An Honest Piece on Alcohol

Following last week's Surgeon General broadcast about the cancer risks of alcohol, there's been another set of fulmination on the subject. I forget that there remain Prohibitionists out there, who really do still want to eliminate the stuff and regret that it didn't work the last time around. There are, though.

This piece is the most honest thing I've read from a doctor on the subject. 

The report describes the relationship between alcohol and cancer in different ways: the number of new cases of cancer a year in the United States potentially related to alcohol consumption (roughly 100,000); the number of annual cancer deaths that might be attributed to alcohol (roughly 20,000, compared to nearly 200,000 cancer deaths attributable to smoking); the increase in absolute risk for developing alcohol-related cancers (a 2.5-percentage-point increase for women and a 1.5-percentage-point increase for men); and the relative risk for specific cancers, such as breast cancer (one study suggests that a drink a day increases a woman’s risk by 10 percent).

But it’s hard for individuals to translate statistics to their own lives. A small increase in relative risk is difficult to make meaningful, even for people who understand what “relative risk” means. (It doesn’t mean a 10 percent risk of breast cancer; it means women who drink may be 10 percent more likely to get breast cancer than women who don’t.)

There are many other open questions that might seem important to a person deciding whether to change her habits: Is a glass of wine as carcinogenic as a daily martini? Does it matter how old you are when you start or stop drinking? And perhaps most important, do you lower your cancer risk if you quit drinking tomorrow, regardless of your age? The answers to all of these questions are unclear.

A one-point-five percent increase in absolute risk doesn't seem like a lot; and I think she raises a good point about the wine-vs-martini issue as well. Wine has a lot of antioxidants, especially red wine, which are supposedly associated with decreases in things like cancer. We keep getting told that one drink is the same regardless of format, whether it's 12 oz of beer or 8 oz of wine or 1.5 oz of hard liquor; but one thing I know from first aid training is that poisoning is often wisely treated by diluting the poison. It would make sense that a drink that is 92-96% water and carbohydrates was less toxic than one that was 40% pure alcohol. 

It's good to see a medical professional trying to talk about it in an honest manner. I notice the editor changed the headline to "When it comes to drinking, there are no good answers." The original, which you can still see reflected in the bar at the top of the page, was "Don't overthink the connection between alcohol and cancer."