Thank you! I realize there is no such thing as absolutely no risk to anything potentially bad for us! So, I feel much better checking off most of the healthy boxes here! Thanks again Dr Springer. You made my day!
Hi Dr Springer - Thank you for your great reporting! My question is, do these studies take into consideration smoking , obesity and HPV in their case studies (participants) to alcohol causing specific cancers? Smoking/tobacco alone can cause up to 89 % of many of the 7 cancers. There are 7 cancers that are caused by alcohol as per reported by Surgeon General Murthy in 2025. I am wondering if overall habits, lifestyle or infections are recorded when making their assessments of cancer risk from alcohol?
Hi Suzy - great question!! These studies do include adjustments for smoking, BMI, and other variables associated with the cancers being studied. So when a researcher links a certain amount of alcohol intake to some health outcome, the influence of variables like smoking will have been controlled for statistically.
But that's not the end of the story! Researchers can't adjust for every possible variable that might increase the risk of cancer. Also, they can't always make adjustments in a very sensitive way (e.g., people might be labeled as "highly active", "moderately active", or "sedentary", which is crude and may be of limited value).
Part of what makes this problematic in health research is that some risky behaviors tend to co-occur. People who drink more alcohol also smoke more, consume more red meat, etc. So, after adjusting for these variables, the researchers might still be missing something.
I'm actually reviewing a study this week representing the other end of the spectrum. The researchers link yogurt consumption to lower rates of colorectal cancer, but folks in the study who ate the most yogurt were living healthier lives in many other ways too, and it's not clear that the researchers measured every healthy thing that they do. So maybe it's not the yogurt, or at least not by itself, that reduces the risk of cancer.
As for the alcohol studies, my takeaway isn't that the findings are invalid, but that we have to interpret them cautiously, study by study. Some studies do a better job than others at adjusting for confounding variables like the ones you mentioned.
Also - sorry this got to be such a long response! - converging evidence can increase our confidence in the data. I am persuaded that beyond some hard-to-define threshold, drinking alcohol increases the risks of various health problems, because evidence from observational studies is consistent with what we know from, for instance, petri dish-type studies where the impact of alcohol on living cells is recorded.
Dr. Springer, Thank you once again for your comprehensive answer to my question! I think I am obsessing literally about my one "vice" which is my daily 5 oz glass of white wine at dinner meal time only (for the past 30 years) ! I am a very healthy 58 year old female with healthy BMI, never- smoker, very physically active (healthy parents in their 90's), almost all fresh fruits and veggies and not much else other than caffeine...but after the Surgeon General report came out I got scared. Breast cancer is a risk of course just being female + moderate alcohol I understand for sure , but I then became overly scared about mouth cancer for example (I don't mean to be doom and gloom). I was looking at the absolute life time risk of mouth cancer for example which appeared to be about 0.71% ( mouth cancer is less than 1% in women), vs according to the HHS there was a 40% increase in risk of mouth cancer in drinking 2 or less drinks per day. Therefore there is still a 99% chance that one who checks off all the healthy boxes but drinks a 5 oz glass of wine a night would NOT get oral cancer (because 40% is so minuscule of 0.71% ; but of course still a risk). I am so grateful for your response! My initial question you answered so thoroughly, is related to this question as a statistical example so I understand relative risk in an otherwise healthy person.
I appreciate your kind words, Suzy. IMO, the data doesn't show that a the child of a healthy couple who lives a healthy lifestyle herself would experience an increased risk of any sort of cancer from drinking one 5 oz glass of wine per day. (Including mouth cancer, which is especially rare if we exclude cases attributable to tobacco use and/or sun exposure.)
Not an easy subject. We all want to hear that what gives us pleasure is not "bad". Sometimes is not, sometimes it is and sometimes is a little...
My opinion in this case is that the WHO message, is the most sensate.
A health organisation's (Country or worldwide) message or recommendation must be "universal". That means that it must fulfill "precaution principle" and "cause no harm" to any single subject as a norm.
WHO message is directed to "all manhood", with all the physiologies, habits, cultures and living factors in the whole world. It must be a "one size fits all" independent of any particularly.
Not everybody is physically equal and the effects of ingestion of an intoxicating substance as alcohol can be different in every individual, specially in the most sensible ones.
Everyone's particular health, genetics, physical or particular sensitivities are like a lottery ticket (reversed). If by any chance your body is heavily affected by alcohol (by genetics or by past events), even small quantities can cause harm. If you "win the lottery" you have to live with it, even without knowing "you have won the big price", because lots of people do not know. From "Permissive" (in quotes) messages an individual may find a justification to keeping an harmful habit in its case. Messages with exceptions are too long, hard to understand and easily misinterpreted. Short and strong is easy.
And yes, I am a social drinker. Free decisions need knowledge. No knowledge, no liberty.
No need to apologize. You make a good point: Variability among individuals requires that organizations like the WHO frame their health advice cautiously. Creating advice that's both realistic and maximally protective is complicated by inconsistencies and limitations in the scientific data.
Thank you! I realize there is no such thing as absolutely no risk to anything potentially bad for us! So, I feel much better checking off most of the healthy boxes here! Thanks again Dr Springer. You made my day!
Hi Dr Springer - Thank you for your great reporting! My question is, do these studies take into consideration smoking , obesity and HPV in their case studies (participants) to alcohol causing specific cancers? Smoking/tobacco alone can cause up to 89 % of many of the 7 cancers. There are 7 cancers that are caused by alcohol as per reported by Surgeon General Murthy in 2025. I am wondering if overall habits, lifestyle or infections are recorded when making their assessments of cancer risk from alcohol?
Hi Suzy - great question!! These studies do include adjustments for smoking, BMI, and other variables associated with the cancers being studied. So when a researcher links a certain amount of alcohol intake to some health outcome, the influence of variables like smoking will have been controlled for statistically.
But that's not the end of the story! Researchers can't adjust for every possible variable that might increase the risk of cancer. Also, they can't always make adjustments in a very sensitive way (e.g., people might be labeled as "highly active", "moderately active", or "sedentary", which is crude and may be of limited value).
Part of what makes this problematic in health research is that some risky behaviors tend to co-occur. People who drink more alcohol also smoke more, consume more red meat, etc. So, after adjusting for these variables, the researchers might still be missing something.
I'm actually reviewing a study this week representing the other end of the spectrum. The researchers link yogurt consumption to lower rates of colorectal cancer, but folks in the study who ate the most yogurt were living healthier lives in many other ways too, and it's not clear that the researchers measured every healthy thing that they do. So maybe it's not the yogurt, or at least not by itself, that reduces the risk of cancer.
As for the alcohol studies, my takeaway isn't that the findings are invalid, but that we have to interpret them cautiously, study by study. Some studies do a better job than others at adjusting for confounding variables like the ones you mentioned.
Also - sorry this got to be such a long response! - converging evidence can increase our confidence in the data. I am persuaded that beyond some hard-to-define threshold, drinking alcohol increases the risks of various health problems, because evidence from observational studies is consistent with what we know from, for instance, petri dish-type studies where the impact of alcohol on living cells is recorded.
Dr. Springer, Thank you once again for your comprehensive answer to my question! I think I am obsessing literally about my one "vice" which is my daily 5 oz glass of white wine at dinner meal time only (for the past 30 years) ! I am a very healthy 58 year old female with healthy BMI, never- smoker, very physically active (healthy parents in their 90's), almost all fresh fruits and veggies and not much else other than caffeine...but after the Surgeon General report came out I got scared. Breast cancer is a risk of course just being female + moderate alcohol I understand for sure , but I then became overly scared about mouth cancer for example (I don't mean to be doom and gloom). I was looking at the absolute life time risk of mouth cancer for example which appeared to be about 0.71% ( mouth cancer is less than 1% in women), vs according to the HHS there was a 40% increase in risk of mouth cancer in drinking 2 or less drinks per day. Therefore there is still a 99% chance that one who checks off all the healthy boxes but drinks a 5 oz glass of wine a night would NOT get oral cancer (because 40% is so minuscule of 0.71% ; but of course still a risk). I am so grateful for your response! My initial question you answered so thoroughly, is related to this question as a statistical example so I understand relative risk in an otherwise healthy person.
Thank you so much!
I appreciate your kind words, Suzy. IMO, the data doesn't show that a the child of a healthy couple who lives a healthy lifestyle herself would experience an increased risk of any sort of cancer from drinking one 5 oz glass of wine per day. (Including mouth cancer, which is especially rare if we exclude cases attributable to tobacco use and/or sun exposure.)
Sorry long reply. Apologies.
Not an easy subject. We all want to hear that what gives us pleasure is not "bad". Sometimes is not, sometimes it is and sometimes is a little...
My opinion in this case is that the WHO message, is the most sensate.
A health organisation's (Country or worldwide) message or recommendation must be "universal". That means that it must fulfill "precaution principle" and "cause no harm" to any single subject as a norm.
WHO message is directed to "all manhood", with all the physiologies, habits, cultures and living factors in the whole world. It must be a "one size fits all" independent of any particularly.
Not everybody is physically equal and the effects of ingestion of an intoxicating substance as alcohol can be different in every individual, specially in the most sensible ones.
Everyone's particular health, genetics, physical or particular sensitivities are like a lottery ticket (reversed). If by any chance your body is heavily affected by alcohol (by genetics or by past events), even small quantities can cause harm. If you "win the lottery" you have to live with it, even without knowing "you have won the big price", because lots of people do not know. From "Permissive" (in quotes) messages an individual may find a justification to keeping an harmful habit in its case. Messages with exceptions are too long, hard to understand and easily misinterpreted. Short and strong is easy.
And yes, I am a social drinker. Free decisions need knowledge. No knowledge, no liberty.
Sorry for long post. My bad...
No need to apologize. You make a good point: Variability among individuals requires that organizations like the WHO frame their health advice cautiously. Creating advice that's both realistic and maximally protective is complicated by inconsistencies and limitations in the scientific data.
great deep dive. one of my friends is doing "sober october" and i hope this is helping her
Thanks for a detailed and unbiased analysis of the data on this important health topic.