Few substances are as deeply embedded in everyday life as alcohol. It is a common item at Christmas celebrations, work-related social gatherings, sporting events, airports, and lunch or dinner tables. A glass raised in a toast, the ubiquitous open bar at weddings, or shared drinks during the Fourth of July celebration demonstrate how deeply alcohol has become embedded in social customs and cultural traditions.
However, alcohol contributes to millions of deaths worldwide each year and is linked to cancer, liver disease, unintentional accidents, violence and, most importantly, dependency and addiction. Despite this, the disconnect between the cultural role of alcohol and its serious health burden is striking.
Although alcohol consumption patterns vary substantially between countries, an estimated 2.3 billion people worldwide consume alcohol. It is deeply integrated into social life around the world, despite its well-documented health risks.
As a doctor working in addiction medicine, I regularly see patients whose alcohol use affects almost every organ system. Often, it is not until these patients end up admitted to the hospital that they learn of the impact of alcohol on various parts of their body besides the liver.
There is no “safe” amount
The latest evidence challenges assumptions about what has long been considered “safe drinking.” Even moderate alcohol consumption carries risks and is not as harmless as people, including experts, once thought.
Many people associate alcohol risk primarily with addiction or legal complications such as drunk driving. However, its effects extend far beyond that, encompassing almost every aspect of a person's well-being.
While alcohol can temporarily improve mood and alleviate social anxiety, prolonged alcohol use can lead to worsening mood, cognition, and sleep, which can further aggravate alcohol use.
A 2021 literature review found that consuming approximately two standard beverages approximately doubles the odds of injury from both motor vehicles and non-motor vehicles. The review also found that excessive alcohol consumption (binge drinking) can increase the risk of injury by 20 to 50 times, depending on the amount of alcohol consumed and the type of injury. While the effects of alcohol on the liver are well known, it can also lead to gastrointestinal complications and heart disease.
The World Health Organization estimates that 2.6 million deaths each year are attributable to alcohol, accounting for almost 1 in 20 deaths worldwide.
Mixed messages about alcohol and cancer
While many people recognize the risks of alcohol addiction, they are generally much less aware of the links between alcohol consumption and cancer risk.
The World Health Organization classifies alcohol as a group 1 carcinogen, the same category as tobacco and asbestos. In other words, these are agents classified as having sufficient evidence that they cause cancer in humans.
In 2025, an advisory from the U.S. Surgeon General emphasized that alcohol increases the risk of at least seven cancers and called for updated warning labels. It concluded that alcohol increases an individual's risk of developing seven types of cancer, including breast, colorectal, liver, oral, esophageal and laryngeal.
However, less than half of Americans recognize alcohol as a risk factor for cancer, particularly cancers such as breast cancer, which are not commonly associated with alcohol consumption.
The relationship between alcohol and cancer is nuanced. Throughout the 1990s and early 2000s, observational studies suggested that moderate alcohol consumption may offer cardiovascular benefits.
However, over the past decade, higher-quality studies have questioned those findings, suggesting that much of the apparent benefit may have reflected differences in the health and lifestyles of moderate drinkers rather than a protective effect of alcohol itself.
According to the Dietary Guidelines for Americans, current evidence increasingly suggests that even low levels of alcohol can increase cancer risk.
The guidelines recognize that adults should “consume less alcohol for better overall health.” However, the most recent version of the 2025-2030 guidelines, updated in January 2026, removed the previous recommendation to limit intake to no more than one drink per day for women and two for men. It also omitted explicit discussion of alcohol's links to cancer.
These changes have drawn criticism from public health experts, who argue that the revised language downplays growing evidence of alcohol-related harms and provides less specific guidance to consumers.
In this context, Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, characterized alcohol as a “social lubricant” that brings people together, rather than emphasizing its well-established health risks.
Emma Fenske is an addiction medicine fellow and internal medicine physician at Oregon Health and Science University. This article was first published by The Conversation and is republished under a Creative Commons license. Read the original article.
This may be true physiologically, at least temporarily, but it obscures the fact that reliance on alcohol as a social lubricant can lead to chemical and psychological dependence. In my opinion, statements to that effect are short-sighted and prioritize short-term social effects over more insidious, long-term issues, including addiction.
A seismic cultural shift
While many dangerous, mind-altering substances are hidden from public perception, alcohol often sits at the center of them, a trend that shows no signs of changing imminently.
Additionally, large companies often benefit from advertisements that appeal to young people.
A look back at the history of smoking provides some useful insights. In 1965, 42.4% of the American population smoked. By 2022, that figure had fallen to 11.6%.
This dramatic decline occurred not because of a single intervention, but through decades of accumulating scientific evidence, public education campaigns, warning labels, advertising restrictions, smoke-free policies, higher tobacco taxes, and changes in social norms. Together, these efforts transformed smoking from a widely accepted social behavior to one widely recognized as a significant health risk and, consequently, less socially accepted.
Although alcohol consumption has declined modestly in recent years, it remains deeply embedded in social life in a way that smoking no longer is.
People often assume that if a substance is legal, common, and widely socially accepted, as well as encouraged, then it must also be safe. But the history of public health suggests that those assumptions can and should change.
