Is Whiskey Bad For You? It’s Complicated

By Richard Thomas

At the end of 2022, the World Health Organization (WHO) declared “no level of alcohol consumption is good for you.” Before that came an EU study linking even moderate drinking to cancer, but that received less media attention. This issue did not garner cause a press furor until Summer 2024, when a new study was released linking alcohol consumption to cancer, while also declaring that drinking yielded zero compensatory benefits. The storm on the matter truly broke when the U.S. Surgeon General advised that bottles of alcohol should have cancer warning labels, in the same way that tobacco products do, in the early days of 2025.

Whiskey drinkers who are aware of this controversy fall into two categories, I think. There are the bro-types who dismiss it automatically, because they reflexively ignore everything they hear that disagrees with what they think they know. But the group I’m writing for are the folks who like the idea that whiskey delivers alcohol in a lower calorie, low carb, no sugar, no gluten format relative to other drinks, and are at least moderately concerned with their health. I count myself in the latter group, so this is what I think you need to know to evaluate this story today and going forward.

Of Course Alcohol Is Bad For You. At Least A Little Bit.
Yes, alcohol is bad for you. Like almost all drugs, ethanol is a mild poison that humans in particular evolved to metabolize as an evolutionary, ominvorous adaptation. Already well-established eavy drinking is destructive for the liver, but has also been linked to cognitive decline as well as (most recently and at current issue) cancer, as well as other negative effects. Yet the definition of what constitutes moderate or heavy drinking has shifted and varies from authority to authority, and compounding that poor definition is that individuals are bad at judging how much they are actually drinking.

But keep in mind, everything you consume can be labeled as bad for you. Even drinking water and breathing oxygen can kill you in extreme enough circumstances. This point is best is best illustrated by the infamous Fat Versus Sugar debate, which began in the 1960s and culminated in the 1980s. The nature and details of that debate will matter later on in this essay, so remember it, but for now it will suffice to point out that a human needs to consume fats and sugars to live. Not just to live a healthy life, but to live period. Just watch a season of the reality TV program Alone sometime to see what happens to people who try to live energy intense lives on just protein, with little or no fat, sugar or carbohydrate intake: even when someone on that show can get enough in raw calories, the absence of certain sources inevitably leads to malnutrition. The problem with our modern scourges of fat and diabetes is not fats or sugars in their various forms and in and of themselves. It’s about over-consumption, sedentary lifestyles, over-processed foods and (as an external issues) the environmental impact of food production. When discussing these issues, the big picture matters.

As part of this health, lifestyle and foods issue, I believe alcohol falls into the same category as caffeine-carrying drinks or added sugars: it can be harmful under some circumstances, and we don’t actually need it. As a question of human evolution, we never need high fructose corn syrup, sugar processed from sugar cane or beets, the beets or cane itself, or even honey for that matter. Want it, yes, but fruits and berries are much better for you because of what else is in them, and supply what one actually needs in terms of immediate, usable energy. Added sugars are unnecessary. Also unnecessary are caffeine sources like coffee or tea, which can also be harmful if over-consumed.

Humans absolutely do not need alcohol to live and it has proven negative health consequences. A modest amount may have positive health benefits but may also have negative health benefits as well, and the relative points and balance between those remain unproven. A rational argument can be made that, given the only certainty is that you do not need alcohol to live, wouldn’t it be better to just go without? That is a choice people can certainly make for themselves, just as they do with their cola and their cups of coffee.

That Said, Be Wary Of Statistical Studies
The first problem encountered in evaluating the recent stream of “alcohol causes cancer” research is that almost all of it comes from statistical sources. As someone who has had graduate level statistical analysis courses and also finds his subscription to BBC Science a source of regular amusement, I can tell you: sometimes a statistical study can be just plain ridiculous. But leaving aside the absurd examples, science relying solely on number crunching is much more prone to biases (sometimes neutral, but sometime malicious — more on that later), confounding variables and choices in data sources and weighting data and bad assumptions.

Once you read enough articles about these things, you begin to realize just how much actual laboratory work and field research count for in physical science. A biologist I knew once told me that having a bunch of studies zero in on something is not conclusive, but is instead a flag that a subject needs more laboratory study. So, climate change is real, because the science has that laboratory and field work behind the number crunching. Ditto for Covid and ditto for vaccines. Alcohol causes cancer, however…?

A point to consider is that the studies don’t prove alcohol cause cancer in the sense of “our slides clearly indicate that alcohol in the cell causes this part of DNA to degrade and produce cancer.” Instead, they prove that alcohol is associated with cancer. Just how strong an association and under what circumstances alcohol is a causal factor is still open for plenty of debate, and on that determination the data as presented thus far is cloudy and far from conclusive. Studies like the ones at issue say “if you drink, your risk of cancer goes up,” but even when a given study concludes something very specific like women who drink are at 10% more risk of breast cancer than women who do not, another study using the same data or a separate data set can and probably will draw a different conclusion about how much alcohol and at what rate the cancer appears.

Take the 1986 Chernobyl disaster. This was by far the worst nuclear disaster the world has ever suffered and contaminated broad swaths of eastern, central and northern Europe. I was a teenager at the time, and vividly remember the experts opine that the disaster’s fallout would cause cancer rates to skyrocket from Ukraine to Germany and Sweden. What actually happened was far more modest: 0.01% of all cancers in the affected area since 1986 are demonstrably a result of Chernobyl. Radiation probably played a causal role in many more cancers than that, but a causal role is a problematic thing. This is because the overall cancer rate did not rise in a statistically significant way, so to prove cancers in general were caused radiation, one must somehow rule out all the other causes.

If a man smokes three packs of cigarettes a week, is continually exposed to heavy metals contamination in his environment, drank heavily and had some contact with Chernobyl cesium in the aftermath of the disaster, and then dies of cancer in his sixties, what actually caused the cancer? And what kind of cancer was it? That lifestyle description covers most of the male population of Belorussia for the affected period. The official conclusions about Chernobyl and cancer are that cancer rates did not explode, so basically radiation was not as important a cause as the other continuing health issues in the affected areas. The anti-nuclear movement continues to decry those results to this day, but their complaints amount to “but, but radiation” because they have produced no serious work of their own to debunk it.

Other problems with these studies stem from the data itself, such as abstainer bias. The data set in these studies for non-drinkers routinely includes both lifelong teetotallers and folks who have gone sober. Since the main reason people choose to quit drinking is due to health problems (sometimes not even caused by alcohol), the inclusion of folks who have gone sober skews the data. Another problem are confounding variables, like socio-economic status, age and other lifestyle issues that may also be associated with cancer. One needs to really dig into the nitty gritty of a study to understand what it is actually saying (as as important, what it is not saying or not able to say), and those details are usually absent from a clickbait headline or even the article beneath it.

Why Zero In On Alcohol?
I am firmly of the opinion that the reason so much attention from the public health community is now focused on alcohol is not because it is the most dangerous, optional and controllable factor in public health today. Instead, they are focused on it because booze is an easy target.

Compared to the plethora of well-understood and fully proved health risks associated with multiple features of ultra-processed foods in the West, the desire of the former US Surgeon General to put warning labels on Budweiser and not Doritos defies logic. Yet alcohol has always been associated with bad habits, and is one of the commodities long subjected to “sin taxes.” Let’s not forget that a century ago, alcohol production and sales were banned in the US, as religious leaders, public health advocates and feminists came together to form a political alliance that would be unimaginable today. To them, alcohol was the root of many evils. In Kentucky, we are the bourbon state but still have ten completely dry counties. “Alcohol = evil” is a Puritanical idea that still echoes in our culture to this day.

Because of that, pushback from the alcohol industry will not be nearly as fierce or as resonant as it would be if the authorities wanted to put scary warnings on fat-laden chips or sugary colas, this despite the brutally obvious fact that such foods are at the center of a vastly larger crisis than anything to do with alcohol. There are 29 million alcoholics in America against over 100 million obese and 22 million severely obese Americans. Double the number of deaths per year are associated with obesity as with alcohol.

Another fair question to ask is who is behind the study. Recall the Fat Versus Sugar Debate: it is so pertinent to the alcohol and health question is the whole reason fats were demonized as severely as they were was numerous studies were quietly paid for by the sugar industry to prove that they were bad for human health, so as to deflect from the very real fact that added sugars are also bad for your health.

The argument of fat versus sugar versus salt (sodium should have been part of that conversation all along) is not really over. Even though the facts and conclusions are well-understood–one should be mindful of the intake of all three substances–the push and pull between them continues, because the marketing continues. New research is very helpful for scientists and public health officials, but also for a marketing strategy designed to show the other guy’s stuff is worse than yours.

In this vein, recent years have seen more research suggesting that smoking pot is not as harmful as once thought. That may or may not actually be the case, but those reports always have three elements in common: they ignore the broader picture (such as the obvious point that smoking anything is a health negative); draw a very narrow positive conclusion; and that positive conclusion is always presented as “on this point, alcohol is much worse.” Someone is paying for that research, just as someone is cherry picking what kind of harm they want to study in order to make a pointed claim. The rising cannabis industry and associated new sober culture are absolutely pushing an anti-alcohol line as part of their commercial agenda.

As for the WHO, whenever a UN organization does or does not do anything, I think it is useful to evaluate that action in terms of the UN’s internal politics. Deciding to label alcohol a public health crisis would hardly be the first time the WHO did something because of internal politics: leaving aside the spoiled whining of some American voters who, 3 1/2 years later, are still bitter about Pandemic-era restrictions, the WHO is still embroiled in allegations that it covered for Chinese obfuscations during the outbreak of Covid-19 (indeed, the WHO did not formally accuse China of withholding data until 2023, long after the Pandemic was over). The world is home to 1.8 billion Muslims and 1.2 billion Hindus, two religions that prohibit alcohol. It’s not hard to see where political biases could play into how certain choices get made.

Aside from bias, priorities also play a role. The WHO is concerned with more than just what industrialized countries are doing. Alcohol abuse is a much more profound health and social problem in the developing world than it is in the West, analogous to the role it played in America prior to Prohibition. This becomes quite clear when one looks at the WHO’s own studies about alcohol abuse in Africa, Russia and East Asia. Hyping booze as a cancer risk helps when the goal is to get people to stop drinking themselves to death or getting so drunk they beat up their families, even if the latter two priorities are much less of an issue for, say, Denmark.

The National Academies produced a rigorous report on this issue, and concluded that 5% of all deaths in America can be associated with alcohol consumption. Again, not that “associated” means “played a role in” and not  “caused.” But the most interesting conclusion was that they also found a 16% lower risk of all-cause mortality for moderate drinkers. That is very much at odds with the “no amount of drinking is good for you” hard line that seems to be in vogue with certain authorities nowadays, and those authorities are bitterly critical of that report. The push and pull continues and will continue.

I’m a Gen Xer. My lifetime encompasses an arc that saw the food culture turn against both sugar and fat, leading  the industry to embrace sugar and fat substitutes, only for later studies to find fault with those substitutes. This is so much the case that, even today, the WHO still does not really known whether to classify aspartame as cancer-causing or not, and there are people who swear by their Diet Coke or swear Diet Coke causes cancer. So, I am quite confident that twenty years from now, the debate over health and alcohol will still be ongoing. That debate may be quieter or louder by then, but it will never be definitively settled the way tobacco and smoking were.