Is your drinking healthy? 3 charts break down the connection between alcohol and cancer, heart disease and more.
As one of his final acts as U.S. surgeon general, Dr. Vivek Murthy called for alcohol products to carry a label warning that they can cause cancer. His office also published a report detailing just how carcinogenic booze can be, estimating that more than 741,000 cases of cancer worldwide in 2020 were attributable to alcohol.
In truth, it isn't news that alcohol can cause or increase risks for cancer. Nor is it new knowledge that alcohol intake is linked to all manner of other health problems, including brain damage and liver disease. But even amid a broader shift away from drinking culture and toward sober living, moderate drinking (especially of red wine) has continued to be perceived by many as heart-healthy. The World Health Organization (WHO), however, has declared that no amount of alcohol is safe.
So what, really, is the relationship between alcohol and health, particularly when it comes to cancer and heart disease? These charts break down the complicated connection, while experts recommend easy ways to make your drinking habits healthier.
Alcohol and cancer
First, a word about cause versus risk. On a cellular level, alcohol is carcinogenic due to the ways it damages cells. When it comes to a whole person, alcohol is one of many factors — which also include smoking, genetics, diet and environmental exposures — that contribute to cancer risks. So it's unlikely that alcohol alone would be the reason someone developed cancer.
On the other hand, 5.4% of all cancers in the U.S. are attributable to alcohol, (meaning that booze likely accounted for the difference between someone getting the disease or not), according to the American Association for Cancer Research's (AACR) 2024 report. Alcohol is unequivocally linked to increased risks of six types of cancer: head and neck, esophageal, colorectal, liver, stomach and female breast cancer.
But just how much alcohol does it take to meaningfully put someone at risk of these diseases? "As highlighted in the surgeon general's report, even at low levels [of alcohol consumption] there’s a small increased risk of cancer," Dr. Michael Pignone, a Duke University professor of primary care and member of the steering committee for the AACR's 2024 report, tells Yahoo Life. That said, Pignone is less concerned about the risks facing someone who has one or two drinks a day — “frankly, that doesn’t matter very much,” he says. “What I’m worried about are the people drinking four or five drinks a day who may not recognize that that may have risks for cancer or other health consequences."
According to the then-surgeon general's report, a woman who has two drinks a day faces a nearly 22% chance of developing an alcohol-related cancer, compared with a 16.5% risk for a woman drinking less than one drink a week. For men, the risk increases from 10% (less than one drink a week) to over 13% (with two drinks a day). Not drinking at all won't reduce your risks to zero, but drinking any amount will raise your risks to some degree.
You may want to also consider other risk factors, such as a family history of alcohol-related cancers, including breast or colorectal cancer. "If you are superworried about cancer, you might want to take that into account when you decide whether you’re going to drink alcohol at all," says Pignone.
Alcohol and heart disease
You’ve probably heard or read plenty about red wine’s supposed cardiovascular benefits. It’s sometimes referred to as the “French paradox.” France has low rates of heart disease, despite most people having diets high in saturated fats and cholesterol, which contribute to cardiovascular problems. Some scientists theorized that the custom of drinking red wine might have protective effects because it has anti-inflammatory properties. But the claim — as well as studies that support it — is somewhat misleading.
The hypothesis has what scientists call “biological plausibility” — meaning that we know alcohol can do things that theoretically help protect heart health — but the evidence is “mixed,” Priscilla Martinez, deputy scientific director at the Alcohol Research Group, tells Yahoo Life. There’s real research to suggest that red wine has anti-inflammatory effects. But drinking alcohol can also contribute to and worsen high blood pressure, a key risk factor for heart disease.
Alcohol’s contradictory impacts may be why studies on the link between heart health and alcohol often show a J-shaped curve. In other words, people who drink alcohol have lower risks of dying from heart disease than non-drinkers — up to a point, when those who drink over a certain number of alcoholic beverages in a week have considerably higher risks than those who abstain.
But, notes Martinez, “sometimes we see a J-shaped curve, and sometimes we don’t,” when studying this relationship. And the relationship between drinking (and red wine drinking in particular) and heart health might actually not be about alcohol at all. Researchers have noted that people who drink moderately — defined as two or fewer drinks a day for men, and one or fewer for women, according to the Centers for Disease Control and Prevention (CDC) — may be more likely to have higher incomes and therefore have better diets and better access to health care. All of those factors may do more to protect their heart health than red wine ever could.
And in the end, even if red wine or other forms of alcohol have slightly protective effects for the heart, “nobody should ever start drinking for health reasons,” says Martinez. “There is no benefit to initiating drinking for the risks of dying or getting diseases.”
Alcohol and the risk of dying from any cause
Heart disease and cancer are, respectively, the first- and second-leading causes of death in the U.S., but alcohol can increase the risks of dying from many other diseases and injuries. Risks of dying from either of these causes, injuries caused by drinking or liver cirrhosis start to rise with even one drink a day, according to a recent draft report by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). “Our report says that no level of [alcohol] consumption is completely risk-free,” says Martinez, who contributed to the ICCPUD report. “Among drinkers, the lower your use of alcohol, the lower your risk of dying or developing an alcohol-related disease,” she adds.
There’s not much controversy there: Drinking a lot is more dangerous than drinking a little or not drinking at all. But how much constitutes light, moderate or heavy drinking is up for debate. Currently, the CDC defines “light” drinking as having had 12 drinks in the past year but no more than three in a week on average. The agency says that “occasional” drinking means having 11 or fewer drinks in a year — but some experts think that CDC’s standards are too loose. Studies on how much light or moderate drinking increases your risks of disease or dying are much less consistent. “When you get down to very low levels of [alcohol] use, the epidemiology gets a little more challenging,” says Pignone.
In fact, another report, published just weeks before the ICCPUD’s, found that people who drank “moderately” (here, meaning one drink a day or less for women, two or fewer for men) were less likely to die of any cause than those who didn’t drink at all. That report still concluded that heavy drinking (five or more drinks a day or 15 or more per week for men; four or more a day or eight and up for women) is linked to higher risks of death from any cause.
The takeaway
The impact alcohol has on your health is complex, but experts’ guidance is actually pretty simple:
If you don’t drink, don’t start. Both Pignone and Martinez stress that there simply isn’t strong enough evidence of any benefit from alcohol to suggest it’s worth taking up drinking.
Be aware of the risks. “If you’re drinking at low levels, you should make an informed decision” about your habits, says Pignone. He notes that he drinks at the “less than one drink a day level” and isn’t going to stop, because “that’s not where most of the excess adverse effects are.” Martinez says she just wants people to be informed about the negative impacts alcohol can have on their health, “so they can go into their behaviors and say, ‘Yes, I know what I’m doing.’”
If you do drink, get "sober curious." While “not drinking is best for your health, drinking less is also great,” says Martinez. Instead of thinking of changing your habits as taking something enjoyable away, try “adding in days you don’t drink into your weekly drinking pattern,” she advises. Keeping less alcohol in the house and buying some enjoyable, nonalcoholic beverages to have on hand can make that easier.
Not sure if you’re drinking too much? Keep a journal. Pignone notes that many people drink at levels that may harm their health but don’t meet the criteria for alcohol use disorder. If you think you’re regularly drinking more than the CDC considers moderate, keep a log of your habits. If you are indeed drinking more than that, talk to your doctor or counselor. “Evidence-based screening questions that we use to identify alcohol use essentially turn on whether there have been occasions where you’ve drunk four, five or more drinks in one occasion," says Pignone.
