Why Cancer Warnings On Alcohol Dilute The Meaning Of Risk

Canada is a cold place, and to get around my home of Ontario comfortably during the winter I’m lucky to have a top-shelf pair of American premium leather cowboy boots by Durango. They’re perfect, except for the part where they supposedly can increase my risk of cancer.

Yes, because my boots comply with California’s Proposition 65, they came with a Cancer and Reproductive Harm warning label in the event I were to excessively lick or dine upon my footwear. Everything from DVD players to couches now carry these labels if they’re sold in California, in case a consumer were to ingest them instead of watch a movie or take a nap. Considering the earth’s sun is a well-known carcinogen, it’s a wonder California hasn’t legislated some kind of labeling on the menacing gaseous ball elevating the cancer risk of everyone beneath its rays.

Perhaps the U.S. Surgeon General Dr. Vivek Murthy will take action after he’s done frightening consumers about alcohol. Murthy’s latest advisory report on “the causal link between alcohol consumption and increased risk for at least seven different types of cancer” has America spooked. We experienced the same tactics in Canada.

The political collapse of Prime Minster Justin Trudeau in Canada temporarily killed a bill that would have had Canada follow Ireland in slapping cancer warnings on all alcoholic beverages. It’s part of a movement within the public health establishment via the World Health Organization, to shift world governments away from the message of “drink responsibly” and toward “no amount is safe”.

Consumers should know the risks associated with alcohol consumption, but what exactly are those risks?

First, Dr. Murthy’s report is what’s known as an observational study, which means conclusions are drawn without experiments featuring variables and controls. These reports study large pre-existing data sets and can show correlation, not causation, of illness associated with certain products like alcohol. It is literally not possible for observational studies to demonstrate cause and effect.

Second, the data sets informing the research are biased toward respondents underreporting their level of drinking. It is to be expected then that the data for moderate drinkers is systematically enmeshed with that of heavy drinkers who underestimate their weekly intake.

The result is that moderate drinking ends up looking more risky than it might otherwise be on a chart illustrating a correlation between alcohol consumption and certain cancers.

The Canadian Centre for Substance Use and Addiction (CCSA) led the charge for warning labels in Canada, and their own findings illustrated the same kind of disproportionate response being mimicked by Dr. Murthy in the US. The CCSA’s report argued that a male who consumes 2 drinks per day may increase their absolute colorectal cancer risk by 0.0028 percent. If you add the increased risk for all cancers measured by the CCSA (liver, colorectal, esophagus, larynx, and oral/pharynx) related to alcohol consumption, the total absolute increase in cancer risk for a male drinking 2 drinks per day is 0.0099, or 9.9 one-hundredths of a percent.

These are not the kind of numbers you’d take seriously if they were on the warning label, and it’s not especially helpful to slap tobacco-style cancer warnings on products that are exponentially less harmful. The CDC estimates that smoking increases cancer risk by 15-30 times when compared to non-smokers.

Smoking comes with an increased cancer risk that is more than 1,000%. Two alcoholic drinks per day, however, is only an increase of 0.0099% in risk. These things are not the same.

A 2016 paper from Harvard Kennedy School laid out the best case against an overzealous warning label regime like California’s Prop 65 and the movement to associate alcohol with the hazards of cigarettes. Harvard said of Prop 65 that it “fails miserably at distinguishing between large and small risks; that is to say between wolves and puppies.” The cancer warning label movement “cries wolf” over statistically insignificant risks and deters consumers from taking labels seriously when a genuinely dangerous product comes to market in the future.

It is not good for consumers when warning labels are a punchline, but that’s precisely what happens when cancer warnings are on cigarettes and Starbucks self-serve sugar stations.

The connection between heavy drinking and certain cancers of the mouth and throat is generally accepted by researchers, including the most recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM) about the health impacts of alcohol. NASEM showed the same uptick in the risk for breast cancer with moderate drinking but did not replicate a connection between moderate drinking and the rest of the other afflictions.

Any consumer should scratch their head when the Surgeon General’s alcohol warning is that “evidence shows that this risk may start to increase around one or fewer drinks per day.”

May start? Fewer than one drink per day? This barely clever wording means Dr. Murthy cannot demonstrate total sobriety as having a 0.0 correlation with developing cancer.

This strategic uncertainty should tell you something about the claims being made by Vivek Murthy and public health authorities in places like Canada. The conclusions don’t make that much sense. For example, Dr. Joseph Sparano, deputy director of the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, told NBC’s Today “Drinking may explain some of the increased cancer risk we are seeing in young people – Cancers in people under the age of 50 have been increasing at a rate of 1-2% per year over the last 15 years.”

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But nothing is said about the years of coverage on reliable trendlines showing adults under 35 drink less frequently and in lower quantities than any prior generation. Older cohorts are driving the majority of alcohol consumption, and recent Center for Disease Control data shows us that 5.1% of American adults are heavy drinkers, meaning a man who consumes more than 14 drinks per week and a woman who has more than seven. That slim cohort represents 75% of the cancer cases related to alcohol consumption.

If public health authorities are going to increase their focus on alcohol, it should be on heavy drinkers and tested messages of moderation and responsible drinking. 

Comparing the risks of moderate drinking to smoking is statistically false and misleading for consumers. The U.S. Surgeon General’s words carry incredible weight throughout the world, and like with California’s overzealous risk labeling system, Murthy risks squandering even more public trust in a public health advisory that can’t prove its own claims.

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David Clement is the North American Affairs Director for the Consumer Choice Center. Follow him on X: @ClementLiberty

The views expressed in this piece are those of the author and do not necessarily represent those of The Daily Wire.