggestion that those quantities could have significant deleterious effects.

I think it makes sense to have a different regulatory regime and societal perception for drugs that can have theoretically 'safe' recreational usage. Would love if there were biomarkers of alcohol doing damage that could be measured with a urine test strip or something like that at home: would acetaldehyde in urine be a good proxy of how much damage alcohol has done to the body?

Regardless, warning labels make a lot of sense - the way many people use alcohol is carcinogenic, and drinkers should be aware of that risk.

You assume everyone is "smoking" cannabis. I would argue cannabis edibles are the future. I would also argue cannabis edibles are infinitely safer than any kind of alcohol.

Alcohol is a hardcore drug that is readily available, cheap, and highly addictive. I don't enjoy the taste of any alcohol and it seems cheap alcohol is what most people are buying which is not known for taste/flavor. Sure a cocktail might taste fine but most normal people and even alcoholics aren't consuming pina coladas every night.

"burning organic material, inhaling it deeply, and keeping it for long periods of time in your lungs is obviously dangerous" - While intuitively true, I'm not at all convinced it is factually true, though of course it may well be. Also it likely depends a lot on how much/often.

Likewise for: "charred material slowly snaking its way through your intestines"

"Life is hard enough without having to worry about every last damn thing." - Amen

> Grilled and smoked meat - with charred material slowly snaking its way through your intestines - is definitely extremely dangerous.

Extremely dangerous? How would you describe swallowing some magnets?

> I’m surprised marijuana has such widespread praise given burning organic material, inhaling it deeply, and keeping it for long periods of time in your lungs is obviously dangerous.

Edibles :-)

> I like the taste

That's the part that's hard to completely replace with anything else, for me. I like weed better in basically every other way, but a nice minerally wine or complex whiskey or layered, perfectly-balanced mixed drink... mmm.

There are ways to “use marijuana” that don’t involve combustion.

The future where a nano infused cannabis drinkable where the high hits and leaves in similar timeframes as alcohol is nearly here.

> Or is the DNA roulette wheel already spinning, like it is for people who have been heavy smokers in the past?

Just so this information is out there, particularly for prospective quitters, this is actually a bit nuanced:

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002...

As you can see, after 15-20 years of smoking cessation, excess risk for various causes of mortality drops substantially.

You are correct that the risks never truly return to baseline, but for lung cancer, for example, the excess risk drops to between 5 and 13%.

This is the thing that's so tricky about... well, I guess the way our world models in general work.

Is drinking bad for you? Yup. Is smoking bad for you? Yup.

Is moderate social drinking bad for you? Likely, but definitely less bad for you than slamming a 6-pack nightly.

Are there other (mainly socially-mediated) health benefits from moderate social drinking? Plausibly? Probably? Occasional social smoking? Probably in some contexts.

If these effects both exist, they can be compared. Do the risk curves intersect? Where? The crossover will land in different places for different people, different circumstances.

I am not a biomedical unit, (but I have played one at work). The mechanism to my limited understating is alcohol was invented by yeast to slightly poison their food so the bacteria present could not out compete them.

It's fundamental creation in nature is a deliberate toxin.

At least one of the chemicals alcohol breaks down into in mammals is known to cause double strand DNA breaks.

Most often "no problem" we have builtin genetic resources to repair those breaks. (unless you have something like Fanconi Anemia).

The reason we have a builtin mechanism to repair this sort of damage is it happens anyway at a lower rate without alcohol.

If the rate of breakage is greater than the ability to repair then stuff stays broken.

Basically the more lottery tickets you buy the more likely you are to win but not buying them doesn't mean you wont be gifted some.

It is a strange thing to reconcile, intellectually I have first hand data there is no safe dosage, but genetically I'm from a line of alcoholics and socially (in the before times) it provides a very comfortable community building fabric.

I have become comfortable with a single drink on rare occasion.

There’s a dose dependent relationship, where heavy drinkers have the highest cancer burden. So we do expect (but aren’t sure) discontinuing use reduces risk.

I’d say we should treat alcohol very differently than tobacco. It’s got a much lower addiction liability (under 10% of people who try alcohol become addicted, while 32% of people who try nicotine become addicted). Heavy alcohol use is also way more destructive than heavy nicotine use.

Additionally, users seem to find alcohol somewhat more fun that nicotine. [1] That said, the literature supports the conclusion that alcohol decreases sleep quality and increases stress, despite what users think. Any objective benefits are likely social in nature.

Overall, I think there’s a better case to be made for socially accepting moderate alcohol use compared with the case for nicotine.

That doesn’t mean we shouldn’t have warning labels though - most people currently underestimate the risks of alcohol.

1: https://pubmed.ncbi.nlm.nih.gov/23438502/

> Or is the DNA roulette wheel already spinning, like it is for people who have been heavy smokers in the past?

Heavy smokers ingest trace amounts of radioactive metals that continue to emit radiation for years to come. The mechanism is certainly not the same with alcohol.

I'm a heavy drinker and what I've read about alcohol and sleep says that it's bad for your sleep, in particular the quality of REM sleep. Anecdotally I can back that up with my own experience, as I drink before I go to sleep.

However, it's much easier to fall asleep after you've been drinking, but that's just because alcohol is a nerve depressant anyway.

https://en.wikipedia.org/wiki/Alcohol_use_and_sleep

> So I should live forever!

No but you probably get to die from something else and hopefully much later.

Interestingly, some alcoholic beverages in the US now have nutrition facts labels. I don't know if there was a rule change or if they saw the writing on the wall and wanted to opt in to a crappier version to try and delay any rule change or if it was part of the marketing push a few years ago to imply their brand was the only brand with "natural" ingredients or other nonsense.

I don't think I've seen a hard alcohol with that label.

This. It's crazy in the UK where normal drinks have to have it, but alcoholic ones are exempt.

Yes! As a diabetic I'm always annoyed that they don't even try to print the carbs on the label. I don't get why alcohol gets a pass when other food and drink have to.

When they have an alcohol-free version, I believe that you can find some more information on them (but of course it probably somewhat differs).

This has been pretty well established for a while, and confirmed by the WHO. But for some reason, that fact never seems to have gained much traction.

Here is some literature in case anyone is interested:

1. A 2006 review in The Lancet Oncology: http://drugfree.org.au/images/pdf-files/library/alcohol/Canc...

2. A recent study in The Lancet Oncology: https://www.thelancet.com/article/S1470-2045(21)00279-5/full...

3. A meta-analysis of the effects of light drinking on cancer incidence (Annals of Oncology): https://www.sciencedirect.com/science/article/pii/S092375341...

Yep, new to me but the article doesn't explain much. I assume massive drinking could lead to all sorts of cancers as you're taxing every part of your body. It follows that a bit of drinking would have a small effect but is it enough to really matter?

There's definitely a link with esophageal cancer, and imo that's being blurred and handwaved into a generalized cancer risk.

Last time I visited Disneyland with my kids, there was a sign by the entrance that Disneyland causes cancer.

Ok, it said something to the effect that there were substances on the premises known to the State of California that cause cancer. But the end result is that it was not clear WHAT was there that causes cancer, so it basically says Disneyland causes cancer.

Perhaps if the risk were quantified somehow, things would improve? Could be incorporated into the Nutrition Facts label, even.

One of the side effects of the type of society we have is it is going to eventually bend to the dedicated nut jobs that lack hobbies and interests. So that group of nutters who insist that everything have a label on it will eventually get their way as they're super organized, loud, and they only have to win once. Their opponents don't care nearly as much and have to constantly defend so they just move on to and let the nut jobs have their way.

Warning labels were part of an effective strategy to curb smoking. This is from the same playbook. Warning labels on alcohol have been shown to reduce consumption in localized testing, as stated in the article you are commenting on.

While most people have some idea that alcohol is had for them, the link between cancer and alcohol is not widely known. This is also reflected upon in the article.

Google broccoli thiocyanate, and enjoy a bottle of red from time to time.

Being obese seems to have an effect of between 3-14 years depending on the study. I think emphasis should be proportionate, so maybe less emphasis on alcohol and more emphasis on the negative effects of being overweight. But still some emphasis on alcohol... proportionate.

The study that page relies on is about all-cause mortality (in particular, CVD); the article is about cancer warnings.

The dose makes the poison. In your first link for example, I couldn't find a definition of what "moderate" consumption even is.

Human body tolerance to alcohol probably comes from thousands of years of experience with it.

Warnings aren't informational, they're motivational. Have you ever seen a health warning with a QR code that links to the data? No you haven't. Alcohol already carries health warnings, adding to them will likely have only marginal effect.

I'm not saying that this information shouldn't be in health warnings, but it's worth considering how health and safety warnings and signage are absolutely ubiquitous in modern society. It could be that the consumer warnings are a mediocre substitute for industrial regulation at source - just slap a disclaimer on it to avoid lawsuits and call it a day, so to speak. It's also possible that this leads people to either filter them out or causes them additional levels of stress. I value safety information, but I don't value having it shoved in my face all the time.

It’s not just correlation. We do have a good reason to expect that alcohol causes cancer. First, we see increased cancer in areas the alcohol and decomposition products touches/interacts with (mouth, esophagus, colon, liver, etc.). The exception is the breast cancer correlation, but there is an explanation for that too (based on a secondary metabolic pathway). We don’t see, for example, alcohol causing lung cancer or brain cancer. Second, we know alcohol breaks down into likely carcinogens.

Then there is really no reason not to put these warnings. People can make their own decisions if it matters to them or not. It would be worth it even if the results were not significant. Any amount of people becoming more informed in their decision making is worth it.

If I was a smoker and had to look at those pictures on the pack I think I'd think about that from time to time. Not sure if that alone would cause me to quit but perhaps it would be one aspect.

Probably warranted in this case, given the still-treated-as-true-in-pop-culture flawed studies about a drink or two a day being net-beneficial.

I hope studying the effects of the things we ingest and publicizing the results never ends, I agree.

> There is a sector of the economy that lives off banning and regulating things

The economy can't ban anything, what are you referring to here? In fact, nothing is being regulated or banned here.

Ah yes, because the people in charge of alcohol labeling are definitely the ones who can cut red tape in the area of funding battery development.

Indeed I take an interest in health and nutrition, but it honestly gets a bit silly following some people to the letter The Huberman podcast for example, really interesting, but how many supplements do you actually need and how big a benefit do they give you?

You can usually find contradictory studies on almost anything. Refined sugar and processed crap seem to be the one thing that everyone agrees are bad. And exercise and proper sleep are good. I live a balanced lifestyle. A reasonable amount of alcohol or cannabis but I eat well and do plenty of exercise. I seem in better shape than most people with less alcohol and less exercise.

Blood pressure, for one: https://www.sciencedaily.com/releases/2019/03/190307081024.h...

According to https://www.jsad.com/doi/10.15288/jsad.2020.81.284, as of 2020 only South Korea does this.

That logic isn't sound. Why put warning labels on anything? We could find a way to replace damaged lungs with artificial ones instead of not smoking.

It is like treating the symptoms when we could instead just not poison ourselves. We should of course do both, but curing cancer is about as difficult as any medical science task can be. In the meantime we could try letting people know that something might cause unwanted health effects.