It's time to put cancer warning labels on alcohol, experts say | Hacker News Reader

It's time to put cancer warning labels on alcohol, experts say

cbc.ca

94 pointspigtailgirl190 comments

How our society treats alcohol and tobacco is fascinating to me. Alcohol is known to cause all sorts of terrible health outcomes, yet our society glorifies it's consumption. Getting hammered in college / university is seen as a right of passage. Ads for alcohol are filled with sexy cool people drinking and partying. Our media portrays drinking as cool. Many people could not fathom having a celebratory moment without alcohol.

This was exactly where we were with tobacco in the 1950s. Ask a random person today if they think that efforts done to curb tobacco usage we're "good" they would probably say yes. We agree that glorifying tobacco consumption was bad. Attempts to brand tobacco as cool through figures as Joe Camel are viewed as stupid, we are much smarter and more enlightened now. Yet we don't apply the same critical lens to a Budweiser commerical where a guy pops open a bottle and is immediately surrounded by cool friends and beautiful women.

How long until we move past the plastic leeching into food era? Or lets burn gas and put it in the air and let's ignore cancer effects era?

It'll happen.

Once the planet runs our of such resources to consume and we are forced to stop.

Has been done before that for countless other substances.

There is already a lot of alarm over PFAS and plastics. It's likely to be the lead paint or asbestos of our generation.

It probably has something to do with the near-universal consumption of alcohol stretching back to (check notes) the dawn of human history.

Doing something since the dawn of human history is a poor metric of whether something should be in a glorified position in our modern society.

It's a great metric in determining whether something is Good, per the Lindy effect.

violence also is as old as humanity, so…

It also seems fairly popular, solves the pesky problem of presides/rivals horning in on your resources. It is a good option if your metric is ‘helps you survive’ for most of our history.

Same with hallucinogenics. Sexy media didn’t create demand for these products/resources.

I’m no drug historian, but isn’t it safe to say that alcohol consumption is far more universal than hallucinogenic consumption, across time and space?

I have my doubts. Alcohol requires fermentation. Many of the traditional hallucinogenics just require munching the right leaf, fungus, etc.

Fermentation is natural and common.

Your liver can process fermented products because yeast is everywhere -- including in your gut, and will ferment carbs in tiny quantities as they move through you; your body is processing tiny quantities of alcohol all the time.

Plenty of examples of bears, pigs, birds, etc. getting drunk off of fruit that's gone a little off.

Yeah definitely. There are some people who are real passionate about the magic-mushrooms-caused-cognitive-evolution theory because it validates their lifestyle choices.

The difference is that alcohol is quite fun...

Smoking was popularly seen as quite fun as well. Less so now. It's role in culture shifted.

But it was never actually fun though. Maybe it was advertised that way. But there was no positive effect from it.

Drinking on the other hand DOES effect peoples mood, behaviour, confidence etc.

This is what always mystified me about smoking: at least other drugs have some effect, nicotine just gets you addicted.

Edit:

To be clear: smoking has no meaningful affect unless you're already addicted. A non smoker who tries their first cigarette is no more relaxed or confident or calm than they were before.

The same is not true for alcohol or marijuana or basically any other drug people use recreationally...

Smoking has a calming effect.

How is that fun?

Smoking also helps with weight loss.

No positive effect from it? I take it you haven't been a smoker yourself. You being mystified about why smoking was seen as a desirable drug by many is evidence of the massive culture shift that occured surrounding that particular drug.

this is why we are taught in HS how insidious smoking is. We were taught that with many drugs (say heroin), one is always chasing that "first high", as it is tremendous feeling, and subsequent usages never are the same. While with cigarettes, almost universally people will tell you that their initial usage is terrible, they can't stand it.

The only reason people are able to keep doing it is because they get used to it, and their body develop a dependency on it.

> While with cigarettes, almost universally people will tell you that their initial usage is terrible, they can't stand it.

Sounds like beer.

> Sounds like beer.

I disagree. While a lot of people might not like the taste of their first beer, they tend to not have the same feelings about the effects of it.

E.g., the first time i tried mezcal, I was not really into the flavor of it, but I liked how it made me feel afterwards. Eventually I developed an appreciation for the flavor and started genuinely liking it (just like it happened with beer for a lot of people). But I liked the effects of it the first time around just like I liked them later on, all that's changed is flavor.

Had a similar experience in terms of flavor with some cheeses as well, it is just an acquired taste. And in case of cheeses (unlike with mezcal), there was no "feeling" that I liked the first time around, I just eventually started enjoying the flavor.

With cigarettes, the first time I tried it, there was not a single feeling I liked about it at all.

as he said, there's a difference between disliking the taste of something and something physically making you ill (i.e. it making you cough and feel terrible). i.e. your body is telling you "this is poison". so yeah, you can acclimate to the poison, but its still poison. Even if one considers ethanol to be poison, the first consumptions of it (say in wine) doesn't give the same reaction.

I'm not sure this is really true, you get huge nicotine buzzes at first, though too much can make you feel nauseous.

The limited amount I’ve smoked shows it has an effect similar to coffee but less jittery.

> A non smoker who tries their first cigarette is no more relaxed or confident or calm than they were before.

Heh, I can tell you've never smoked.

I'm not a smoker, but did try a cigar once. Combined with alcohol, it was an utterly euphoric experience. Think caffeine times ten, at least. I quite literally dreamed about smoking for a couple of days after that experience.

Does that effect persist for regular users? Nope. But for non-smokers it can be a very pleasurable experience.

You aren’t supposed to inhale the cigar smoke!

I mean my first experiences with tobacco did involve a bit of a head rush, but I’d hardly call it a “utterly euphoric experience”

>smoking has no meaningful affect unless you're already addicted

This isn't true. I started smoking socially in the summer and nicotine absolutely gives you a head rush and relaxing feelings. It also suppresses my appetite quite a bit. I found if I just ate and I'm full and then smoke a cigarette it makes me want to throw up.

And on the topic of fun, it is a social thing and you meet all kinds of interesting people by smoking. It's such a great ice breaker at the bar to meet people.

I gave it up because it's winter and I don't go out to bars as much. Plus it's cold and I have no desire to go outside and smoke anyways. I'll definitely pick it up socially again next summer though, it was one of the best summers of my life.

I would say the difference is that smoking has a bystander effect while alcohol doesn't (besides bar fights, j/k). At least in the country I currently live in, anti-smoking measures were not introduced to protect smokers but to protect those around them. At least that was the official narrative.

Getting hit by a drunk driver is a significant bystander effect.

Alcohol abuse has a huge effect on other people. Just think of drunk driving and domestic abuse.

https://www.nhtsa.gov/risky-driving/drunk-driving

https://pbinstitute.com/alcohol/domestic-violence/

Sure, but abolishing all alcohol because of possible consequences of too much alcohol is hard to sell. Even when talking about people getting really pissed, I would bet that more often than not nothing too bad happens to their environment.

> he difference is that smoking has a bystander effect while alcohol doesn't (besides bar fights, j/k)

I don't think we were talking about abolishing alcohol. Parent claimed alcohol consumption does not have an effect on others which is objectively wrong.

The vast majority of problem drinking is done by like 10% of americans. I don't think a warning label is going to stop them when they already consume a HUGE amount of alcohol every week

I always thought the "bystander effect" was a load of propaganda.

Even though I'm happy that airplanes/restaurants/offices are now free of smoke. I'm old enough to remember when every building stank of stale smoke.

Interesting. What made you think that? I was under the impression that passive smoking was pretty well studied.

For one thing, the concentration has to be a thousand times less. For another, you're just not around it that much. For a third, how can one reliably measure the exposure? Far too many variables.

PM2.5 concentrations tend to be very high around smokers. I live next to one, and even though we're separated by a door and he smokes in his own apartment, the smoking frequently pushes air in my apartment above 200 µg/m³. (I have 3 years of data to prove it.)

Since the outside air is typically even more dangerous here, I can't simply open a window and have to use air filters to combat this.

https://0x0.st/s/6LnsVC92Wy4es4tLN9iF5w/ohKp.png

So the outside air is more dangerous than second hand smoke?

> I always thought the "bystander effect" was a load of propaganda.

I can personally confirm that standing by smokers / staying in smokers' houses is quite good for triggering asthma. So I suggest you tampen down your propaganda claims.

Funny you're mentioning that. I've got a relative who counters onset of asthma by smoking, though with very light tobacco and long, thin filters, and on demand only.

I do similar things after eating, because I seem to have varying intolerances against the foods which are common now. Making my nose run, sometimes going to the eyes, giving me tears, over to coughing, and in more rare cases even constricting my throat. All that is going away instantly after a few draws of a selfmade small cigarette with long thin filter, exhaling the smoke through the nose.

Furthermore I don't wan't to lose the ability to smoke light weed from time to time, without coughing and spitting fits :-)

https://pubmed.ncbi.nlm.nih.gov/26440943/ seems a good place to start in correcting your misconception here.

    Conclusions: Our overview of systematic reviews of observational epidemiological evidence suggests that passive smoking is significantly associated with an increasing risk of many diseases or health problems, especially diseases in children and cancers.

edit: removed some unnecessary sarcasm

Then you have a poorly configured bullshit detector. Second hand smoke was studied in depth, and plenty of children have ended up with health problems from their parent's smoking. It is only a "controversial" fact among people who refuse to give up smoking for the benefit of their families.

> only

I've never smoked, and neither has anyone in my family except my mom who quit before I was born. I've never smoked marijuana, either, though I voted to legalize it.

I.e. I have no personal agenda with either.

Drinking has enormous external effects and I'd rather be around a chain smoker than a drunk.

Me, I'm the opposite.

> We agree that glorifying tobacco consumption was bad.

You're using "we" very expansively here. All of the things that we've agreed on in your comment are objectionable to many.

From what I can tell, "we" removes the "stupid" and only includes the "smarter and more enlightened" who will become stupid over time if they fail to apply the same "critical lens" to alcohol as they applied to cigarettes.

I think one key difference between tobacco and alcohol is that tobacco doesn't really have a 'safe' level of usage: every cigarette is bad for you.

However (from my understanding, could be wrong) alcohol isn't bad for you until your BAC exceeds a certain concentration, so 1-2 drinks is benign, but the 3rd one starts doing damage and damage increases in a dose dependent manner.

Most fruit juices and breads contain small amounts of ethanol - and I don't think there is any suggestion that those quantities could have significant deleterious effects.

I think it makes sense to have a different regulatory regime and societal perception for drugs that can have theoretically 'safe' recreational usage. Would love if there were biomarkers of alcohol doing damage that could be measured with a urine test strip or something like that at home: would acetaldehyde in urine be a good proxy of how much damage alcohol has done to the body?

Regardless, warning labels make a lot of sense - the way many people use alcohol is carcinogenic, and drinkers should be aware of that risk.

You think one drink of alcohol doesn't have a negative effect on your liver?

From my (albeit limited understanding) the damage from alcohol primarily lies in the 'backup' metabolic pathways getting used when the liver is saturated and cannot keep up with the primary pathway. The backup metabolic pathways produce acutely toxic byproducts - acetaldehyde most significantly - which are significantly more harmful than ethanol itself.

Some people may generate significant amounts of acetaldehyde from a single drink, but I don't think that's the case for the majority of healthy people.

My also limited understanding is that research seems to be converging on any amount isn't good for you and that a lot of the "one glass of wine is healthy" seem to be more finding out that people who are good at self moderation tend to be healthier because they self moderate on other things too.

I'd like to see gambling given the same scrutiny too. We have endless ads running during sporting events in the UK these days with betting companies boasting about how many of their users are using features like bet limits and it boggles my mind. If your entire advertising budget is being spent trying to persuade people that you're not evil, then maybe you're evil.

What a bunch of killjoys on here today. Most people are happy to accept the small harms from moderate consumption.

Those small harms aren't the problem it's the massive harms these industries generate most of their profit from. Nobody cares about moderate consumption, but they do care when corporations manipulate children and adults into destructive behavior that has resulted in significant harm.

That's why the article isn't saying "ban all alcohol forever!" but is saying "lets make sure people are aware of the risks". Same with gambling, which can be lots of fun, but that doesn't mean we shouldn't be doing things like limiting and policing the ads or keeping exploitative and additive forms of gambling out of video games marketed to children.

Well, meat is also not good for health (it was defined as likely carcinogen by WHO) and it is consumed pretty much everywhere and every day. Alcohol at least is fun and people consume it more sparsely.

Don't the WHO also list cellphones as a likely carcinogen despite repeated studies showing no link?

That list is hyper-conservative I think, as designed.

I’ve never heard of meats like Chicken being carcinogenic, usually only red meats and pork… does anyone have any references to read more on this?

The wedge used against tobacco was second hand smoke. Unless someone can show some kind of second-hand imbibing, alcohol is really not the same.

Automotive pollution, on the other hand . . . there's a parallel.

Well, drunk driving is a serious problem that can affect others.

There are limits to what can be done to ban alcohol. Prohibition was not a success. Bright side is that trends look like younger generations are already drinking less than older ones. They just aren't that into it.

My $0.02 is legal weed. Most of the states that have the bulk of the population have recreational or medicinal marijuana.

Booze is nice, but when they legalized it here I mostly gave up drinking in lieu of edibles. No hangover, no throat-burn, similar cost.

It's 'a rite of passage', or is 'a right of passage' an American thing?

Have you spent anytime outside of the US?

I've never spent any time in the US.

How many first world countries have banned/restricted alcohol advertising already? It's already pretty heavily restricted in Australia for instance (you are still allowed to broadcast TV commercials for alcohol, but because of the limitations around when you can do it and what you can show in such commercials, they're actually relatively rare, certainly compared to what I remember in the past). What I don't know if there's been much research into how effective the restrictions have been - it's true we seem have a younger generation now that drinks less than their parents, but I believe that phenomenon has been observed in countries that haven't significant restricted alcohol advertising either. We don't have cancer warnings, though it's certainly been discussed (and appears to have broad public support). There are typically pregnancy warnings ("Alcohol can cause lifelong harm to your baby"), which have been mandatory since 2020.

And yet, meta-analyses have found that wine, particularly red wine, has little effect on many cancers -- or in some cases even a protective effect, such as in prostate cancer:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909789/

Lung cancer:

https://pubmed.ncbi.nlm.nih.gov/18006934/

Renal cell carcinoma:

https://pubmed.ncbi.nlm.nih.gov/22516951/ https://pubmed.ncbi.nlm.nih.gov/25965820/

No effect of wine on gastric cancer risk:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716786/

No effect on colorectal cancer:

https://pubmed.ncbi.nlm.nih.gov/30247171/

No effect on epithelial ovarian cancer:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895710/

The dose makes the poison. In your first link for example, I couldn't find a definition of what "moderate" consumption even is.

"differences between studies introducing heterogeneous results. Still, all studies had a maximum of one glass of wine per day as moderate consumption."

With one glass of red wine per day my grandmother in law lived to be 96yo.

That's so old! I can't imagine being almost a century old. I hope she had a good life, beginning to end.

Quite and good ol' anecdotic evidence

There are a lot of things that are risky that I do all the time. I’m surprised marijuana has such widespread praise given burning organic material, inhaling it deeply, and keeping it for long periods of time in your lungs is obviously dangerous. Grilled and smoked meat - with charred material slowly snaking its way through your intestines - is definitely extremely dangerous.

But I enjoy alcohol, I like how it impacts social situations, I like the taste. Jesus did turn water into wine, after all. Traces of beer and wine go back perhaps ten thousand years. It’s not something a warning label will change for me, and we already tried prohibition. Life is hard enough without having to worry about every last damn thing.

There are ways to “use marijuana” that don’t involve combustion.

The future where a nano infused cannabis drinkable where the high hits and leaves in similar timeframes as alcohol is nearly here.

And big brands are getting into it. You can buy a cannabis beverage from the companybthat makes PBR. https://www.pabstlabs.com/

You can already buy 99.9% pure cannabinoids and terpenes and mix your own tinctures in MCT and similar oils. You can also buy pre-prepared tinctures. The era is here, really.

> I’m surprised marijuana has such widespread praise given burning organic material, inhaling it deeply, and keeping it for long periods of time in your lungs is obviously dangerous.

Edibles :-)

> I like the taste

That's the part that's hard to completely replace with anything else, for me. I like weed better in basically every other way, but a nice minerally wine or complex whiskey or layered, perfectly-balanced mixed drink... mmm.

I still prefer alcohol to edibles though. I enjoy the effects of alcohol more than cannabis.

"burning organic material, inhaling it deeply, and keeping it for long periods of time in your lungs is obviously dangerous" - While intuitively true, I'm not at all convinced it is factually true, though of course it may well be. Also it likely depends a lot on how much/often.

Likewise for: "charred material slowly snaking its way through your intestines"

"Life is hard enough without having to worry about every last damn thing." - Amen

We spent basically the entire past century figuring out how bad burning leaves are for your body on a regular basis, why the hell do you think it isn't factually true? There's no intuition about it.

The only fact I know of in this area which I think is well established is that smoking a lot of cigarettes over a long period of time is bad for your health.

But what about a lower volume of usage? Say, one cigarette each day? Or two? Or one per week?

You assume everyone is "smoking" cannabis. I would argue cannabis edibles are the future. I would also argue cannabis edibles are infinitely safer than any kind of alcohol.

Alcohol is a hardcore drug that is readily available, cheap, and highly addictive. I don't enjoy the taste of any alcohol and it seems cheap alcohol is what most people are buying which is not known for taste/flavor. Sure a cocktail might taste fine but most normal people and even alcoholics aren't consuming pina coladas every night.

Cannabis edibles are awful. It takes forever to take effect, dosing is annoying, and they are stupid expensive for the amount of THC you get. They are basically the "powder alcohol" of the weed world. The effect you get from eating THC is also different from the effect you get inhaling.

It's a different world forsure, I'm not arguing for or against, I'm just saying that eating cannabis has zero health issues associated with it versus drinking and smoking which are killing your vital organs. I'd also argue cannabis edibles are already a multi billion dollar industry. I personally know a couple of folks that have been anti alcohol and smoking, but have eaten or continue to eat cannabis. It's anecdotal at best, but I was surprised when these specific people told me they tried it despite their stance previously.

It's easier to get https://en.wikipedia.org/wiki/Cannabinoid_hyperemesis_syndro... by edibles. Because of the delayed feedback and difficult dosage. You don't have that delay with smoking or vaping. The feedback is instant, except for really strong stuff that is overwhelming. But that is avoidable. At least where it's legalized, and marked/labeled as such.

> Grilled and smoked meat - with charred material slowly snaking its way through your intestines - is definitely extremely dangerous.

Extremely dangerous? How would you describe swallowing some magnets?

One area where alcohol could be improved is by requiring food labels. Just how much sugar and calories are in your drink? Finding answers to this is a bit opaque, so having a bit more transparency would be great.

This. It's crazy in the UK where normal drinks have to have it, but alcoholic ones are exempt.

Canada as well. It leads to the absurd scenario where non-alcoholic beverages like de-alcoholized wine can sometimes appear less healthy when side by side with the normal stuff on the shelves.

I'd also like to see ingredients lists in general. Why is alcohol exempt?

Yes! As a diabetic I'm always annoyed that they don't even try to print the carbs on the label. I don't get why alcohol gets a pass when other food and drink have to.

Aren't alcoholic drinks required to label their percent of alcohol?

Interestingly, some alcoholic beverages in the US now have nutrition facts labels. I don't know if there was a rule change or if they saw the writing on the wall and wanted to opt in to a crappier version to try and delay any rule change or if it was part of the marketing push a few years ago to imply their brand was the only brand with "natural" ingredients or other nonsense.

I don't think I've seen a hard alcohol with that label.

When they have an alcohol-free version, I believe that you can find some more information on them (but of course it probably somewhat differs).

One thing that would be helpful in making this type of decision is to know the impact on average life expectancy. For instance, cigarettes shorten one's life by an average of 13 years. Most would agree that 13 years is an absolutely massive number.

According to this one source, the average lifespan of a drinker consuming 10-15 drinks a week is shortened by 1-2 years: https://www.nationaltasc.org/years-drinking-take-away-from-l...

Warnings are important, but giving people clear data on the consequences of their decisions are is important too.

Being obese seems to have an effect of between 3-14 years depending on the study. I think emphasis should be proportionate, so maybe less emphasis on alcohol and more emphasis on the negative effects of being overweight. But still some emphasis on alcohol... proportionate.

The study that page relies on is about all-cause mortality (in particular, CVD); the article is about cancer warnings.

But why warn about cancer unless the cancer is going to shorten your life? I need more information to decide whether or not I heed the warning.

I'm just saying that this study doesn't necessarily validate the proposed labeling.

All organic solvents are a cancer risk for the same reason: they imitate water (an inorganic solvent) inside our cells, but they're not water. Therefore, every single chemical reaction inside the cell is a bit different. Whether inhibited or triggered, or slowed, or sped up. So more reactions are likely to go wrong; perhaps creating free radicals that can rip up any molecule they touch, including DNA.

We are immensely better than other mammals at coping with alcohol (which yeast uses to poison other organisms and so preserve its food sources such as fruit.) Our livers prioritize neutralizing and excreting alcohol; letting other chemicals pile up meanwhile. Hence, just about any medication becomes more toxic if you drink alcohol at the same time.

We like the brain effects, but in truth every chemical reaction in the body is affected.

Speculating, however: some of the cancer risk from modern alcohol sources, however, may come from very long storage. Wine put down for more than the three years nec to sediment out lousy-tasting tannins continues to form Frankenstein flavor molecules (flavinoids) that have unusual tastes because they're random, they don't occur in nature. While flavinoids promote health, the Frankenstein versions of them likely don't and may be a potent extra source of cancer risk, even though we highly value those rare, weird flavors. Evolution hasn't necessarily shaped us to cope with these novel molecules, since we wouldn't have encountered them.

Of course, wine retains many of the very significant health-enhancing virtues of grape juice so it may often not do net harm (esp if the wine hasn't been put down for too long) but you can also buy grape juice.

Human body tolerance to alcohol probably comes from thousands of years of experience with it.

It's a very recent trait evolutionarily but seems to predate deliberate alcohol production for the most part. It's been thought that when the human population became very small during an ice age, the ability to eat old fruit under snow might have been very important. But you're right, populations used to deliberate fermentation for thousands of years, such as in China seem to be much better protected.

Also that American Indians seem to have less of a tolerance to it, as alcohol was fairly unknown before the Europeans came.

Whereas, middle and South America did have a tradition of alcohol in Pre-Columbian times. However, alcohol was often exclusively reserved for those who had attained extreme old age.

Alcohol was probably the only safe beverage to drink, as the alcohol would kill pathogens. Even safer than water.

I've heard that's why sailors drank a lot of rum in past times. But I don't know if it's true, or if sailors actually drank a lot of rum.

I can't seem to find any info on whether or not the risk disappears if/when you give up drinking. Or is the DNA roulette wheel already spinning, like it is for people who have been heavy smokers in the past?

I think it's going to be harder for people to take on board the idea that any amount of alcohol is bad for you as, intuitively, I still believe that, in moderation, it can have some positive affects such as de-stressing and aiding sleep. Mind you, I suppose you could say some of the same about smoking and I can intuitively accept that any amount of that is bad for you.

Well, I've never smoked [tobacco] and [apart from a bit of a 'sociable relapse' over Christmas] haven't drunk for over a year now. So I should live forever!

I'm a heavy drinker and what I've read about alcohol and sleep says that it's bad for your sleep, in particular the quality of REM sleep. Anecdotally I can back that up with my own experience, as I drink before I go to sleep.

However, it's much easier to fall asleep after you've been drinking, but that's just because alcohol is a nerve depressant anyway.

https://en.wikipedia.org/wiki/Alcohol_use_and_sleep

Why would you do that? Just to get to sleep easier? There are other, better ways.

I don't know why any particular person would do it, but I don't drink to sleep.

This is the thing that's so tricky about... well, I guess the way our world models in general work.

Is drinking bad for you? Yup. Is smoking bad for you? Yup.

Is moderate social drinking bad for you? Likely, but definitely less bad for you than slamming a 6-pack nightly.

Are there other (mainly socially-mediated) health benefits from moderate social drinking? Plausibly? Probably? Occasional social smoking? Probably in some contexts.

If these effects both exist, they can be compared. Do the risk curves intersect? Where? The crossover will land in different places for different people, different circumstances.

> Or is the DNA roulette wheel already spinning, like it is for people who have been heavy smokers in the past?

Heavy smokers ingest trace amounts of radioactive metals that continue to emit radiation for years to come. The mechanism is certainly not the same with alcohol.

There’s a dose dependent relationship, where heavy drinkers have the highest cancer burden. So we do expect (but aren’t sure) discontinuing use reduces risk.

I’d say we should treat alcohol very differently than tobacco. It’s got a much lower addiction liability (under 10% of people who try alcohol become addicted, while 32% of people who try nicotine become addicted). Heavy alcohol use is also way more destructive than heavy nicotine use.

Additionally, users seem to find alcohol somewhat more fun that nicotine. [1] That said, the literature supports the conclusion that alcohol decreases sleep quality and increases stress, despite what users think. Any objective benefits are likely social in nature.

Overall, I think there’s a better case to be made for socially accepting moderate alcohol use compared with the case for nicotine.

That doesn’t mean we shouldn’t have warning labels though - most people currently underestimate the risks of alcohol.

1: https://pubmed.ncbi.nlm.nih.gov/23438502/

> under 10% of people who try alcohol become addicted

Iffy number or definition? In my circles I am sure more than 10% of people abuse alcohol daily, and I would consider them addicts. Then again, New Zealand has a drinking problem.

According to the NIH, only 5.3% of Americans 12 and older are alcoholics (https://www.niaaa.nih.gov/publications/brochures-and-fact-sh...). Factor out the fact that some of those people haven't tried alcohol and you get about 7% addiction liability.

In New Zealand, according to health.govt.nz:

  18.8% of adults had a hazardous drinking pattern in 2021/22.
  Hazardous drinkers are those who obtain an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or more, representing an established pattern of drinking that carries a high risk of future damage to physical or mental health.

I agree that definition of addiction, and alcoholism, vary by country.

Makes sense. I don't currently know any active alcohol abusers (knew some in college), so the 18.8% seems incredibly high to me. That said we all have biased samples

> So I should live forever!

No but you probably get to die from something else and hopefully much later.

I am not a biomedical unit, (but I have played one at work). The mechanism to my limited understating is alcohol was invented by yeast to slightly poison their food so the bacteria present could not out compete them.

It's fundamental creation in nature is a deliberate toxin.

At least one of the chemicals alcohol breaks down into in mammals is known to cause double strand DNA breaks.

Most often "no problem" we have builtin genetic resources to repair those breaks. (unless you have something like Fanconi Anemia).

The reason we have a builtin mechanism to repair this sort of damage is it happens anyway at a lower rate without alcohol.

If the rate of breakage is greater than the ability to repair then stuff stays broken.

Basically the more lottery tickets you buy the more likely you are to win but not buying them doesn't mean you wont be gifted some.

It is a strange thing to reconcile, intellectually I have first hand data there is no safe dosage, but genetically I'm from a line of alcoholics and socially (in the before times) it provides a very comfortable community building fabric.

I have become comfortable with a single drink on rare occasion.

> Or is the DNA roulette wheel already spinning, like it is for people who have been heavy smokers in the past?

Just so this information is out there, particularly for prospective quitters, this is actually a bit nuanced:

https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002...

As you can see, after 15-20 years of smoking cessation, excess risk for various causes of mortality drops substantially.

You are correct that the risks never truly return to baseline, but for lung cancer, for example, the excess risk drops to between 5 and 13%.

This appears to be the actual CCSA study that led to the "no safe amount" conclusion: https://www.ccsa.ca/canadas-guidance-alcohol-and-health-fina...

I haven't read the report in detail so I can't comment on the methodology. Some salient points:

• I don't see an actual recommendation that no alcohol is safe. The conclusion is that there is a continuum of risk, and that 3-6 drinks per week carries "moderate" risk.

• The risk model output is presented on Pages 25 (females) and 26 (males).

• The risk model appears to include both long-term health risks as well as short-term risks such as injury due to accident or violence that occurred while intoxicated with alcohol.

• The risk model is developed using meta-analysis of several pre-existing studies.

• The "2 drinks or less" recommendation is shown on the chart on Page 29, which shows the lifetime risk of year-of-life-lost as an increasing function of weekly average alcohol consumption. 2 drinks is approximately the crossover point where the risk goes above baseline.

I’d be delighted if everything that was as risky as tobacco, asbestos, alcohol, etc had health warnings. Same with foods: full dietary info, plus excess sugar/fat/etc labelling.

Only 25-30% of Canadians know that alcohol carries a cancer risk. A lot of Canadians drink well in excess of “safe” limits. Informing the public allows everyone to make a conscious choice about a significantly risky product.

No one knows these things intuitively: they need to encounter that information repeatedly before they will know it well enough to use that information in making a decision. Adding a written warning on the bottle label is a sensible, inexpensive, effective way to accomplish this.

I want to be more informed, not less.

Warnings aren't informational, they're motivational. Have you ever seen a health warning with a QR code that links to the data? No you haven't. Alcohol already carries health warnings, adding to them will likely have only marginal effect.

I'm not saying that this information shouldn't be in health warnings, but it's worth considering how health and safety warnings and signage are absolutely ubiquitous in modern society. It could be that the consumer warnings are a mediocre substitute for industrial regulation at source - just slap a disclaimer on it to avoid lawsuits and call it a day, so to speak. It's also possible that this leads people to either filter them out or causes them additional levels of stress. I value safety information, but I don't value having it shoved in my face all the time.

It amazes me that people argue in favour of having a population that is less informed.

Seems like a non-sequitur as that's not the argument I'm making. I gave context and reasons, perhaps you should try the same approach.

The labels already have a danger to pregnancies warning. It helps reduce FAS rates. Your concern trolling over extending that warning with one about cancer risk doesn’t deserve any greater attention.

I live in California, and I love it here, but the cancer warnings in everything really do absolutely nothing. They are comical at this point.

Perhaps if the risk were quantified somehow, things would improve? Could be incorporated into the Nutrition Facts label, even.

The problem with cancer risk labels is that they're never actionable, it's too vague.

My Nintendo Switch games include a cancer warning. Am I actually at risk during regular usage or is the risk only if a crush up the cartridge and snort it?

And whole restaurants have the cancer warning. Would it be possible to avoid the foods with cancer risks associated with them?

AFAIK, some companies even include the label just to be safe.

I'm waiting for it to be mandated that doors and windows have cancer labels near the knobs and handles. "WARNING: Opening this window may cause cancer"

Last time I visited Disneyland with my kids, there was a sign by the entrance that Disneyland causes cancer.

Ok, it said something to the effect that there were substances on the premises known to the State of California that cause cancer. But the end result is that it was not clear WHAT was there that causes cancer, so it basically says Disneyland causes cancer.

Much like life itself, which is effectively a carcinogen.

The longer you are exposed to being alive, the more likely you are to get some type of cancer.

One of the side effects of the type of society we have is it is going to eventually bend to the dedicated nut jobs that lack hobbies and interests. So that group of nutters who insist that everything have a label on it will eventually get their way as they're super organized, loud, and they only have to win once. Their opponents don't care nearly as much and have to constantly defend so they just move on to and let the nut jobs have their way.

It's good a lot more to do with the history of litigation in the US, and politicians putting a sign on something as a way to appease people who want proper regulation. A vague unhelpful label or a plaque is cheaper than an audit.

I figure it’s pretty easy enough to show correlation but how many people are self medicating undiagnosed issues? Surely that would significantly color the stats.

It’s not just correlation. We do have a good reason to expect that alcohol causes cancer. First, we see increased cancer in areas the alcohol and decomposition products touches/interacts with (mouth, esophagus, colon, liver, etc.). The exception is the breast cancer correlation, but there is an explanation for that too (based on a secondary metabolic pathway). We don’t see, for example, alcohol causing lung cancer or brain cancer. Second, we know alcohol breaks down into likely carcinogens.

That makes sense. It seems that the main carcinogen of concern is Acetaldehyde which I was unaware of. That's also in milk and fruit juice, but I figure 'the dose makes the poison'. I do think a lot of people are self medicating and really wish that area was better researched.

Yeah, we're talking mg/kg of acetaldehyde for apples. You would end up with perhaps 12 grams of acetaldehyde in your system from a single standard drink (probably about 0.85 grams acetaldehyde/gram ethanol). It's like comparing the radiation dose of a banana to a stroll through the Chernobyl exclusion zone.

I think the Canadian report it references is here: https://www.ccsa.ca/sites/default/files/2023-01/LRDG%20Lifet...

I might be being dumb but does anyone understand the graphs on page 18? There are multiple lines for different consumption levels but the x axis is also consumption level? I also don't understand why everything is piece-wise linear. It makes me think they don't actually have very high quality data? Maybe people just self selecting buckets?

This will never end.

There is a sector of the economy that lives off banning and regulating things, and it will constantly need new prey to prosper.

If you think this is good or bad is a separate issue.

I hope studying the effects of the things we ingest and publicizing the results never ends, I agree.

> There is a sector of the economy that lives off banning and regulating things

The economy can't ban anything, what are you referring to here? In fact, nothing is being regulated or banned here.

Oh yeah, because "contains chemicals known the state of california" really helps us all out.

Come on, aren't there real problems to solve? Do we have grid scale battery storage yet? Are we building more GenIV nuclear reactors? Do we have environmentally friendly desalinization? Let's not waste our breath on dumb crap like this.

This is a distraction.

Ah yes, because the people in charge of alcohol labeling are definitely the ones who can cut red tape in the area of funding battery development.

Labelling alcohol with a message that states that acetaldehyde is carcinogenic I have no issue with.

However, if this is going to be anything like smoking, the labels won't be there for the sake of informing, they'll be there as an emotional appeal. They'll start out as "surgeon general recommends", then they'll become high contrast, then they'll start putting gross pictures on it, then all beer bottles will be one colour and hidden away behind a counter.

If pubs end up having to have pint glasses with a picture of an inflated liver or something equally disgusting it would frankly not be informational but abusive.

It'd be an attempt to shame people into submission.

I fully expect to see this within my lifetime and it honestly just sickens me. Fuck off, man, just give me the information and let me decide.

If "no amount of alcohol is safe", we should put cancer warnings on bread and fruit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421578/

Indeed I take an interest in health and nutrition, but it honestly gets a bit silly following some people to the letter The Huberman podcast for example, really interesting, but how many supplements do you actually need and how big a benefit do they give you?

You can usually find contradictory studies on almost anything. Refined sugar and processed crap seem to be the one thing that everyone agrees are bad. And exercise and proper sleep are good. I live a balanced lifestyle. A reasonable amount of alcohol or cannabis but I eat well and do plenty of exercise. I seem in better shape than most people with less alcohol and less exercise.

I had no idea there was a link between alcohol and cancer. Is this new info for anyone else?

https://en.wikipedia.org/wiki/Alcohol_and_cancer

Thanks, the Talk page is especially interesting here.

Yep, new to me but the article doesn't explain much. I assume massive drinking could lead to all sorts of cancers as you're taxing every part of your body. It follows that a bit of drinking would have a small effect but is it enough to really matter?

I’m not sure it follows, eg, a lot of radiation will give you cancer but a minuscule amount may boost health by stimulating an immune response that is overall protective.

I could similarly see a single shot of alcohol per week not significantly taxing your system and ending as a net benefit due to, eg, triggering cellular cleanup that also removes accumulated junk.

This has been pretty well established for a while, and confirmed by the WHO. But for some reason, that fact never seems to have gained much traction.

Here is some literature in case anyone is interested:

1. A 2006 review in The Lancet Oncology: http://drugfree.org.au/images/pdf-files/library/alcohol/Canc...

2. A recent study in The Lancet Oncology: https://www.thelancet.com/article/S1470-2045(21)00279-5/full...

3. A meta-analysis of the effects of light drinking on cancer incidence (Annals of Oncology): https://www.sciencedirect.com/science/article/pii/S092375341...

There's definitely a link with esophageal cancer, and imo that's being blurred and handwaved into a generalized cancer risk.

But what is the actual risk? I can't find any specific information. It says in https://en.wikipedia.org/wiki/Alcohol_and_cancer that in Europe 10% of cancers in males is due to alcohol, but is this mainly from heavy drinking, the two bottles of whisky a day type? It would be good to know what the risk of moderate drinking is, for example 15 units per week, it would be good if this were in an understandable number like the average years of good health lost.

Blood pressure, for one: https://www.sciencedaily.com/releases/2019/03/190307081024.h...

Personal/un-scientific opinion. It's worth trying going on/off alcohol to see the effects on your sleep, mental health, behavior, and honestly finances.

I'm trying no alcohol Jan (like a lot of people) and I've been noticing the effects on my sleep, mental health and the $$$ saved.

Similar to skipping coffee, a week or so every year. It's good to just introspect and question your defaults.

You'll learn something about yourself.

Similar to eating meat, maybe we are better off just eating less of it. Just my two cents.

Well, we all already know alcohol does more harm than broccoli. If that isn't enough to stop someone drinking it, why would cancer warning labels?

Warning labels were part of an effective strategy to curb smoking. This is from the same playbook. Warning labels on alcohol have been shown to reduce consumption in localized testing, as stated in the article you are commenting on.

While most people have some idea that alcohol is had for them, the link between cancer and alcohol is not widely known. This is also reflected upon in the article.

The "experts" (by the media's reckoning) haven't yet advocated doing this for marijuana products, which bear no cancer warnings, so I think a great deal of cynicism is warranted here.

That's because there's not conclusive evidence that smoking only marijuana causes cancer - especially to the same degree as tobacco.

While it may seem like "smoke is smoke", that doesn't appear to hold for marijuana - and it's not clear why.

Definitely not true. Inhaling combustion byproducts is what causes cancer. Marijuana smokers typically just don't inhale as much smoke as tobacco smokers. Nobody chain smokes joints all day unless they're Snoop Dogg or something.

I quit tobacco years ago and the last studies I read pointed to smoke and tar, not nicotine, as the specific cause of cancer.

But later when vaporizers got popular they changed the tune to "tobacco is bad, no matter how you consume it". Honestly, I don't know which is true.

Nobody chain smokes joints all day unless they're Snoop Dogg or something.

There are many somethings out there. But vapes are indeed more convenient.

At the risk of diminishing my small position in this thread I can only anecdotally state my perspective which is... indeed whatever you're vaping is better than smoking it.

To address your comment about nicotine, vaping nicotine salts (what is the standard now; juul, vuse, etc.) is a huge upgrade from cigarettes. My lungs have literally healed. My doctor (who disapproves but admits the difference) and I would love to see a reply refuting this.

Your comment doesn't count as conclusive evidence.

Oh, they do.

I fail to see how a failure to properly label a different product with the appropriate health warnings is a an argument to also fail with a different one. If a risk exists, proper labelling is warranted regardless of substance.

I'd also like to point out that the Canadian Cancer Society (one of the groups highly involved with advocated for labelling) has also issued statements about inhalation (of any substance). So they quite literally have done the thing that you accuse them of having not done.

> Warning labels were part of an effective strategy to curb smoking.

Raising the prices of cigarettes beyond the means of poor people and passing restrictive laws about smoking in public and private were the only effective strategies against smoking. The warning labels were an intermediate justification, and in the case of Swedish snus, actual misinformation.

Google broccoli thiocyanate, and enjoy a bottle of red from time to time.

Is there a study showing countries with differences in life expectancies between countries with low or high alcohol consumption? Given that we've had prohibition in the US before and that couldn't have gone worst, I feel like the society-level considerations are very relevant here.

Do other countries already have them? Honestly, it probably wouldn't change my habits but who knows, it might get me from 8 to 7 drinks per week or so.

What I find interesting is that it's so much worse for women, moralistic messaging about changing behavior specifically for women could backfire.

According to https://www.jsad.com/doi/10.15288/jsad.2020.81.284, as of 2020 only South Korea does this.

I don't really care if they put these warnings on. But that presents a problem: If a low-level drinker who is reasonably interested in his health doesn't care about the warnings, will anyone? And if no one cares, why bother?

Was there a significant drop in smoking when they added warnings?

If I was a smoker and had to look at those pictures on the pack I think I'd think about that from time to time. Not sure if that alone would cause me to quit but perhaps it would be one aspect.

Then there is really no reason not to put these warnings. People can make their own decisions if it matters to them or not. It would be worth it even if the results were not significant. Any amount of people becoming more informed in their decision making is worth it.

What's the purpose of these warnings? Do they even save lives or just make these bureaucrats feel productive? If they really want to save lives, they need to find the cure to cancer. Do more work there.

That logic isn't sound. Why put warning labels on anything? We could find a way to replace damaged lungs with artificial ones instead of not smoking.

It is like treating the symptoms when we could instead just not poison ourselves. We should of course do both, but curing cancer is about as difficult as any medical science task can be. In the meantime we could try letting people know that something might cause unwanted health effects.

Go ahead, put the labels on. Still won't stop me.

My liver! The labels do nothing!

Warning: Participating in life causes death.

"no amount is safe"

give me a break

Probably warranted in this case, given the still-treated-as-true-in-pop-culture flawed studies about a drink or two a day being net-beneficial.

Cant wait to see the warnings on Listerine and medical swabs.

EUA mRNA shots should have a warning, and not legal immunity for the manufacturers.

They definitely should have a warning. The legal immunity was a practical measure, so I can understand that. The issue I have with the immunity is that it stands as an ongoing precedent, if it's never rolled back.

Yes, they seem to have taken this as an approval of mRNA technology, despite the trials not actually being complete, skipping important parts (testing for cancers, and testing for where the vaccine ends up in the body). And basically ignoring any adverse events. There are massive signals in VEARS, but they are being ignored, the CDC admitted they weren't actually monitoring this at one point.

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