As someone who is 6 1/2 years sober now, I have some thoughts here. I do think that when one is drinking regularly, not even excessively, it is impossible to understand the benefits that come from giving up alcohol entirely. There is a marvelous clarity of thought and intense peace and calm that comes when one has been sober for some time. Deep sleep each and every night is an amazing thing and probably contributes to the many mental health benefits. When I was drinking I was certainly willing to take on many risks to my health in order to justify what I was doing. Now the "benefits" of alcohol, if there are any at all, look so very small in the vast improvement in every aspect of my life that there is no question I would not risk taking a drink. As to the doctor's role, I wish when I had begged for help with severe insomnia problems, lowgrade depression, etc any of my doctors had said "you know, alcohol can cause all these problems - I recommend you take 100 days off of drinking and see what you feel like".
It's pretty tragic that some doctors don't recognize or understand the harms of alcohol - and the complexity of peoples' relationship with it
It's such a fundamental part of American life- and such a ubiquitous factor affecting people's health - that it needs to be addressed early and often IMO
As always, love the way you frame risk and trade-offs. It’s so helpful.
My husband and I are “accidentally sober” — we would only drink when we’d go out with friends, and when that paused during the pandemic we lost all of our alcohol tolerance. I don’t miss alcohol now — the hangovers, the heart racing while trying to sleep, the questionable behavior.
What I *do* DEEPLY miss are the rituals around it: meeting up for happy hour, savoring a nice wine, kicking back with a beverage. I live in wine country, so wine tasting is a local pastime!
Non-alcoholic alternatives are becoming more common, but still tough to find and sometimes sugarbombs that leave a different hangover. All of this is to say, there is a way to get the social benefits of drinking without actually drinking — our culture just needs to catch up a bit! Maybe then giving up alcohol wouldn’t feel like giving something up quite so much?
Yes - I agree w you. The rituals are part of the appeal - and the social aspects, too. Personally I have fallen in love with Kombucha but many people hate it!! Thanks for reading this piece and for your comments!
Hi, Tamara. Non-alcohol shops are popping up all over now. I have The New Bar by me (they are also online). I like Leitz's Zero-Proof Pinot Noir and NOOH's rose (reg and sparkling). Neither are sweet/sugary. I mean, when I tried Ariel, I should've just gotten pomegranate juice. At my natural foods store, I found Lautus Sauvignon Blanc, which is also not sugary. None have given me a headache. And, if you want to make a mean blended mockarita, put in some ginger ale. It gives that heat/burn like booze would. I fooled a friend once. I suppose real ginger would do the same, but I'm lazy. LOL. Hope you find something you like! And ask your local wineries if they are going to get on this dealcoholized trend. They can be ahead of the curve when the big quit happens. xo
Very well written! As a doctor myself, I find the hardest emotion to navigate with patients is defensiveness, which is also built into alcohol misuse. People often have their own idea of what it means to be a “social drinker”. At one point I found that I was drinking more at 50 than at 25 (granted, I was in med school), because 2 glasses of wine with dinner is a lot of alcohol, for a woman, especially. So now I don’t drink on weekdays, and a huge benefit is that instead of having a drink after coming home from a hard day at work, I exercise, which does a lot more to reduce stress than wine!
The key is honest appraisal, and keeping track. If you say you don’t know how much you drink, it’s probably too much.
Honesty with ourselves and our patients is so crucial - I agree! So is creating a non- judgemental space in the doctor's office to discuss things like alcohol use. Like you, I try to make sure that no patient EVER feels judged for having habits that are less-than-ideal - we're human! - however patients can still be defensive, which I think is often a reflex reaction to shame about lack of control. I get it. As they say in AA "you are only as sick as your secrets" ... Doctors often feel the reverberations of patients' secrets when they are kept hidden in the dark
Lucy, can you enlighten us about the specific and additional risks and impacts on 50+ women? I think there is some gender disaggregation in the research results and it looks like women can 'take' it even less, sadly.
So yes, I'll be moderating my love of wine even more. But I believe in moderation in most things, including abstinence.
Hi Avivah! There is no organ system that "isn't" negatively impacted by alcohol - based on the totality of data on it. Anecdotally, the biggest risks for women 50+ is emotional/mental health (eg depression, anxiety, PTSD, insomnia, social isolation), gastrointestinal health (heartburn/GERD, IBS, colitis, liver disease, pancreatic disease), cardiovascular health (Afib, hypertension, obesity), metabolic health (diabetes, weight gain), and on breast, oral and colorectal cancers.
Is there a more specific question you had it mind?
In September of 2024 I decided to address my drinking habits by doing The Sinclair Method. I heard a podcast, did some research, read some articles and personal stories and decided it made the most sense for me. Both parents died in their 60s of alcoholism and I liked the drink waaayyyy too much. I have been 100% compliant with the method and my average drinks per week had dropped down to 9 a week from well over 20 a week. During the holidays I picked back up a bit (still staying compliant with the method) and what I have noticed in the way that I feel is significant. When I drink less my sleep is amazing and my body naturally wakes up rested after 7-8 hours, my constant muscle cramps (despite drinking tons of water and even taking electrolytes) were gone, my skin was radiant and my eyes were clear (as reported to me by my best friend who I had not seen in a few months) and I felt more general contentment. But it took me increasing my drinking again to really experience the difference. It was no surprise to me when the new report came out and I am thankful that I heard about the Method and that it is helping me make changes.
I am having the absolute best time drinking while not drinking. Give me a sec...
Last year, with all of the reports coming out about booze trying to kill us, I realized I was gonna have to break up with it. But when? End of 2024 (it was summer when I started thinking about this)? Maybe too soon. End of 2025? Then, the first week of August, I got food poisoning, barfing for the first time in 20 years. I don't know what brand of food poisoning I had, but it killed my cravings. All of them. I mean, I eat. I have hunger. I just don't crave things like I used to (and I had major cravings). And that included cravings for booze. I no longer desire it. Still, I like the ceremony of it. The concocting of cocktails. The pop of a bubbly bottle's uncorking. Holding a wine glass. Now, I drink dealcoholized wines (granted, they are still 0.5% alcohol, same as kombucha, I believe). I make "grin and tonics" with faux gin, mockarita's with Lewis Hamilton's phony tequila (the Almave blanco has a heavy vanilla note which pairs best with orange). At my favorite Mexican restaurant, I'll have the hibiscus agua fresca. At my favorite Greek place, they make a lovely mocktail, also with hibiscus (I think hibiscus is going to have a big year). So, I sort of had the choice made for me. I don't call myself sober, because I'm not. There may come a day when a glass of champagne is called for. I don't see that happening (really happy with the NOOH sparling rose), but I leave the door open. I have too many sober friends who work at sobriety; this isn't that, and I mean that with deep respect. I was able to make a choice. And I'm truly glad I did.
If you're looking for recs, you can check out The New Bar online. I like NOOH's roses (can't make the accent on this computer, ugh), both still and sparking, and Leitz's Zero-Proof Pinot Noir. At my natural foods store, I get Lautus' Sauvignon Blanc. I haven't tried it, but I hear Tanqueray makes a zero-proof version of its gin. Also, since there's no alcohol, it's not going to sit around and "age", so keep that in mind and an eye on the expiration dates. xo
Hibiscus in mocktails is *chef’s kiss*. It feels exotic and fun still. I see a lot of restaurants getting very inventive with mocktails, and I’ve been ordering more of them. Plus, they’re about half the price!
LOL. Not in LA. They are still on par with “well” drinks. Someone wrote that “Mocktails need to remember what they are NOT” in regards to pricing. Still worth it! xo
In my younger days I drank quite a bit. Mostly social drinking, but occasional "benders". Intellectually I knew the risks but preferred to ignore them. When I turned seventy I realized that alcohol was detrimental to my health, and if I wanted to be around for awhile longer, going dry might make that more probable. I've been completely dry now for 7 years and wish I'd made that choice earlier. I still have other 'problems' both physical and mental - sobriety hasn't cured those, but there is a subtle subjective change of "consciousness." This change wasn't immediate. It took several years to develop but I think it's real and valuable.
I am also nearing 7 years and wish I had done it years earlier. It's also important to point out what you say to those who might be now considering sobriety - it takes time to see the best changes. Stick with it, make the commitment and the rewards will far exceed anything alcohol ever gave you.
Thanks for sharing this.. so many people feel that way ... that once they quit drinking they wonder why they didn't sooner. It does take some to "marinate" in a signif lifestyle change - taking note of that process helps, as you have done well to do!
I came home from a vacation in Mexico last March where I had a mojito every night and enjoyed them. But I decided to just stop alcohol for a while. And I lost my taste for it. Before, the desire for alcohol always grew as the day wore on and I could look forward to a glass of wine with dinner but without it, I slept deeper, longer and didn’t have to count points for it on my WW program. So now I just make sure I treat myself to a different drink at dinner than the rest of the day, be it tomato juice or a Bai water mixed with soda and lime. I am the child of two alcoholics so that has always been on my mind. I actually think the real addiction with alcohol as with so much else is to sugar…when my mother got sober, she drank Cokes all day long or coffee with three spoonfuls of sugar.
Thanks for this - addiction is about so much more than merely alcohol - it can be about anything - from wine, sugar, internet shopping or anything to soothe an unquiet mind
It would be helpful to have more information on (1) how large the risk is, based on peer reviewed studies, and (2) how reliable are the peer reviewed studies. As for the first, it's obviously not an issue of is there a risk, yes or no, but rather how great is the risk along the continuum of not drinking at all to getting drunk every night. As for the second, how good is the available data, among other issues (e.g., is the amount that people drink self-reported in most or all studies -- that would seem highly unreliable, and biased on the low side).
the NYT has a good piece discussing some of the data - there is TONS of it. Ultimately the risk of alcohol is highly variable and depends on the person - which is why a conversation with one's primary care doc is more appropriate that trying to discern what data to "use" if appropriate - as there is no single study that can appropriately capture one's individual risk.
When I was young, I abused alcohol. Partied and drank way too much in my late teens and twenties. I can barely bring myself to drink more than two drinks in an evening anymore, but I do enjoy maybe 2-3 small pours of wine a week, and sometimes a cocktail. A beer from time to time (especially at a baseball game or after a big hike). I can’t remember the last time I woke up with a hangover but it’s been literally decades. So I tend to feel like my occasional drink is likely less of an issue for my health than my everyday dessert habit or my love of French fries. I bristle at the idea of full deprivation of anything that I enjoy in moderation or even just occasionally. I suppose if my doctor told me in no uncertain terms I had to give it up, I would, but part of me thinks that this is one more thing in a world of possibly-less-than-healthy elements (some of which we have little control over, like the quality of our drinking water or the air we breathe) for which we all need to find our individual balance. As Joe Jackson sang, “Everything gives you cancer…”
Thanks for sharing this, Janet. Good for you for having this insight - and for being able to moderate your drinking which can be so very difficult for some people. And yes, you are right, everything carries risk! :)
.Before retiring, I only drank on weekends and basically not on "school nights". After retiring 3 years ago, every night was a weekend and I was drinking 2 glasses of wine or more with dinner! In the Fall of 2024 I joined Sunnyside which is an app that helps you modify your drinking habits. It is inexpensive and non judgemental and flexible. You create a weekly plan including dry days and they text you in the evening to confirm and the next morning to see how you did. I have found it helpful to be more accountable and without judgment. I would highly recommend it to anyone interested in modifying their alcohol intake. I am attempting a modified dry January. Wish me luck!
I stopped drinking two years ago, which is great because I no longer have to worry about the cost-benefit analysis of alcohol...but as a worrier this framing is still very helpful to me for the many many other things I worry about. Thanks 💙
Serious question (and maybe the data you link in NYtimes addresses): does that mean countries where drinking is a part of social fabric -- like France where it seems like people drink wine daily at lunch and dinner -- do they have higher rates of cancer?
And if not, is that it's difficult to untangle from lots of other factors (american's stress, healthcare system, etc etc.)
Great question! I, too, consider the French quite fond of alcohol ... and indeed the French historically have had high levels of alcohol consumption, particularly wine. However, the data I've seen shows that per capita alcohol consumption in France actually has *decreased* significantly over recent decades due to public health campaigns and cultural shifts.
France's overall cancer incidence rate is comparable to other developed countries. As you know, the incidence of cancer is influenced by numerous factors, including lifestyle factors, genetics, and access to (and quality of) healthcare. While alcohol consumption is a known risk factor for several types of cancer (e.g., breast, liver, mouth, throat, esophagus, and colon), it is not the sole determinant of cancer rates in any population.
I really liked your nuanced discussion of risk versus reward and the fact that it is an individual decision, which can be made in light of a person's preferences combined with data and when needed - some guidance! I already drink rarely, so nothing about my behavior will change in light of the Surgeon General's new warning, however the risk discussion was valuable to me as it can be generalized!! Lisa
As a retired Emergency Physician who makes wine (running a 123 year old family winery in Argentina) I agree with everything you say. It's important to counsel patients about risk and give them real data and accurate information (without being judgy). I often - like you- make the comparison with driving. Also, a comparison can be made between moderation in drinking and wearing sunscreen/hat when going outside. Even if UV Radiation is responsible for 4.6% of modifiable cancer risk, we don't tell people to stop going outside. In the case of alcohol, we need to explain to patients what moderation is (up to one unit per day for women, up to 2 for men and drinking less is better than drinking more). I do think it would be helpful to add to your column the recent information from NASEM - National Academies of Sciences, Engineering and Medicine Review of Evidence on Alcohol and Health (2025) where they found that "based on data from the eight eligible studies from 2019 to 2023, the committee concludes that compared with never consuming alcohol, moderate consumption is associated with lower all-cause mortality." They also found with moderate certainty - for moderate drinkers - a lower risk of cardiovascular mortality and an increased risk for breast cancer (not for other cancers). This report by leading researchers in U.S. used only never drinkers as controls. I also agree that for many people the best decision is to stop drinking. This depends on the enjoyment they derive from alcohol and whether they are able to drink in moderation and whether their general health is not a contraindication - all to be discussed with their primary care physician. For me, drinking wine as part of the Mediterranean Diet which my Italian and Spanish ancestors have followed for centuries (and continued after immigration to Argentina and then to U.S.) drinking wine with dinner, with friends and family and as something that brings joy and relaxation, is not something that I want to give up, especially in the context of the new NASEM review 2025.
As someone who is 6 1/2 years sober now, I have some thoughts here. I do think that when one is drinking regularly, not even excessively, it is impossible to understand the benefits that come from giving up alcohol entirely. There is a marvelous clarity of thought and intense peace and calm that comes when one has been sober for some time. Deep sleep each and every night is an amazing thing and probably contributes to the many mental health benefits. When I was drinking I was certainly willing to take on many risks to my health in order to justify what I was doing. Now the "benefits" of alcohol, if there are any at all, look so very small in the vast improvement in every aspect of my life that there is no question I would not risk taking a drink. As to the doctor's role, I wish when I had begged for help with severe insomnia problems, lowgrade depression, etc any of my doctors had said "you know, alcohol can cause all these problems - I recommend you take 100 days off of drinking and see what you feel like".
100% agree
It's pretty tragic that some doctors don't recognize or understand the harms of alcohol - and the complexity of peoples' relationship with it
It's such a fundamental part of American life- and such a ubiquitous factor affecting people's health - that it needs to be addressed early and often IMO
As always, love the way you frame risk and trade-offs. It’s so helpful.
My husband and I are “accidentally sober” — we would only drink when we’d go out with friends, and when that paused during the pandemic we lost all of our alcohol tolerance. I don’t miss alcohol now — the hangovers, the heart racing while trying to sleep, the questionable behavior.
What I *do* DEEPLY miss are the rituals around it: meeting up for happy hour, savoring a nice wine, kicking back with a beverage. I live in wine country, so wine tasting is a local pastime!
Non-alcoholic alternatives are becoming more common, but still tough to find and sometimes sugarbombs that leave a different hangover. All of this is to say, there is a way to get the social benefits of drinking without actually drinking — our culture just needs to catch up a bit! Maybe then giving up alcohol wouldn’t feel like giving something up quite so much?
Yes - I agree w you. The rituals are part of the appeal - and the social aspects, too. Personally I have fallen in love with Kombucha but many people hate it!! Thanks for reading this piece and for your comments!
Hi, Tamara. Non-alcohol shops are popping up all over now. I have The New Bar by me (they are also online). I like Leitz's Zero-Proof Pinot Noir and NOOH's rose (reg and sparkling). Neither are sweet/sugary. I mean, when I tried Ariel, I should've just gotten pomegranate juice. At my natural foods store, I found Lautus Sauvignon Blanc, which is also not sugary. None have given me a headache. And, if you want to make a mean blended mockarita, put in some ginger ale. It gives that heat/burn like booze would. I fooled a friend once. I suppose real ginger would do the same, but I'm lazy. LOL. Hope you find something you like! And ask your local wineries if they are going to get on this dealcoholized trend. They can be ahead of the curve when the big quit happens. xo
Very well written! As a doctor myself, I find the hardest emotion to navigate with patients is defensiveness, which is also built into alcohol misuse. People often have their own idea of what it means to be a “social drinker”. At one point I found that I was drinking more at 50 than at 25 (granted, I was in med school), because 2 glasses of wine with dinner is a lot of alcohol, for a woman, especially. So now I don’t drink on weekdays, and a huge benefit is that instead of having a drink after coming home from a hard day at work, I exercise, which does a lot more to reduce stress than wine!
The key is honest appraisal, and keeping track. If you say you don’t know how much you drink, it’s probably too much.
Honesty with ourselves and our patients is so crucial - I agree! So is creating a non- judgemental space in the doctor's office to discuss things like alcohol use. Like you, I try to make sure that no patient EVER feels judged for having habits that are less-than-ideal - we're human! - however patients can still be defensive, which I think is often a reflex reaction to shame about lack of control. I get it. As they say in AA "you are only as sick as your secrets" ... Doctors often feel the reverberations of patients' secrets when they are kept hidden in the dark
Lucy, can you enlighten us about the specific and additional risks and impacts on 50+ women? I think there is some gender disaggregation in the research results and it looks like women can 'take' it even less, sadly.
So yes, I'll be moderating my love of wine even more. But I believe in moderation in most things, including abstinence.
Hi Avivah! There is no organ system that "isn't" negatively impacted by alcohol - based on the totality of data on it. Anecdotally, the biggest risks for women 50+ is emotional/mental health (eg depression, anxiety, PTSD, insomnia, social isolation), gastrointestinal health (heartburn/GERD, IBS, colitis, liver disease, pancreatic disease), cardiovascular health (Afib, hypertension, obesity), metabolic health (diabetes, weight gain), and on breast, oral and colorectal cancers.
Is there a more specific question you had it mind?
In September of 2024 I decided to address my drinking habits by doing The Sinclair Method. I heard a podcast, did some research, read some articles and personal stories and decided it made the most sense for me. Both parents died in their 60s of alcoholism and I liked the drink waaayyyy too much. I have been 100% compliant with the method and my average drinks per week had dropped down to 9 a week from well over 20 a week. During the holidays I picked back up a bit (still staying compliant with the method) and what I have noticed in the way that I feel is significant. When I drink less my sleep is amazing and my body naturally wakes up rested after 7-8 hours, my constant muscle cramps (despite drinking tons of water and even taking electrolytes) were gone, my skin was radiant and my eyes were clear (as reported to me by my best friend who I had not seen in a few months) and I felt more general contentment. But it took me increasing my drinking again to really experience the difference. It was no surprise to me when the new report came out and I am thankful that I heard about the Method and that it is helping me make changes.
CONGRATS and nice work, Shannon!!! It's great that you feel better *and* that you are making a clear effort to document it. That's the spirit!!
I am having the absolute best time drinking while not drinking. Give me a sec...
Last year, with all of the reports coming out about booze trying to kill us, I realized I was gonna have to break up with it. But when? End of 2024 (it was summer when I started thinking about this)? Maybe too soon. End of 2025? Then, the first week of August, I got food poisoning, barfing for the first time in 20 years. I don't know what brand of food poisoning I had, but it killed my cravings. All of them. I mean, I eat. I have hunger. I just don't crave things like I used to (and I had major cravings). And that included cravings for booze. I no longer desire it. Still, I like the ceremony of it. The concocting of cocktails. The pop of a bubbly bottle's uncorking. Holding a wine glass. Now, I drink dealcoholized wines (granted, they are still 0.5% alcohol, same as kombucha, I believe). I make "grin and tonics" with faux gin, mockarita's with Lewis Hamilton's phony tequila (the Almave blanco has a heavy vanilla note which pairs best with orange). At my favorite Mexican restaurant, I'll have the hibiscus agua fresca. At my favorite Greek place, they make a lovely mocktail, also with hibiscus (I think hibiscus is going to have a big year). So, I sort of had the choice made for me. I don't call myself sober, because I'm not. There may come a day when a glass of champagne is called for. I don't see that happening (really happy with the NOOH sparling rose), but I leave the door open. I have too many sober friends who work at sobriety; this isn't that, and I mean that with deep respect. I was able to make a choice. And I'm truly glad I did.
If you're looking for recs, you can check out The New Bar online. I like NOOH's roses (can't make the accent on this computer, ugh), both still and sparking, and Leitz's Zero-Proof Pinot Noir. At my natural foods store, I get Lautus' Sauvignon Blanc. I haven't tried it, but I hear Tanqueray makes a zero-proof version of its gin. Also, since there's no alcohol, it's not going to sit around and "age", so keep that in mind and an eye on the expiration dates. xo
Thanks, Sandra!! Such helpful observations and suggestions - thanks for writing it down!
Hibiscus in mocktails is *chef’s kiss*. It feels exotic and fun still. I see a lot of restaurants getting very inventive with mocktails, and I’ve been ordering more of them. Plus, they’re about half the price!
LOL. Not in LA. They are still on par with “well” drinks. Someone wrote that “Mocktails need to remember what they are NOT” in regards to pricing. Still worth it! xo
😂😂
Nothing makes me happier than two readers bonding w each other 🥳
Sandra and I go way back (maybe a year? lol). But I’m not surprised that we both happen to be fans of yours, doc 😉
LOVE IT
The feeling is mutual 😎
In my younger days I drank quite a bit. Mostly social drinking, but occasional "benders". Intellectually I knew the risks but preferred to ignore them. When I turned seventy I realized that alcohol was detrimental to my health, and if I wanted to be around for awhile longer, going dry might make that more probable. I've been completely dry now for 7 years and wish I'd made that choice earlier. I still have other 'problems' both physical and mental - sobriety hasn't cured those, but there is a subtle subjective change of "consciousness." This change wasn't immediate. It took several years to develop but I think it's real and valuable.
I am also nearing 7 years and wish I had done it years earlier. It's also important to point out what you say to those who might be now considering sobriety - it takes time to see the best changes. Stick with it, make the commitment and the rewards will far exceed anything alcohol ever gave you.
Yes and yes - health is a process - two steps forward, one step back :)
Thanks for sharing this.. so many people feel that way ... that once they quit drinking they wonder why they didn't sooner. It does take some to "marinate" in a signif lifestyle change - taking note of that process helps, as you have done well to do!
I came home from a vacation in Mexico last March where I had a mojito every night and enjoyed them. But I decided to just stop alcohol for a while. And I lost my taste for it. Before, the desire for alcohol always grew as the day wore on and I could look forward to a glass of wine with dinner but without it, I slept deeper, longer and didn’t have to count points for it on my WW program. So now I just make sure I treat myself to a different drink at dinner than the rest of the day, be it tomato juice or a Bai water mixed with soda and lime. I am the child of two alcoholics so that has always been on my mind. I actually think the real addiction with alcohol as with so much else is to sugar…when my mother got sober, she drank Cokes all day long or coffee with three spoonfuls of sugar.
Thanks for this - addiction is about so much more than merely alcohol - it can be about anything - from wine, sugar, internet shopping or anything to soothe an unquiet mind
Good for you for being so self aware!
It would be helpful to have more information on (1) how large the risk is, based on peer reviewed studies, and (2) how reliable are the peer reviewed studies. As for the first, it's obviously not an issue of is there a risk, yes or no, but rather how great is the risk along the continuum of not drinking at all to getting drunk every night. As for the second, how good is the available data, among other issues (e.g., is the amount that people drink self-reported in most or all studies -- that would seem highly unreliable, and biased on the low side).
the NYT has a good piece discussing some of the data - there is TONS of it. Ultimately the risk of alcohol is highly variable and depends on the person - which is why a conversation with one's primary care doc is more appropriate that trying to discern what data to "use" if appropriate - as there is no single study that can appropriately capture one's individual risk.
https://www.nytimes.com/2025/01/03/health/alcohol-surgeon-general-warning.html
When I was young, I abused alcohol. Partied and drank way too much in my late teens and twenties. I can barely bring myself to drink more than two drinks in an evening anymore, but I do enjoy maybe 2-3 small pours of wine a week, and sometimes a cocktail. A beer from time to time (especially at a baseball game or after a big hike). I can’t remember the last time I woke up with a hangover but it’s been literally decades. So I tend to feel like my occasional drink is likely less of an issue for my health than my everyday dessert habit or my love of French fries. I bristle at the idea of full deprivation of anything that I enjoy in moderation or even just occasionally. I suppose if my doctor told me in no uncertain terms I had to give it up, I would, but part of me thinks that this is one more thing in a world of possibly-less-than-healthy elements (some of which we have little control over, like the quality of our drinking water or the air we breathe) for which we all need to find our individual balance. As Joe Jackson sang, “Everything gives you cancer…”
Thanks for sharing this, Janet. Good for you for having this insight - and for being able to moderate your drinking which can be so very difficult for some people. And yes, you are right, everything carries risk! :)
I believe the doctor should provide good medical advice but everyone is still responsible for their choices with or without good advice.
yes indeed!
.Before retiring, I only drank on weekends and basically not on "school nights". After retiring 3 years ago, every night was a weekend and I was drinking 2 glasses of wine or more with dinner! In the Fall of 2024 I joined Sunnyside which is an app that helps you modify your drinking habits. It is inexpensive and non judgemental and flexible. You create a weekly plan including dry days and they text you in the evening to confirm and the next morning to see how you did. I have found it helpful to be more accountable and without judgment. I would highly recommend it to anyone interested in modifying their alcohol intake. I am attempting a modified dry January. Wish me luck!
Good luck indeed! It is true that accountability to someone *other* than ourselves is often the best way to maintain a new habit!
I stopped drinking two years ago, which is great because I no longer have to worry about the cost-benefit analysis of alcohol...but as a worrier this framing is still very helpful to me for the many many other things I worry about. Thanks 💙
:)
Serious question (and maybe the data you link in NYtimes addresses): does that mean countries where drinking is a part of social fabric -- like France where it seems like people drink wine daily at lunch and dinner -- do they have higher rates of cancer?
And if not, is that it's difficult to untangle from lots of other factors (american's stress, healthcare system, etc etc.)
Great question! I, too, consider the French quite fond of alcohol ... and indeed the French historically have had high levels of alcohol consumption, particularly wine. However, the data I've seen shows that per capita alcohol consumption in France actually has *decreased* significantly over recent decades due to public health campaigns and cultural shifts.
France's overall cancer incidence rate is comparable to other developed countries. As you know, the incidence of cancer is influenced by numerous factors, including lifestyle factors, genetics, and access to (and quality of) healthcare. While alcohol consumption is a known risk factor for several types of cancer (e.g., breast, liver, mouth, throat, esophagus, and colon), it is not the sole determinant of cancer rates in any population.
Does that make sense?
I really liked your nuanced discussion of risk versus reward and the fact that it is an individual decision, which can be made in light of a person's preferences combined with data and when needed - some guidance! I already drink rarely, so nothing about my behavior will change in light of the Surgeon General's new warning, however the risk discussion was valuable to me as it can be generalized!! Lisa
Thanks for reading, Lisa!
As a retired Emergency Physician who makes wine (running a 123 year old family winery in Argentina) I agree with everything you say. It's important to counsel patients about risk and give them real data and accurate information (without being judgy). I often - like you- make the comparison with driving. Also, a comparison can be made between moderation in drinking and wearing sunscreen/hat when going outside. Even if UV Radiation is responsible for 4.6% of modifiable cancer risk, we don't tell people to stop going outside. In the case of alcohol, we need to explain to patients what moderation is (up to one unit per day for women, up to 2 for men and drinking less is better than drinking more). I do think it would be helpful to add to your column the recent information from NASEM - National Academies of Sciences, Engineering and Medicine Review of Evidence on Alcohol and Health (2025) where they found that "based on data from the eight eligible studies from 2019 to 2023, the committee concludes that compared with never consuming alcohol, moderate consumption is associated with lower all-cause mortality." They also found with moderate certainty - for moderate drinkers - a lower risk of cardiovascular mortality and an increased risk for breast cancer (not for other cancers). This report by leading researchers in U.S. used only never drinkers as controls. I also agree that for many people the best decision is to stop drinking. This depends on the enjoyment they derive from alcohol and whether they are able to drink in moderation and whether their general health is not a contraindication - all to be discussed with their primary care physician. For me, drinking wine as part of the Mediterranean Diet which my Italian and Spanish ancestors have followed for centuries (and continued after immigration to Argentina and then to U.S.) drinking wine with dinner, with friends and family and as something that brings joy and relaxation, is not something that I want to give up, especially in the context of the new NASEM review 2025.
Excellent points! I appreciate the time you took to reply here -- super helpful and I like the sunscreen analogy.