US Surgeon General calls for cancer warnings on alcohol

By Anna Edney and Deena Shanker

Alcoholic drinks like beer and wine should carry warnings of their links to cancer, the US’s top doctor said, citing a lack of public awareness of the popular products’ health risks.

Evidence of links between drinking and cancer has been rising for decades, yet less than half of Americans recognise that it raises their chances of developing several cancers, Surgeon General Vivek Murthy said Friday in an advisory.

Alcohol causes about 100,000 cases of cancer and 20,000 related deaths each year in the US, Murthy said, far more than the 13,500 alcohol-associated annual traffic fatalities. Adding a cancer warning would highlight severe health concerns for products that more than 70 per cent of US adults consume at least once a week, with some $260 billion in 2022 nationwide sales.

Shares of drinks makers declined after the announcement. Anheuser-Busch InBev NV, the maker of Budweiser beer, closed down 2.8 per cent in Brussels. Constellation Brands Inc. fell 0.3 per cent at the close of New York trading and Molson Coors Beverage Co. dipped 3.4 per cent.

Studies have linked cancer to alcohol since the 1980s, and it ranks behind only tobacco and obesity among preventable causes of the disease. Direct connections have been shown between alcohol and at least seven types of cancer, including those of the breast, throat, mouth, esophagus, voice box, colon and liver, according to the surgeon general’s bulletin.

Guidelines for use should be reassessed to account for those risks, and doctors should highlight alcohol’s danger when advising patients about drinking, the announcement said.

The American Medical Association has said for years that “alcohol consumption at any level, not just heavy alcohol use or addictive alcohol use, is a modifiable risk factor for cancer,” AMA President Bruce Scott said in a statement. The advisory and label update “will bolster awareness, improve health, and save lives,” the association said.

The issue is a global one, with about 741,300 cases of cancer attributable to alcohol consumption worldwide in 2020. Yet in a 2019 survey, just 45 per cent of Americans were aware of the risk posed by alcohol, compared with about 90 per cent awareness for radiation exposure and tobacco each, according to the Surgeon General’s advisory.

Other Warnings

Of the 47 World Health Organization member countries with warning labels on alcohol, only South Korea’s cites cancer. Ireland will require a cancer caution starting in 2026.

In 2020, consumer advocacy and medical groups petitioned the US Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau, which regulates alcohol labeling, to change the warning label on alcohol. Currently, bottles and cans state that alcohol “may cause health problems” with a warning against consumption by pregnant women.

The Treasury unit would have to work with the surgeon general to report to Congress on the need for any updates, according to the Center for Science in the Public Interest, one of the groups that filed the petition. The Treasury Department didn’t immediately respond to a request for comment.

Kenneth Shea, a Bloomberg Intelligence analyst, said the surgeon general’s evidence for the label update wasn’t particularly compelling.

“It’s probably less of a threat near term than the market would suggest right now,” Shea said.

Debate Persists

The debate around alcohol consumption and health is far from settled. Government advisers at the National Academies of Sciences, Engineering, and Medicine released a report last month on numerous alcohol studies that found both positive and negative health effects.

People who never drink alcohol are more likely to die from any cause — not just cancer or heart disease — than those who drink moderately, according to the advisers’ report. Moderate drinking may also lower the risk of death from heart disease, it said.

The report did find that women who drink moderately are at higher risk for breast cancer than nondrinkers, and increasing alcohol consumption was linked to higher colorectal cancer risk. The authors couldn’t draw conclusions on the risks of other cancers related to moderate drinking and said more study on alcohol and health is needed overall.

Dietary Guidelines

The Department of Agriculture and the Department of Health and Human Services have said they will take the National Academies report into consideration as they draft new dietary guidelines for 2025-2030.

What Bloomberg Intelligence Says:

Spirit and beer companies with high US exposure, such as Diageo (35 per cent-plus of revenue), Remy Cointreau (25 per cent) and AB InBev (22 per cent) may see sales decline if cancer-warning labels become mandatory in the US, in line with the Surgeon General’s recommendations. Alcohol premium-sales strategies might help them offset the volume decline, though that would likely take time — two years in tobacco’s case.

— Duncan Fox, BI consumer-goods analyst. Read the research here.

While drinking alcohol has long been a social norm for American adults, sobriety has also gained popularity in recent years. In 2020, Anheuser-Busch InBev released Budweiser Zero; last year, Molson Coors released its non-alcoholic brand Naked Life in the US. Craft breweries like Sierra Nevada and Boston Beer Co. also offer alcohol-free products. Younger Americans are even more likely than older ones to try to cut back on drinking, a January 2024 survey from NCSolutions found.

Representatives for AB InBev, French distiller Pernod Ricard, and LVMH Moët Hennessy Louis Vuitton SE’s wines and spirits unit declined to comment. Diageo Plc and Heineken didn’t respond to requests for comment. LVMH owns labels such as Moët & Chandon and Dom Perignon Champagne as well as Hennessy Cognac. Diageo is the maker of Smirnoff vodka and Don Julio tequila. Pernod Ricard brands include Absolut vodka and Jameson whiskey.

The Distilled Spirits Council of the United States said it’s the government’s role to determine any label changes to alcohol based on scientific evidence and that it urges adults to follow the recommendations of their health-care providers and public health officials for use. The Beer Institute said it encourages adults of legal age to make choices that best fit their circumstances, and if they choose to drink, to do so in moderation. WineAmerica, the National Association of American Wineries, declined to comment.