“Knowledge is in every country the surest basis of public happiness.” – George Washington, First Annual Message to Congress, 1790
Last January a report on alcohol and health was posted by the US Department of Health and Human Services for public comment, Draft Report: Scientific Findings of the Alcohol Intake & Health Study for Public Comment. The study found that even low levels of alcohol consumption are associated with increased risk of death from health conditions casually associated with alcohol use. It also found that early life drinking influences lifetime risk of alcohol-related death and that risks increase sharply with more frequent or heavier consumption during youth.
A related report examining the findings identified that as alcohol use increases, mortality risks increase progressively, which is not particularly surprising, but what is revealing is that the threshold of risk is associated with relatively low levels of consumption. “For men, the lifetime risk of dying from alcohol exceeds 1:1000 (i.e., 1 death per 1000 people) above 7 drinks per week and exceeds 1:100 above 8.5 drinks per week. For women, the risk of dying from alcohol exceeds 1:1000 above 6.5 drinks per week and exceeds 1:100 above 8.5 drinks per week.”
How we educate the public and use date to inform policy is particularly important in respect to alcohol associated mortality in the United States over the last decade. Mortality is increasing substantially, with unprecedented surges in the early years of the COVID Pandemic. National alcohol-related death rates have risen substantially over the past decade. From 2012 to 2022, the age-adjusted alcohol death rate increased 70%, rising from about 7.97 to about 13.53 deaths per 100,000 people.
While alcohol consumption patterns are changing high rates of illness and mortality persist. Post-pandemic alcohol associated mortality declines have been uneven across age groups. In several reports, younger groups (e.g., 25–34) saw their peak earlier, with some declines thereafter, whereas mortality among other groups (including women) remained comparatively elevated through 2024. Recent survey data indicate alcohol consumption (self-reported drinking) is declining, especially among younger adults while mortality remains high, likely reflecting harmful drinking patterns, long-term disease progression, and broader alcohol-related causes (like chronic liver disease or accidents). Here is where the interests of the public, reduced mortality, decreased healthcare expenditures and improved health are in conflict with the alcohol industry that like any industry wants to sell more of its product, not less.
This is why the alcohol industry, for nearly identical reasons that tobacco industries are intent on influence over related research, public facing reports and government policy in respect to alcohol.
In 2018, Alcohol industry involvement in policymaking: a systematic review. It examined peer‐reviewed journal reports from 1980 and 2016 and explored the alcohol industry involvement in policymaking. What it found is that the alcohol industry in two major ways: “(1) framing policy debates in a cogent and internally consistent manner, which excludes from policy agendas issues that are contrary to commercial interests. (2) adopting short‐ and long‐term approaches to managing threats to commercial interests within the policy arena by building relationships with key actors using a variety of different organizational forms (McCambridge, Mialon, Hawkins 2018).”
The study articulates how the alcohol industry has framed harm from alcohol as limited to those who are very heavy use as a strategy to maximize sales. As described in the study above, the industry works to ensure that that minimizes issues contrary to its commercial interests. The problem from the alcohol industry perspective with the draft report released in January of 2025 is that even moderate levels of alcohol use is associated with risks of cancer, liver disease and deteriorated cardiovascular health. The report is bad for business and so far the government has been more responsive to the desires of industry than to public health.
Mike Marshall, the Chief Executive Officer (CEO) of the US Alcohol Policy Alliance (USAPA), recently stated in the NYT article, New Dietary Guidelines Abandon Longstanding Advice on Alcohol (Rubin 2026), “The thing the industry fears most are consumers educated about the link between cancer and alcohol. One drink a day can impact your health and do things like increase cancer risks and the industry does not want Americans to know this.
As found in that 2018 study of industry influence over policy, the knowledge that even the casual use of alcohol has health impacts, including increasing the likelihood of cancer could devastate sales. Money is at stake, and far too often in our society, money trumps lives. The industry works to create the perception that alcohol use in moderation is healthy, and only heavy users are at risk for health consequences to make money.
A January 2026 article in USA Today, The chaos and confusion of RFK Jr.’s new alcohol policy note how “federal health officials are no longer advising how many alcoholic drinks are safe for Americans, instead urging people to “consume less alcohol” and abstain altogether if they have certain health conditions. The new advice from Robert F. Kennedy Jr.’s Department of Health and Human Services is an about-face from a longstanding government guideline that said drinking in moderation meant two drinks a day for men and one drink a day for women.” As noted by Alcohol and Drug Abuse Weekly, (Knopf 2026) this is the first time since 1980, there are no recommended limits.
“Consume less” is quite subjective and abandons a stance in public health in which we arm people with good data to inform their choices. I have known several people close to me who cut down their alcohol use and still died far too young from alcohol related illness. Drinking one fifth of vodka a day is deadly, even if it is reduced from two fifths a day, but in the alcohol addled mind, it is certainly cutting down.
As I wrote in Occam’s Razor and the Industries of Addiction in December 2024, there is a phenomenon called the Pareto Principle or 80/20 rule, 20% of the customers are responsible for 80% of the consumption. Heavy users are alcohol industries bread and butter . The industry cannot tolerate and educated American public who would then realize how toxic alcohol is to every organ of the body even in moderate amounts. Can there be any doubt that removing the guidelines was done to benefit the industry at the expense of the people?
Alcohol is part of American culture. For context around the time of the American Revolution, colonialists drank about 3.5 gallons of pure alcohol per person per year on average. By the 1830s Alcohol use peaked during the at about 7.1 gallons per year per person. Historic accounts abound of people being intoxicated beyond the capacity to function from sunrise to sunset. While our current U.S. per-capita consumption of ethanol of around 2.5 gallons per person per year is lower than our historical high, we live in a very different society than that agrarian one we were born out of. Never before in history have we so well understood that even moderated alcohol use is associated with cancer and other life threatening diseases. We should trust the American people with this knowledge.
In the broadest sense, the provision of accurate data plays a foundational role in a free society. Liberty depends not just on the right to choose, but on the capacity to choose wisely. When citizens have access to truthful, timely, and comprehensible information, they can evaluate policies, hold leaders accountable, consent meaningfully to laws, and pursue their own interests without manipulation. People who are informed about the health risks may well choose to drink alcohol, but when data is distorted, hidden, or selectively presented, our society suffers.
Federal policy in respect to informing the public on the associated risks of alcohol consumption should rest on several key points, principally that accurate data:
- Enables informed choices: Americans deserve the best available data so that they can decide how much to drink or to drink at all. Consumer freedom is only free if it is properly informed.
- Prevents industry manipulation: Misinformation or selective information sets up dynamics in which Americans may make decisions about how much to drink influenced by an industry that profits off what they do not know. In this way what we do not know does in fact kill us.
- Supports industry accountability: The broad dissemination of accurate data in respect to the health impacts of alcohol use would foster a culture of accountability. This would be a check and balance against an industry that by definition is interested in profiting off of harm. The industry should not call the shots but rather consumers do so based on the best information we can give them. Our government should side with people and not industry.
- Supports the Health of the American People: The very strength of our nation rests on a healthy populace. Alcohol saps the vitality of our nation. It is costly in lives and resources. A healthy America is in fact a strong America, and taking and educated look at our alcohol consumption is a step towards improving it.
At the end of the day everyone reading this piece would want to make decisions about and choices that they make based on the best data one can get. In this respect we should provide what we would want for ourselves to every family across America and that is the best information we have. We must base our evidence base on the evidence in respect to the use of Alcohol.
We should publish guidelines based on the best available evidence and support the health and welfare of the American people.
Sources
Bustard, B. (2014). Spirited REPUBLIC. https://www.archives.gov/files/publications/prologue/2014/winter/spirited.pdf
Draft Report: Scientific Findings of the Alcohol Intake and Health Study for Public Comment – Public Health Institute. (2025, January 15). Public Health Institute. https://www.phi.org/thought-leadership/draft-report-scientific-findings-of-the-alcohol-intake-and-health-study-for-public-comment
Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). (2025). Draft Report: Scientific Findings of the Alcohol Intake & Health Study for Public Comment. U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/sites/default/files/2025-draft-public-comment-alcohol-intake-health-study.pdf.
kffheathers. (2024, May 23). A Look at the Latest Alcohol Death Data and Change Over the Last Decade | KFF. KFF. https://www.kff.org/mental-health/a-look-at-the-latest-alcohol-death-data-and-change-over-the-last-decade/
Knopf, A. (2026). Alcohol limits removed in dietary guidelines. Alcoholism & Drug Abuse Weekly, 38(3), 8–8. https://doi.org/10.1002/adaw.34783
Gershon, L. (2016, August 12). A Brief History of U.S. Drinking | JSTOR Daily. JSTOR Daily. https://daily.jstor.org/a-brief-history-of-drinking-alcohol/
Mansfield, E. (2025). The chaos and confusion of RFK Jr.’s new alcohol policy. USA TODAY. https://www.usatoday.com/story/life/health-wellness/2026/01/09/rfk-jr-dietary-guidelines-alcohol/88087217007/
McCambridge J, Mialon M, Hawkins B. Alcohol industry involvement in policymaking: a systematic review. Addiction. 2018 Mar 15;113(9):1571–84. doi: 10.1111/add.14216. Epub ahead of print. PMID: 29542202; PMCID: PMC6100095. https://pmc.ncbi.nlm.nih.gov/articles/PMC6100095/
Rabin, R. C. (2026, January 7). New Dietary Guidelines Abandon Longstanding Advice on Alcohol. The New York Times. https://www.nytimes.com/2026/01/07/health/dietary-guidelines-alcohol.html
Rabin, R. C. (2025, September 5). Federal Report on Drinking Is Withdrawn. The New York Times. https://www.nytimes.com/2025/09/05/health/alcohol-drinking-hhs-report.html
Saad, L. (2025, August 13). U.S. Drinking Rate at New Low as Alcohol Concerns Surge. Gallup.com; Gallup. https://news.gallup.com/poll/693362/drinking-rate-new-low-alcohol-concerns-surge.aspx
Stauffer, W. (2024, December 8). Occam’s Razor and the Industries of Addiction. Recovery Review. https://recoveryreview.blog/2024/12/08/occams-razor-and-the-industries-of-addiction/
Surveillance Report #121 | National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2024, April). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/publications/surveillance-reports/surveillance121
Wong T, Böttcher L, Chou T, D’Orsogna MR. Alcohol-induced deaths in the United States across age, race, gender, geography, and the COVID-19 pandemic. PLOS Glob Public Health. 2025 Sep 17;5(9):e0004623. doi: 10.1371/journal.pgph.0004623. PMID: 40961045; PMCID: PMC12443242. https://pmc.ncbi.nlm.nih.gov/articles/PMC12443242/
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