I feel like the harms of alcohol are also magnified by adulterants here. For example, an alcoholic will often choose dirt-cheap beer or spirits to consume on the regular. Is that stuff pure and clean? No. There is no requirement to label ingredients in a bottle of wine, beer, or vodka. You can put any old stuff in there as long as you're not outright poisoning people.
They're going to a convenience store, or a dive bar that carries the worst stuff and they're going to drink that, day-in, day-out, to excess.
I believe that, if drinkers had access to pure and clean ethanol-based beverages, and also maintained good nutrition and a decent diet, they wouldn't get all this liver failure and horrific metabolic stuff that they suffer as alcoholics. I feel it's often tangential to the substance itself.
When I smoked, I often picked up clove cigarettes. My hairdresser friend with purple hair advised me that the molecules of clove smoke were huge compared to tobacco smoke and I was killing myself that much faster. I thank President Obama for finally closing out the clove cigarette market. I was eventually smoking American Spirits, which are mass-market, but touted as extra pure or clean. Who knows, really?