1989 — the year of big hair. The first season of "The Simpsons" and the fall of the Berlin Wall. It’s also the last time the U.S. government updated the health warning labels on alcohol.
"The bottom line is our government is asleep at warning people about alcohol," said David Jernigan, a professor at Boston University School of Public Health.
For over 30 years the label at the bottom of your can or bottle mentions risks to pregnancy, operating heavy machinery and your health — but nothing specifically about cancer’s link to alcohol. Every so often a new study may bring a headline showing a potential health benefit from drinking certain types of alcohol, like one suggesting red wine could reduce COVID infection rates. Some doctors preach everything in moderation, but other health professionals are skeptical that any alcohol provides any benefits.
"There's actually over 200 unique health risks caused by alcohol," said Marissa Hall, behavioral scientist at the University of North Carolina.
The World Health Organization warns there is "no safe level"of alcohol consumption. Now there's a renewed push from scientists, researchers and doctors who say the current label in the U.S. is not effective, nor is it up to date with science. Current federal dietary guidelines state: If you do drink, men should not have more than two drinks a day and women should only have one or less. Those same guidelines don’t recommend starting to drink alcohol for any reason.
Pamela Trangenstein, a scientist with the federally funded Alcohol Research Group, says that’s because the more you drink, the more your cancer risk goes up.
"Alcohol is responsible for 20 cancer deaths every hour of every day of the year. And all of those deaths are preventable," Trangenstein said.
Hall, a scientist who specializes in health behaviors, says the cancer risk applies to all alcoholic drinks — even among light and moderate drinkers.
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"It's really the amount of ethanol and acetaldehyde that is in the alcohol that can contribute to cancer," Hall said.
According to the CDC, when our body breaks down the ethanol in alcohol, it turns into a toxic chemical called acetaldehyde.
Acetaldehyde damages DNA and makes it tough for our bodies to repair, which could lead to dangerous cell growth and eventually cancerous tumors. The National Cancer Institute says alcohol could also affect our body’s ability to absorb vitamins and nutrients that keep us healthy. We didn’t widely know this when the U.S. first implemented warning labels on alcohol in 1989. It was also only a year after the International Agency for Research on Cancer first categorized alcohol as a "group one" carcinogen.
"It's actually the strongest possible classification for cancer risk. And so that means that alcohol is in the same category of risk as cigarette smoking, for example," Hall said.
Current law requires the treasury consult with the Surgeon General and Congress if new scientific evidence justifies a change in the labels. But that hasn’t happened in over 30 years, despite numerous studies from the CDC, the NIH and the surgeon general all linking alcohol to at least half a dozen different types of cancers.
"A study published in Lancet Oncology found that in 2020, at least 4% of the world's newly diagnosed cancer cases were caused by drinking alcohol, which has over 700,000 people just in that one year," Hall said.
The alcohol industry generally does acknowledge the link between excessive drinking and cancer. But it asserts a healthy lifestyle doesn't have to mean cutting out drinking — completely.
Scripps News reached out to several beverage groups. Only the Distilled Spirits Council got back to us. In a statement, the trade association said it urges "all adults who choose to consume alcohol to consult their doctor and follow the recommendations of the 2020-2025 U.S. Dietary Guidelines for Americans," which state, in part, that "drinking less is better for health than drinking more. There are some adults who should not drink alcohol, such as women who are pregnant.”
The Distilled Spirits Council went on to add, "When federal regulators last reviewed proposals to change the required warning label, they found that the current warning is sufficient and that changes are 'unwarranted and unnecessary.' While the current warning has served to remind consumers that consuming alcohol may cause health problems, we defer to the government’s authority to determine warning statements and will adhere to any decision to change the statement."
David Jernigan says to see a good example of an effective warning label — pick up a pack of cigarettes.
"They're big. They're in a box all by themselves. They rotate. So there's a new message happening all the time," Jernigan said.
Numerous studies show the graphic warnings on cigarettes do help smokers kick the habit, but don’t necessarily change their beliefs on smoking risks. Still, Jernigan says, alcohol labels are in desperate need of an update, considering a third of Americans aren’t even aware of the cancer risks. But he acknowledges the road to change is rife with obstacles.
"It doesn't hurt that this industry spends billions of dollars every year convincing people that alcohol is wonderful," Jernigan said.
And Trangenstein acknowledges communicating the dangers of alcohol to consumers can be complex and confusing. She says another reason Americans are less aware is because of an industry practice called "pinkwashing."
That’s when a company sells potentially carcinogenic products under pink packaging for breast cancer awareness even though research shows that same product can raise breast cancer risks.
"What that does is it makes it hard to believe that two conflicting truths can be true at the same time. So one is that the product causes cancer, and the second is that the product is working to fight cancer," Trangenstein said.
Both the surgeon general and the treasury declined requests for interviews. The treasury did tell Scripps News in a statement "it is actively consulting with the Surgeon General regarding changes to the language, although it's too early to comment on what those changes may be."
Updating labels may take a while — the current warnings took over three years to implement.
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Last year, the percentage of adult smokers dropped to about 11%.
