Media Briefing: Alcohol Consumption’s Health Effects

Note: The following transcript is automatically generated and may contain errors. Please cross-reference the audio before quoting.

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Ellen Wilson: Welcome, and thank you for joining us today. My name is Ellen Wilson, and I'll be the moderator for this media briefing, which is hosted by the Johns Hopkins Bloomberg School of Public Health. Today's speakers will discuss alcohol consumption and its health effects.

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Ellen Wilson: I'd like to briefly introduce our speakers. Johannes Thrul is an associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. He has a joint appointment at the Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins School of Medicine.

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Ellen Wilson: Elizabeth Platz is a professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health. She also has a joint appointment at the Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins School of Medicine.

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Ellen Wilson: We will have time for questions following our speakers' remarks. We will take some that have been submitted in advance of the briefing and some from the Zoom chat. If you have a question, please enter it in the Zoom chat addressed to panelists and hosts. Please enter your name, media outlet, and question. We hope to cover as many as possible.

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Ellen Wilson: Please note that participants are welcome to use images, video, or quotes directly from the briefing, and that the content is for immediate release. Participants will be muted during this briefing, and it will be recorded.

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Ellen Wilson: Let's go ahead and start. Professor Thrul, a lot of people believe that moderate or low-level drinking is safe or even beneficial. What does the evidence actually show?

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Johannes Thrul: The biggest misconception about alcohol is that low levels are harmless, but recent evidence shows that this is not the case. Even just one drink a day adds health risk, and reductions in drinking can lead to meaningful improvements in sleep, mental health, and daily functioning.

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Johannes Thrul: Alcohol might feel relaxing in the moment, but physiologically, it disrupts restorative sleep, increases anxiety the next day, and can contribute to long-term mental health problems.

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Johannes Thrul: We're learning that even one or two drinks can impair sleep architecture and worsen stress reactivity.

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Johannes Thrul: There are also meaningful short-term gains when people cut back and take a break. In dry January studies, participants often see lower blood pressure, better energy, stronger concentration, and reduced anxiety within a few weeks.

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Johannes Thrul: Those improvements are not subtle, and people often report feeling better than they expected. So, abstinence or reduced drinking does not only prevent future disease, but also improves how you feel tomorrow morning and next month.

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Johannes Thrul: At the same time, we're seeing a major cultural shift in the US.

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Johannes Thrul: Younger adults are drinking less than previous generations, and social pressures to drink are weakening.

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Johannes Thrul: The booming market for non-alcoholic beer, wine, and spirit reflects a broader change. More people want the social experience without the physiological downsides of alcohol.

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Johannes Thrul: But while younger generations are drinking less, public awareness still lags behind the evolving science on the health effects of alcohol.

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Johannes Thrul: Moderate drinking is still widely interpreted as low risk, even though newer international guidelines, like Canada's, emphasize that lower consumption is consistently better for health.

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Johannes Thrul: We should be honest that alcohol is a carcinogen, which has been well established, but we can also emphasize immediate, tangible benefits of cutting back that matter to people's everyday lives.

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Johannes Thrul: From a public health standpoint, the message is straightforward. We need clear communication to make sure consumers know the risks and can make informed decisions.

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Johannes Thrul: We should encourage and support drinking reduction, and we need social environments that make not drinking as easy and as accepted as drinking.

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Ellen Wilson: Thank you, Professor Thrul. Now a question for Professor Platz. What is the link between alcohol consumption and cancer?

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Elizabeth Platz: Yes, experts have known for decades that alcohol is a risk factor for certain cancers, including liver cancer, also,

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Elizabeth Platz: Including liver cancer, often following alcohol-induced cirrhosis. Also, cancers of the mouth, throat, and esophagus, especially in people who smoke.

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Elizabeth Platz: And you may not be aware, also, colon and rectal cancer and breast cancer in women. And while public health experts are aware of this alcohol-associated cancer risk, much of the public is not aware.

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Elizabeth Platz: A 2025 published report using 2024 US survey data indicated that only 37% of adults were aware that alcohol increases the risk of cancer. A full 53% said they didn't know whether or not alcohol increases cancer risk.

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Elizabeth Platz: When smoking was highly prevalent in the U.S, smoking accounted for the majority of preventable causes of cancer, death.

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Elizabeth Platz: But now that smoking prevalence is down from about 33% to 10% in women, and from more than 50% to 13% in men, it is time to highlight for the public that alcohol drinking is a preventable cause of cancer and death from cancer. In fact, it is the third leading preventable cause of cancer.

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Elizabeth Platz: Earlier in 2025, the U.S. Surgeon General did just that by issuing an advisory to inform the public that alcohol drinking is a preventable cause of cancer. That advisory indicated that alcohol drinking causes about 100,000 cancer cases and 20,000 deaths from cancer each year in the U.S. The advisory also indicated that of the 100,000 cases

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Elizabeth Platz: of cancer caused by alcohol. More than 44,000 are breast cancer cases. Death from breast cancer accounts for most of the alcohol-related cancer deaths in women, and liver and colorectal cancers account for most of the alcohol-related cancer deaths in men.

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Elizabeth Platz: The public should know that the risk of cancer increases with the amount of alcohol consumed.

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Elizabeth Platz: And the public should be aware that for some cancers, like breast cancer, risk is increased at even one drink per day.

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Elizabeth Platz: Alcohol causes cancer in several ways, I'll mention two. The first is that a metabolite of ethanol, which is the alcohol that we drink, that metabolite is called acetaldehyde. It is a mutagen. It causes DNA mutations, and it is a known human carcinogen.

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Elizabeth Platz: A second mechanism is during the process of metabolizing alcohol, there's a byproduct formed called reactive oxygen species. These are highly reactive molecules that can damage cellular molecules, including DNA, and the lipid molecules in cell membranes, and damage to cells can cause inflammation, and thus cancer risk.

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Elizabeth Platz: There are ways to reduce the risk of cancer caused by alcohol drinking. One is never drinking alcohol.

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Elizabeth Platz: But for those who do drink, quitting drinking or reducing the amount of alcohol consumed can reduce the risk of some cancers, like cancers of the mouth or the esophagus.

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Ellen Wilson: Thank you, Professor Platz. Now we'll take questions. A reminder, if you have a question, please enter it in the Zoom chat and with your name, media outlet question, and to whom you'd like to address your question.

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Ellen Wilson: Let's start with a question from… there are two questions that are related. First, from Andrew Rhodes at Helio for Professor Thrul, both of these will be for you, Professor Thrul. What have you heard about, or do you anticipate any possible changes to alcohol intake guidance in the 2025-2030 Dietary Guidelines for Americans?

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Ellen Wilson: What kind of implications would changes have? And related from Gabriel Etzel at the Washington Examiner, what is or ought to be the role of alcohol consumption in the Make America Healthy

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Ellen Wilson: again, agenda.

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Johannes Thrul: At this point, we don't have information on what exactly the guidelines will say, but what research is showing is that alcohol contributes to chronic disease and is harmful at lower doses and drinking frequencies than what we previously thought.

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Johannes Thrul: So, for example, if we look at Canada's 2023 guidance, that dropped the low-risk limit to roughly 2 drinks per week across the board, and also emphasized that every extra drink raises risk.

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Johannes Thrul: If the US guidelines adopt a similar limit, the implications would be quite substantial, for how we counsel patients.

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Johannes Thrul: For how we design interventions to reduce drinking, how the public sees alcohol, and how we design policies as well.

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Johannes Thrul: it would mean changing norms of what moderate drinking is, and the bottom line is, I would say, that guidance, if the guidance shifts downward, the burden isn't just on individuals to drink less, it's on the entire system that includes public health, it includes medicine.

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Johannes Thrul: It includes the alcohol industry to support that change.

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Ellen Wilson: Thank you so much, and for Professor Platz, what populations are at greatest risk of cancer due to alcohol consumption?

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Elizabeth Platz: Yes, I mentioned that acetaldehyde, a metabolite of alcohol, there are populations with East Asian ancestry that are more likely to have a less effective version of the enzyme that metabolizes acetaldehyde

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Elizabeth Platz: to another molecule called acetate, which is not a mutagen. And in those individuals, this means they have more acetaldehyde around.

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Elizabeth Platz: And if they have this less effective version of the enzyme, that means that they end up having a higher risk of alcohol-related cancers, possibly a cancer that I didn't mention yet, which is stomach cancer. The other population that should be, particularly concerned is women.

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Elizabeth Platz: So alcohol drinking is common in the population, and the number at risk for breast cancer is large, which means the number of cases of breast cancer due to alcohol drinking is large, as I mentioned, about 44,000 of the 100,000 cases of cancer caused by alcohol.

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Ellen Wilson: Thank you so much. For Professor Thrul, from Roberta Burkhart at the Pittsburgh Post-Gazette, can you elaborate on alcohol concerns related to increased consumption around holiday events?

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Ellen Wilson: I'm thinking specifically of Holiday Heart, but are there other concerns that arise around gatherings like Thanksgiving and the winter holidays?

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Johannes Thrul: Yeah, that's a timely question, and we often see spikes and increases in alcohol consumption around the holidays, and that increase comes with real cardiovascular risk.

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Johannes Thrul: We know that heavy drinking can trigger irregular heart rhythms, even in people with no prior heart disease.

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Johannes Thrul: And then we also were concerned about the combination of alcohol, potential dehydration, stress, and salty foods that can stress the heart.

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Johannes Thrul: Beyond that, binge drinking over the holidays also raises blood pressure and can increase accident risk and worsen chronic conditions.

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Johannes Thrul: And so, during holidays, obviously, it is easy to drink more than intended, but there are a few evidence-based steps that can go a long way. For example, keeping account of your drinks.

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Johannes Thrul: Alternate alcoholic drinks with water or other non-alcoholic beverages, eating before drinking, and taking alcohol-free days as well.

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Ellen Wilson: Great, thank you. Here's a question for Professor Platz from Jessica Medor at WABE in Atlanta. If possible, can you address relevant impacts and solutions in the South, in Georgia specifically?

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Elizabeth Platz: Yes, thank you for that question. So, each state participates in a survey called the Behavioral Risk Factors Surveillance System. It's conducted by the CDC on a continuous basis.

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Elizabeth Platz: That survey asks about alcohol consumption.

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Elizabeth Platz: as well as binge drinking and heavy drinking. And so I would recommend that, for those who have interest, to take a look at that survey. It provides information about drinking by state. So in the U.S. overall, about 53% drink at least one alcoholic drink in the last 30 days, 15% engaged in binge drinking, and about 6% are considered to be heavy drinkers.

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Elizabeth Platz: But this varies by state, so people who live in Georgia, the prevalences are not as high as in other parts of the country. So I would recommend taking a look at those national data, and then specifically at the state data, to understand what the patterns of drinking are specific to Georgia.

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Ellen Wilson: Great, thank you. For Professor Platz or Professor Thrul, a question from Apollonia Adeyame at New Telegraph in Nigeria. Why is the negative impact of alcohol on health being promoted now?

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Elizabeth Platz: So, I'll go first, if that's alright. So, as I mentioned, in the U.S, the prevalence of smoking needs to be very high, and that's true in many places in the world, and actually in some places in the world, smoking prevalence is going up, as well as the number of cigarettes smoked.

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Elizabeth Platz: But in places like the U.S, as we have, through public health strategies, reduced

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Elizabeth Platz: smoking prevalence, either through not starting to smoke or through quitting, this means that the import of other behavioral factors that increase the risk of cancer should now be highlighted. And so that's one of the reasons.

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Ellen Wilson: Professor Thrul , anything to add?

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Johannes Thrul: Yeah, I will say two things. So, first, we know that in the US at least, and I wouldn't be surprised if this were the same in other countries around the world, that a large part of the population is unaware of the carcinogenic effects of alcohol. So, I think it is our responsibility as public health professionals

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Johannes Thrul: To get this message out there, so users can make informed decisions of what they want to put in their bodies.

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Johannes Thrul: And the other side I would mention is that the science is changing. Previously, there were some, there was a thinking that low levels of alcohol use are relatively harmless, or even benign.

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Johannes Thrul: And that science has changed substantially over the past 5 to 10 years.

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Johannes Thrul: Where we now know that, that is essentially a myth, and, that the safest drinking level is no drinking, or if you follow the Canadian guidelines, up to 2 drinks per week.

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Ellen Wilson: Great, thank you so much. Another question for you, Professor Thrul, from Jessica Waller at Consumer Reports. Alcohol?

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Ellen Wilson: carries serious health risks, yet many people never hear this message from their doctors. What can be done to ensure that discussions about even moderate alcohol use and social drinking become normalized in primary care?

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Johannes Thrul: Yeah, I mean, this would mean we need to get the message out broadly, right? I think there are still a lot of misconceptions out there, and in my mind, this is… primary care is one approach, right? But, I think it's a…

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Johannes Thrul: All channels, getting the message out there, so that,

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Johannes Thrul: These conversations can happen in primary care, as well as in the public, more broadly.

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Johannes Thrul: And provider training probably has something to do with it as well, because we mentioned already that the science has changed pretty substantially over the last 5 to 10 years.

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Johannes Thrul: And primary care providers have a lot of things on their hands that they need to cover in a relatively short amount of time, and so getting this into provider education, CME, for example, would be one approach, I think, to get the message out there.

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Ellen Wilson: Great, and Professor Platz, if you had anything to add to that, please go ahead.

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Elizabeth Platz: Yes, no, I agree completely with Dr. Thrul.

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Ellen Wilson: Great. For Professor Thrul , have other countries seen success with warning labels on alcohol?

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Johannes Thrul: Yeah, so there's one really good example, specifically from Canada, that has shown good evidence. So, Canada, in a study in one of the provinces in the Yukon, tested different warning labels on alcohol bottles, including one that stated alcohol can cause cancer, so it's pointing out that risk of cancer with alcohol consumption.

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Johannes Thrul: And, they saw that individuals who saw these messages, these warning labels, reduced their alcohol intake, and alcohol sales, declined compared to a control site.

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Johannes Thrul: And, the study had to be scaled back after the alcohol industry pushed back, but it clearly showed that well-designed, science-based warning labels can raise awareness and potentially change behavior as well.

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Ellen Wilson: Great, thank you. Here's a question from Victoria Sanchez with ABC7 News in DC for either panelist.

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Ellen Wilson: Alcohol is big business in the United States, especially when it comes to the restaurant industry and around the holidays. How can public health officials alter the social acceptance of alcohol?

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Ellen Wilson: Professor Platz, did you want to start? And then we'll go to Professor Thrul.

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Elizabeth Platz: Yeah, so this is more in Dr. Thrul's space.

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Ellen Wilson: Great.

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Johannes Thrul: Yeah, so…

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Ellen Wilson: Please, go ahead.

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Johannes Thrul: Happy to respond to that. We're already seeing some changes, and, in… on the population level.

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Johannes Thrul: this is something that moves relatively slowly, but I will say, within, all of that, we already see certain groups that are reducing quite a bit, and I'm thinking specifically about young people.

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Johannes Thrul: We've seen now pretty consistently with clear data that, young people today are drinking way less and less frequent.

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Johannes Thrul: than previous generations.

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Johannes Thrul: And so… They have already… Taken up and absorbed the message of the health harms of alcohol.

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Johannes Thrul: and have made, or are actively making changes to their drinking behavior. Now, how we get that message out to other generations that maybe have more of a habitual consumption pattern already, that's the challenge for all of us, and that's why we're doing events like this, to get the message out more broadly.

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Ellen Wilson: Great, thank you so much. For Professor Platz, are non-alcoholic drinks good for you?

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Elizabeth Platz: So, non-alcoholic drinks sometimes are highly caloric. I'm thinking about mocktails. So, if you have interest in switching to a non-alcoholic beverage, meaning one that is designed to take the place of alcohol, you should look at the nutrition label and check the number of calories.

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Ellen Wilson: Great, thank you.

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Ellen Wilson: Here's a question from Morgan Coulson for either panelists. Trends show an increase in alcohol consumption among women, particularly in middle age and young adulthood, with increases in binge drinking being most pronounced among women with higher education and income levels. Can you talk a little bit about that shift?

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Ellen Wilson: Maybe that's for you, Professor Thrul ?

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Johannes Thrul: Yeah, I'm happy to take that. We're seeing effects of negative alcohol-related consequences, specifically in middle age among women, that has been increasing, and one of the hypotheses of why it is that especially alcohol use is up in that birth cohort is

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Johannes Thrul: That this cohort was in their young adulthood, or late adolescence, when a lot of the

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Johannes Thrul: alcohol mixers came on the market, and, that those were heavily, we know those were heavily marketed to young women. Kind of sweet-tasting, masks the harshness of, the alcohol.

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Johannes Thrul: And again, heavily marketed to that specific population group. And, there are some hypotheses in the literature that, postulate that this essentially

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Johannes Thrul: Brought them into consuming at a certain high risk, earlier on in their trajectory, and we're now seeing some of those consequences in terms of how they habitually consume alcohol, and seeing some early health effects and health risks that emerge from that.

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Ellen Wilson: Great, thank you. Here's a question from Juliette Fairley at Epoch Times for you, Professor Thrul . How are you defining alcoholic beverages? Does it include beer, wine, wine, seltzers, or just liquor?

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Johannes Thrul: Yeah, so alcoholic beverages are across the board, like, any drink that contains alcohol.

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Johannes Thrul: And, we have a standard drink size that essentially means that the amount of ethanol is the same, so the active ingredient, right, would be about the same degree in a beer, a pour of wine, and a shot. And so, for alcohol in general, the active ingredient is the same across all of these different, beverage types.

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Ellen Wilson: Great, thank you.

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Elizabeth Platz: And actually, I'd like… Oh, yes, please, go ahead. We should note that one glass of wine

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Elizabeth Platz: is… there's a definition of the volume, but wine glasses that are currently made tend to be much larger in volume than the standard size of the past. So we need to be mindful of that when thinking about the equivalence across the beverage types.

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Ellen Wilson: Great, thank you. The next question is, why are young people drinking less for you, Professor Thrul ?

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Johannes Thrul: Yeah, so we have compelling data showing that young people are drinking less, so that's what everybody agrees on. The Monitoring the Future study, which is one of those big national surveys that tracks consumption and substance use across the population of young people.

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Johannes Thrul: Shows steady declines in alcohol use over the past about two decades.

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Johannes Thrul: Now, why we're seeing these changes are still a little bit up for debate, but several factors seem to be driving this. So, I think we're seeing greater health awareness and awareness about alcohol harms that I mentioned before, this specific demographic in the population has absorbed more.

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Johannes Thrul: We're seeing more digital forms of socializing, and so alcohol plays less of a role in that if, you know, young people are not as much out and partying and drinking. And, we're potentially seeing shifting social norms around intoxication.

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Johannes Thrul: For some young adults, cannabis may have replaced alcohol in social settings, so we see cannabis use go up in the population as well, specifically among young adults.

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Johannes Thrul: And overall, this generation seems to be more selective about how, when, and why they drink, and alcohol seems to play a smaller role than it did in previous generations.

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Ellen Wilson: Great, thank you. And for you, Professor Platz, is even the occasional drink bad for someone's health?

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Elizabeth Platz: Yeah, so that's a really good question. So, the safest level of alcohol drinking is no alcohol drinking.

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Ellen Wilson: Thank you, and for Professor Thrul, does family history have anything to do with how bodies react to alcohol?

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Johannes Thrul: Yeah, so, on the how bodies react, I would say ethanol has

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Johannes Thrul: Pretty much the same effects to our bodies, just biologically,

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Johannes Thrul: my colleague, Dr. Platz, mentioned that there is a certain cancer risk that is increased for certain populations.

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Johannes Thrul: But in general, it's just how ethanol is metabolized in the body. I will say for

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Johannes Thrul: the risk of alcohol use disorder specifically, right? So, addictive patterns of alcohol use, we know that there is a family history of addiction, and so if there is a family history of alcohol use disorder, then I would estimate that an individual is at higher risk of also developing problematic alcohol use patterns themselves.

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Johannes Thrul: And that's the main thing we know about, family, family factors that might implicate alcohol use outcomes.

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Ellen Wilson: Great, and thank you. Here's the last question from Victoria Sanchez with ABC7 News, a follow-up for either panelists. Prior to 1971,

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Ellen Wilson: Cigarette advertisements highlighted smoking by using celebrities. Today, celebrities are either pushing their own alcohol brands, or are working for alcohol companies. Should there be a ban on alcohol advertisements, too.

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Johannes Thrul: I'm happy to take that. Okay.

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Johannes Thrul: Please go ahead. So, we know that there are evidence-based policies that reduce alcohol-related harm, and the World Health Organization, for example, has doubled down on those as well.

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Johannes Thrul: We know the ones that work is to make alcohol less affordable through taxes or minimum prices, making it less available by limiting the hours and outlet density, and, and this is specifically related to the question, making it less appealing by restricting marketing and promotion.

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Johannes Thrul: And I think we have been treating the alcohol industry differently from, say, the tobacco industry.

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Johannes Thrul: And what would be needed in order to reduce population-level harm would be to double down on those evidence-based alcohol policy strategies, and that includes limiting and restricting alcohol advertisements.

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Ellen Wilson: Great. Thank you both for answering all the questions. We will now take a few minutes just to share brief closing remarks. Professor Thrul, please go ahead.

0:26:30.740,0:26:34.809
Johannes Thrul: Yeah, so to finish up, I want to emphasize, three things.

0:26:35.540,0:26:42.579
Johannes Thrul: We now know, and the science has changed here, that even low levels of alcohol use cause harm, and

0:26:43.000,0:26:47.230
Johannes Thrul: We know that there are no Thruly safe amounts of drinking.

0:26:47.780,0:26:52.480
Johannes Thrul: The second thing is, Cutting back, even for a few weeks.

0:26:52.610,0:26:59.880
Johannes Thrul: Improves sleep, mood, and energy. We know this from studies that investigate the effects of, say, a dry January.

0:27:00.450,0:27:05.339
Johannes Thrul: But there are other months as well that people have started not drinking.

0:27:06.100,0:27:22.599
Johannes Thrul: And broadly, on the population level, we can see that social norms are shifting, and not drinking is becoming just as normal as drinking, and here I'm thinking specifically among young people, where we are observing this change pretty clearly.

0:27:23.720,0:27:27.440
Ellen Wilson: Thank you, Professor Thrul. Professor Platz, please go ahead.

0:27:27.930,0:27:35.140
Elizabeth Platz: Yes, I'd like to leave one message, which is alcohol drinking is a preventable cause of cancer and cancer death.

0:27:37.110,0:27:52.239
Ellen Wilson: Thank you to both of you for your insightful answers. We will email the links to the resources mentioned today and shared in the chat. And with that, I'd like to say thank you again to everyone for joining us today. A link to this recording will be provided later today.
 

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• Alcohol Use and Your Health

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