The myth of ‘moderate’ drinking
Human beings are naturally wired to prioritize and dwell on the negative. Called negativity bias, we recall insults better than praise and respond more strongly to threats than rewards. Experts attribute this positive-negative asymmetry to evolution: Early humans who were more attuned to danger around them were also more likely to survive and pass on their genes.
One seemingly curious exception to this, however, is our relationship with alcohol. Since 1968, the World Health Organization (WHO) has stated that drinking alcohol is linked to certain types of cancer. It is also linked to fatty liver, alcoholic hepatitis, cell necrosis, cirrhosis, as well as increased frequencies of chromosomal aberrations. Yet, when medical researcher Serge Renaud argued in the early 1990s that French people’s regular, moderate consumption of red wine led to better cardiovascular health, the world quickly embraced this positive narrative and seemed to have forgotten the rest. Despite subsequent studies debunking these findings as having been based on flawed data, the romanticized notion that a glass of wine a day is healthy has overshadowed alcohol’s well-documented harms.
On Jan. 3, United States Surgeon General Dr. Vivek Murthy issued a sobering warning detailing the clear link between alcohol consumption and seven types of cancer, including breast, liver, colon, and rectal. The warning cited findings from extensive research conducted in the past two decades, including a global study involving 28 million people across 195 countries and territories. While it is common knowledge that excessive drinking is harmful to one’s health, the report stressed that even people who drink moderately—those who adhere to the US Dietary Guidelines of one drink per day for women and two for men—are at risk. Alarmingly, 17 percent of alcohol-related cancer deaths occur within those who follow the recommended limits.
The WHO has always stressed that there is no safe limit for alcohol consumption. Its 2018 Global Status Report on Alcohol and Health further emphasized that low- and middle-income countries bear the heaviest burden of alcohol-related deaths, with rates nearly double compared to those of high-income nations. Among Filipino men, 21 out of every 100,000 die from alcohol-related liver cirrhosis, while 136 out of every 100,000 succumb to alcohol-linked cancers.
Part of the Surgeon General’s report was a strong recommendation to update health warnings on alcohol labels to visibly and prominently indicate cancer risks. While 47 countries require warnings on alcoholic beverages, most of these labels usually highlight the dangers of drinking while pregnant or driving. Currently, only South Korea prescribes the mention of cancer in warning labels. By 2026, Ireland will start requiring labels that there is a direct link between alcohol and cancer.
These measures are critical but insufficient on their own. Behavior change may start with increased awareness, but it also requires a deeper understanding of the environmental factors that could facilitate or inhibit the desired behavior and the underlying motivations driving it. To understand how to encourage the public to reassess their alcohol use effectively, it is necessary to also consider the context as to when and why people consume alcohol.
Human beings have long associated alcohol with celebrations. Drinking together has been a way for people to celebrate achievements and milestones and is essential to many religious rites and festivals. Raising a toast and clinking glasses together symbolizes camaraderie and collective joy.
Alcohol is also seen as a social lubricant. Since it can lower inhibitions and reduce feelings of anxiety, it has the power to make social interactions feel more comfortable and, therefore, enjoyable. Drinking together has long been used as a tool for connection—from breaking the ice among new acquaintances to fostering goodwill among business partners. A friend who works in marine conservation once told me that one of the most effective stakeholder engagement strategies she learned on the job is to drink gin with barangay watchmen to secure their trust and cooperation.
Beyond warning labels and expanded education efforts on the link between alcohol and cancer, effective population-level alcohol reduction campaigns must focus on promoting sustainable behaviors over demanding complete abstinence. The enduring appeal of the “one glass of red wine per meal is healthy” myth is that it fits nicely into people’s desires and lifestyles. While no amount of alcohol is genuinely risk-free, public health agencies must be ready and willing to offer realistic alternatives. For instance, encouraging people to limit alcohol consumption to no more than three units per week while emphasizing that drinking less is always better could be a more actionable and attainable approach.
By understanding and meeting people where they are, public health campaigns won’t alienate the audience and are more likely to be successful in creating meaningful behavioral change. The goal should be to inspire people to reflect, rethink, and recalibrate how they consume alcohol. Framing the message this way empowers individuals to make conscious and informed choices about their consumption that hopefully align with their long-term health and well-being.
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eleanor@shetalksasia.com
