An Urban's Rural View

Raise a Glass to the Debate Over Drinking

Urban C Lehner
By  Urban C Lehner , Editor Emeritus
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A Surgeon General's advisory warns that drinking alcohol raises risks of seven different cancers. On the other hand, a National Academies report says there's less risk of death from all causes in drinking than not drinking. (Office of the U.S. Surgeon General graphic)

An outspokenly anti-American Japanese politician I interviewed in 1989 called the United States "the scariest country" -- and gave a surprising reason why:

"You had Prohibition."

Human beings, he said, naturally want to drink; it's pleasurable. A country that tries to stop them thinks it can undo what's natural. That's scary.

Curious, I thought. The U.S. and Japan are clashing over trade and this Americaphobe is talking about Prohibition. I quoted his view, but more for what it said about him than America.

Today, teetotaling's resurgence in the U.S. has me reconsidering. America isn't trying to ban alcohol again -- at least not yet -- but the mood of the country has swung against alcohol. Many Americans are giving it up or cutting back.

Today's anti-alcohol sentiment stems from somewhat different concerns than the 19th century Temperance movement's. (Temperance underpinned the 20th century experiment with Prohibition.) Back then, moral concerns were prominent; some Christian denominations railed against drinking as sinful.

Economic and social concerns also weighed heavily. Drunken fathers ruined families, drunken workers couldn't operate the Industrial Revolution's heavy machinery. Alcoholism led to poverty and unemployment.

Today, health concerns dominate. Studies showing an increased risk of cancer and other diseases from even moderate drinking are making headlines. Biden administration Surgeon General Vivek Murthy recently issued an advisory urging Congress to add cancer to the warning label on alcohol bottles. (https://www.hhs.gov/…)

According to Murthy's advisory, alcohol increases the risk of contracting seven different cancers. It's the third leading preventable cause of cancer in the U.S., after tobacco and obesity, responsible for 20,000 cancer deaths in the U.S. annually. Compared to not drinking, the advisory said, people have some risk of cancer even if they consume less than one drink a week.

It also said less than half of American adults are aware of this risk. Maybe, but almost everybody I know is cutting out or cutting back on alcohol. Many millennials hardly touch the stuff. Some who considered themselves moderate drinkers at two glasses of wine a day are down to one. Dry Januarys are all the rage.

There's growing demand for non-alcoholic beer and spirits. The list of drinks at many fine-dining restaurants boast almost as many mocktails as cocktails. While in dollar terms alcoholic-drinks sales are stable or even up a little, that partly reflects "premiumization" -- drinkers opting for craft beers, finer wines, small-batch whiskeys and other pricier tipples.

It also reflects the peculiar fact that 20% of American adults account for 90% of the sales. As the Wall Street Journal put it in a headline, "The Alcohol Industry Is Hooked on Its Heaviest Drinkers." (https://www.wsj.com/…)

After having been told for years that a daily glass of wine or two is healthy, many Americans are pushing back. Even those drinking less have questions about the studies Murthy relied on.

As farmers and ranchers know all too well, there are always conflicting studies, like the small minority of studies finding problems with GMOs. Still, conflicts generally speak well for science. Truth gets refined in the fires of challenges to accepted wisdom.

Murthy's advisory was at odds with a report just a month earlier from the congressionally chartered National Academies of Sciences, Engineering and Medicine. It concluded with "moderate certainty" that "moderate drinking," defined as two drinks a day for men and one for women, "is associated with lower all-cause mortality" than never drinking at all. (https://www.nationalacademies.org/…)

Oversimplified, the National Academies report agreed that alcohol poses risks of two cancers -- breast and colorectal -- but found, with low to moderate certainty, that moderate drinking is better for heart health than not drinking. The cardiovascular benefits more than compensate for the cancer risks, yielding lower deaths from "all causes."

Skeptics, though, have doubts about all alcohol studies, pro and con. There are tricky definitional questions, respondents may lie about their consumption and studies don't always capture explanations for health outcomes other than alcohol. An Atlantic article flyspecking a raft of studies found all these problems and more. (https://www.theatlantic.com/…)

Then, too, risk tolerances vary. A scientist the Atlantic quoted said each drink takes five minutes off the drinker's life. Knowing that might turn some into teetotalers but not the Atlantic's writer: "Personally, I find great comfort in it -- even as I suspect it suffers from the same flaws that plague this entire field."

Bottom line: Were the Japanese politician still alive, I'd assure him America has learned its lesson. Yes, Americans will continue to argue about alcohol. We're not, however, giving Prohibition an encore.

You can drink to that now that dry January is over.

Urban Lehner can be reached at urbanize@gmail.com

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