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The Mythical Monolith Of Big Alcohol

Since the end of February, Alcohol Justice (AJ) has been tweeting the following:

Big Alcohol will never admit #3 Alcohol classified carcinogenic 25 years ago

It’s part of their new series of things that “Big Alcohol will never admit.” I think somebody forgot to tell AJ that there’s no actual organization “Big Alcohol,” no single entity that speaks with one voice on all matters alcoholic.

The mythical monolith of “Big Alcohol” that doesn’t actually exist, but which Alcohol Justice believes should respond to their propaganda demands.

But let’s take a look at what we’re accused of this time. According to AJ, 25 years ago Alcohol was classified as a “carcinogenic.” That tidbit comes from their Alcohol and Cancer Risk “fact sheet” which states. “The International Agency for Research on Cancer (IARC) has classified beverage alcohol as a Group 1 (cancerous to humans) carcinogen since 1988.” That statement is footnoted by two studies. The first is the IARC Monographs on the Evaluation of Carcinogenic Risks to Humans VOLUME 96 Alcohol Consumption and Ethyl Carbamate and the second is Volume 100E A Review of Human Carcinogens: Personal Habits and Indoor Combustions (2012). And those two documents do indeed state that they “concluded that there was sufficient evidence of carcinogenicity for cancers of the oral cavity, pharynx, larynx, oesophagus and liver.” But is that the whole story? Hardly. Since that time, they’ve added colorectal and female breast cancer for a total of seven types of cancer, out of how many different types? Dozens? Hundreds? And for at least a few of those, moderate alcohol consumption reduces risk and for most of the rest is neutral, meaning there’s little or no effect. But AJ also claims that “Big Alcohol” has been somehow denying this for the past 26 years. How exactly has anyone been denying it?

But another questionable exaggeration is this, from AJ’s press release of February 26 of this year, where they attempt to take a position that the moderate consumption of alcohol is also unsafe.

While heavy drinking presents the greatest risk, daily alcohol consumption of as little as 1.5 drinks accounts for up to 35% of alcohol-attributable cancer deaths in the United States. Added [Director of Research Sarah] Mart, “The research is clear: There is no determined safe limit for alcohol consumption with regard to cancer risk.”

But that’s at least a little misleading. That claim comes from a 2013 study in the American Journal of Public Health entitled Alcohol-Attributable Cancer Deaths and Years of Potential Life Lost in the United States. Here’s the relevant bit from the results, in the abstract.

Alcohol consumption resulted in an estimated 18,200 to 21,300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths.

Although they exaggerated the findings by saying “Up to 35%” instead of “26% to 35%,” which is a typical propaganda tactic, what that one study really found is that 26% to 35% of 3.2% to 3.7% of all US cancer deaths may have come from moderate drinking. Put another way, 0.83% to 1.295% of all U.S. cancers may be attributable to people who drank moderately. From that, AJ concludes that “The research is clear: There is no determined safe limit for alcohol consumption with regard to cancer risk.” If you think that’s clear, keep making those donations, because it makes no logical sense. Less than 1% of all cancer deaths up to as many as 1.3% may be attributable to moderate alcohol consumption, and that constitutes clear causation, ignoring all other factors, such as genetics, environment, and lifestyle.

The study itself claims that there’s “no safe threshold for alcohol and cancer risk” despite it representing only around one percent of all cancers in the United States. Not to mention, when you dig deeper into the data, that particular study is only examining six types of cancer. They ignore all other cancers, while still making sweeping pronouncements about cancer, and ignoring any mitigating benefits of moderate alcohol consumption, including the rather hard-to-ignore total mortality.

Here’s what I don’t understand about calling alcohol a carcinogen. If indeed it increases the risk for certain types of cancers, but not others, it seems to me it would have to increase the risk to all persons (or even most) for all cancers to be considered to show “sufficient evidence in humans for the carcinogenicity of alcohol consumption.” My sense in reading through WHO literature over the years is that their mission is more about stopping people from drinking because as an organization they’re convinced that alcohol is always bad and has no positive aspects or benefits. When you only look for negative consequences, that’s all you find.

What AJ, WHO and many of these studies do is start with a premise and try to prove it, ending up cherry-picking the studies that support it and ignoring any that don’t. That creates a powerful propaganda tool but rarely stands up to any scrutiny. Luckily, as prohibitionist groups are well aware, few subject their propaganda masquerading as press releases to much, if any, scrutiny whatsoever. So their incentive to be more truthful is practically nil. So they can just make up whatever they want, like the mythical monolith of Big Alcohol, and then wonder why they won’t admit whatever prohibitionists says, no matter how twisted or distorted.

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