Last month, when U.S. Surgeon General Vivek Murthy called for updating warning labels on alcoholic beverages to reflect a heightened risk of breast cancer, colon cancer and five other malignancies linked by scientific studies from even moderate alcohol consumption, many people reacted as if this news was new to them. 

But the truth is that for many years, a number of credible studies have directly linked alcohol consumption to cancer, not to mention many forms of heart disease. If every bottle of wine or beer or gin carried a warning that its consumption could cause cancer — just like the labels added to tobacco products — would that actually make people think twice about having a drink with dinner?  

Alta DeRoo, M.D., the chief medical officer at Hazelden Betty Ford Foundation and a practicing OB-GYN, likes to think the proposed warning labels could have a positive impact on our overall health and well-being. While she says the consumption of alcohol is “baked into” many of our social rituals, she has hope that warning labels may eventually make the health effects of downing a Bud during the big game feel comparable to lighting up a Lucky Strike. 

“Alcohol is a carcinogen, but it is also such an accepted part of our society,” DeRoo said. “This kind of messaging is what we need to get people to take the health risk seriously.” 

DeRoo talked with MinnPost for the following interview, which has been edited for length and clarity.

MinnPost: People have known for years that drinking too much alcohol is bad for your body, but the surgeon general’s call for labeling alcoholic beverages with warnings about their risks of cancer related to even moderate alcohol consumption is taking the issue to the next level. Why are we only now talking about these serious health risks? 

Alta DeRoo: The reason nobody talks about it is because nobody prefers to talk about it. People like to drink and we don’t want to believe that drinking alcohol causes cancer because we really enjoy drinking alcohol. We have so few vices left in our lives that have a little bit of risk but also bring a lot of joy. People used to smoke cigarettes, but we now know they cause cancer. People used to smoke a little bit of marijuana, but now we know that in some people, high THC levels lead to an increased risk of psychosis. 

Alcohol is still a more socially sanctioned drug. People enjoy drinking alcohol. This news about warning labels was received with mixed emotion: we might understand that alcohol is a carcinogen, but we don’t want to believe it — or hear too much about it — because so many of us enjoy drinking alcohol. It makes us feel good in certain situations. We use it as a social lubricant. 

MP: And for some people, this news could feel confusing because not that long ago we were told that drinking wine is basically good for your health.

ADR: Exactly. In the not-so-distant past, we were given conflicting information that perhaps red wine is good for you, that it helped to lower your blood pressure and improve your memory. It made us feel that if we are drinking red wine we are doing something that’s good for our health. That information was easy to accept because it was already in line with our social habits. 

MP: What do you say when people ask you about the alcohol/cancer risk?

ADR: I say that this is more information for people to use when they decide what they want to put into their bodies. It really depends on what your priorities are in life. We are surrounded by messages about risk all the time: Wear your seatbelt. Don’t wear your seatbelt. Smoke or don’t smoke cigars. We eat processed foods all the time. We know they aren’t good for us. We make these decisions based on our priorities and what we perceive as a risk for us. Some folks may see drinking alcohol as more important than reducing their risk of getting cancer. 

MP: How do you feel about the idea of adding warning labels to alcoholic beverages? 

ADR: I think it’s a fine idea. When the surgeon general says this warning should be on the bottles, he isn’t saying, “Don’t drink.” It is just saying, “We should inform consumers so they could make a better decision.” Take cigarettes, for instance: people are being bombarded with multiple means of understanding how tobacco is a carcinogen. They can take in this information and then make up their own minds about it. Labeling alcoholic beverages would be just another means of making up our own minds, of being informed about the risks. 

MP: The surgeon general’s report highlights the clear link between alcohol consumption and breast cancer risk in women. This seems important, because in recent decades women’s drinking has increased. A lot of that was likely fueled by ad campaigns targeted at women and t-shirts and glasses that say things like, “It’s wine o’clock,” or “mommy juice.”  

ADR: The idea of encouraging women to drink wine has led to this socially sanctioned idea of women gathering and drinking wine together. I can think of many ways this idea has been monetized. It made it an acceptable thing to drink wine with your friends and commiserate. It’s almost encouraged and it is seen as positive and fun for moms to drink wine with each other. The idea is, “That’s just what she does to unwind.” This attitude has caused rates of alcoholism to rise among women. There’s not enough information out there yet about that issue. 

MP: And now the surgeon general is saying that even a little bit of alcohol is actually risky for women’s health. How do you communicate this to your patients? 

ADR: Now we know that a woman who drinks just two glasses of wine a day will increase her risk of developing cancer, that five women out of 100 will develop breast cancer after consuming just two drinks a day. We need more people to speak up about this risk because it is real. 

I tell my patients that we don’t need any more help developing breast cancer. Breast cancer is already way too common. So many other factors contribute to that risk, as well. If we remove alcohol from our diet this is actually one proven thing we can do to reduce our risk of cancer. 

Drinking more alcohol has never improved anything. It doesn’t make us drive better. It doesn’t make us perform anything better. We’re not saying people should stop drinking altogether, but I do say that decreasing alcohol consumption clearly has health benefits. 

MP: I’m assuming you’ve already reduced your own alcohol consumption or maybe even cut it out completely. How do you respond when people offer you a drink? 

ADR: Having a drink with dinner or when you visit a friend is a ritual. Ritual is really good. I don’t even like wine, actually, but I will drink it on some occasions before dinner. I do because it’s a ritual. But this announcement has given me a reason to just say, “No thanks.”

Now, when I’m offered wine, I will say, “No. I want to stay alive for my kids.” Now that we have this information, it is going to help us be more self-aware about the health risks associated with alcohol consumption. 

MP: What do you think will be the impact if warning labels actually do get placed on alcoholic beverages?  

ADR: I think it will be one more reason why a person might seek treatment for alcohol addiction. Often, when we get people into treatment, they come in because they’ve hit rock bottom. They’ve got debts, they are in trouble at work. Their family or friends are threatening to sever ties with them unless they go to treatment. Those situations still happen. But we also get lots of people whose family takes them to treatment out of love simply because they don’t want to lose their loved one to addiction. This change would be one more reason for a spouse or loved one to say, “I would like you to seek treatment. I don’t want you to get cancer and die.” 

MP: Have you talked to other physicians about this move? What are they telling their patients? 

ADR: I think what people are going to start hearing from their physicians is, “We can’t say that any level of alcohol intake is safe.” For instance, even two drinks a day increases your risk for breast cancer. As a woman, any drinking at all should be perceived as a risk. 

Beyond my work at the Hazelden Betty Ford Foundation, I am also an OBGYN. If we go back and look at the history of health warnings around alcohol, it’s been a long road. Think of how many women drank alcohol during their pregnancies in the not-so-distant past. Now we know that alcohol consumption during pregnancy is one of the most preventable causes of mental retardation. Several decades ago, we didn’t know that: Some of us were still drinking during pregnancy. 

MP: Attitudes really do change, don’t they?  

ADR: They sure do. Fifty or more years ago, smoking was considered good for your lungs. Because it caused us to cough, people said that it helped to get everything out of your lungs. Years into the future, we may be looking back on this move and say, “We were right about this when we made this change back then. Remember how much we used to drink? We were increasing our risk of cancer.” 

Those shifting attitudes are already reflected in the way doctors treat patients. I see a lot more doctors today talking about alcohol consumption and cancer risk during wellness checks and screening exams. This is a good change and something I hope people will take seriously.

Andy Steiner

Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at [email protected].

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