Alcohol is an accepted part of almost all societies. It is so engrained in socializing and entertainment, easy to obtain and relatively inexpensive that few think twice about taking a drink or two. Certainly, we know about alcoholism and recognize alcoholics, especially when they are on “skid row,” but we don’t usually think of alcohol as a dangerous drug. But perhaps we should.
Scientific reports reveal that alcohol may be among the most dangerous drugs, illegal or legal, that exist. In the U.S., approximately 88,000 people die a year from alcohol-related causes — including more than 4,300 deaths among underage youth1 — and in 2014, alcohol caused 9,967 driving fatalities in the U.S.2 Worldwide, 5.9% of deaths are attributable to alcohol.3
Why is alcohol not demonized the way tobacco is? There are at least two reasons, say public health experts. One is that the alcohol lobby has bought favorable media coverage through donations and partnerships with public health groups and even government agencies. The other reason is that illegal drugs usually receive the brunt of bad publicity even when the legal drug, alcohol, may do more damage.
Alcohol Is More Harmful Than Many Realize
While most people are aware of drunk driving fatalities and the possible effects of excessive alcohol consumption on the liver, there are other serious consequences from drinking alcohol that are less well publicized. For example, alcohol is strongly linked to mouth cancers and cancers of the pharynx, larynx, esophagus, rectum, colon and breast. It is even linked to cancers of the pancreas and lung.4
The carcinogenic effect of alcohol “is unmistakably proportional to the daily/weekly dosage,” according to research published in the Hungarian journal Magyar Onkologia.5 Alcohol, or ethanol as it is called in the medical profession, metabolizes into the known carcinogen acetaldehyde, which exerts negative actions:6
“Among other things chronic alcohol consumption promotes the production of endogen hormones, affects the insulin-like growth factor-1, alters several biological pathways, raises oxidative stress, and damages the genes. Even modest daily alcohol intake will increase the risk of breast cancer.”
Further, alcohol can encourage colon cancer, according to a report in the journal Evidence Report/Technology Assessment:7
“One human tissue study, 19 animal studies … and 10 cell line studies indicate that ethanol and acetaldehyde may alter metabolic pathways and cell structures that increase the risk of developing colon cancer. Exposure of human colonic biopsies to acetaldehyde suggests that acetaldehyde disrupts epithelial tight junctions.
Among 19 animal studies the mechanisms considered included: Mucosal damage after ethanol consumption. Increased degradation of folate. Stimulation of rectal carcinogenesis. Increased cell proliferation. Increased effect of carcinogens.”
Alcohol Can Contribute to Breast Cancer
The most common cancer in U.S. women is breast cancer and it is the second biggest cause of their cancer deaths. There is a strong correlation between the consumption of alcoholic beverages and breast cancer, according to a study published in the journal Alcohol:8
“Results of most epidemiologic studies, as well as of most experimental studies in animals, have shown that alcohol intake is associated with increased breast cancer risk.
Alcohol consumption may cause breast cancer through different mechanisms, including through mutagenesis by acetaldehyde, through perturbation of estrogen metabolism and response, and by inducing oxidative damage and/or by affecting folate and one-carbon metabolism pathways … Acetaldehyde is a known, although weak, mutagen.”
Because of the oxidative damage alcohol causes and its effects on the insulin-like growth factor-1 and genes, “Even modest daily alcohol intake will increase the risk of breast cancer,” concludes the journal Magyar Onkologia.9 The heightened breast cancer risk likely comes from alcohol’s increase of estrogen, suggests research in Evidence Report/Technology Assessment:10
“Increased estrogen levels may increase the risk of breast cancer through increases in cell proliferation and alterations in estrogen receptors. Human studies have also suggested a connection with prolactin and with biomarkers of oxidative stress.
Of 15 animal studies, six reported increased mammary tumorigenesis … Other animal studies reported conversion of ethanol to acetaldehyde in mammary tissue as having a significant effect on the progression of tumor development.”
Alcohol Is Often Linked to Violence
“Rape culture” and rapes on U.S. campuses are increasingly reported but their link to alcohol consumption is not always included. Social researchers do not think that alcohol, in and of itself, makes people violent or rapists but rather that it boosts the behavior in those with violent tendencies.11 According to research in the Journal of Studies on Alcohol and Drugs:12
“College men’s alcohol consumption is positively associated with sexual aggression perpetration … In the present study … heavy episodic drinking (HED) [was] … hypothesized to contribute to sexual aggression perpetration via more frequent attendance at drinking venues (parties, bars).
College men who more frequently attended drinking ‘hot spots’ were more likely to perpetrate subsequent sexual aggression, supporting a growing body of evidence on the importance of drinking venues in college sexual assault.”
Children also experience violence as the result of alcohol consumption, a study published in the journal Child Abuse & Neglect found:13
“This study is a detailed examination of the association between parental alcohol abuse … and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs) …
Compared to persons who grew up with no parental alcohol abuse, the adjusted odds ratio for each category of ACE was approximately 2 to 13 times higher if either the mother, father, or both parents abused alcohol … exposure to parental alcohol abuse is highly associated with experiencing adverse childhood experiences.“
Alcohol is also correlated with depressive effects in its users and problems in their daily lives, such as trouble in interpersonal relationships including marriage.14
Alcoholic Beverage Makers Have Spun a Good Image
As I mentioned before, alcohol has not been demonized like tobacco and street drugs. In fact, you do not have to look too far to see reports that alcohol is even healthful and that moderate drinkers live longer than non-drinkers. How has alcohol’s positive image been created and maintained?
Two years after launching its Global Smart Drinking Goals campaign in 2015,15 Anheuser-Busch InBev, the world’s largest beer brewer,16 debuted its Ab Inbev Foundation.17 “Built around the idea that partnerships can play an important role in reducing the harmful use of alcohol,” it “works through a collaborative model, with our staff, the City Pilot Steering Committees, and our partners,” says the brewer.18
But, according to a commentary in the British journal The Lancet, the Ab Inbev Foundation is no different in intent and hypocrisy than Philip Morris International’s Foundation for a Smoke-Free World.19
You could even add the hypocrisy of Juul Labs claiming to “transition the world’s billion adult smokers away from combustible cigarettes, eliminate their use, and combat underage usage of our products” while hooking children on vaping.20 The Ab Inbev Foundation betrays unabashed conflicts of interest says the Lancet:21
“In fact, the foundation attracts senior UN and former US government officials to its board and funds and engages in policy making processes. Despite obvious conflicts of interest, the Anheuser-Busch InBev Foundation sponsors a US National Academies of Science forum on global violence prevention.”
For example, a member of the Institute of Medicine’s Forum on Global Violence Prevention in 2011 was Amie Gianino who was identified as “Senior Global Director, Beer & Better World, Anheuser-Busch InBev.”22 Why is the alcohol industry considered a valid government presenter on these topics?
Anheuser-Busch InBev is not the only alcohol giant pretending to be concerned with global health while selling health-destroying products. The Carlsberg Foundation, one of the world’s leading brewery groups,23 created UNLEASH for young people working on “solutions to meet the United Nations Sustainable Development Goals.”24 It also works with government groups, says the Lancet commentary.25
More Deception From Alcohol Beverage Manufacturers
How have alcohol beverage makers been able to minimize the considerable cancer links to their products? According to Drug and Alcohol Review:26
“Three main industry strategies were identified: (i) denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk; (ii) distortion: mentioning cancer, but misrepresenting the risk; and (iii) distraction: focusing discussion away from the independent effects of alcohol on common cancers …
These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including schoolchildren.”
At least one partnership between government and the alcohol industry was flagged as a conflict of interest. In 2018, Heineken, the world’s second biggest brewer, and The Global Fund to Fight AIDS, Tuberculosis and Malaria announced a partnership to tackle infectious diseases in Africa. But, according to a Lancet editorial:27
“The proposed partnership is a clear conflict of interest, offering the alcohol industry — already keen to tap into emerging markets such as in Africa — an opportunity to divert attention from the harms of its products, while also lending it an air of responsibility with policy makers and attracting further visibility and brand recognition.”
Other public health groups such as the NCD (noncommunicable disease) Alliance concurred.28
“‘We have made it clear from the outset that we believe that the Global Fund´s partnership with an alcohol company such as Heineken is incompatible on the grounds of public health,’ said Katie Dain, CEO of the NCD Alliance.
‘It is unacceptable that a company whose core business is based on promoting products and choices that are of detriment to people´s health and wellbeing, should be seen as a viable partner by an organization like the Global Fund that is charged with bettering the health of so many millions of people around the world.'”
The partnership was suspended in 2018, not due to public health concerns but, rather, amid allegations that Heineken’s use of female beer promoters was sexually exploitative and unhealthy.29
Other Alcohol Conflicts of Interest Exist
Public health organizations have seen the value in taxing tobacco and sugar-sweetened beverages because of the clear harm they do. Yet alcohol taxes and control strategies lag behind, says the Lancet. For example:30
“Bloomberg Philanthropies, a worldwide leader in tobacco control, convened a high-level task force with former heads of state and finance ministers to consider fiscal policies for health.
The philanthropic organization recognized that alcohol taxes were underused, and, if implemented, could indirectly save up to 22 million lives over the next 50 years. Yet, Bloomberg Philanthropies has not devoted resources to alcohol control programs.”
Moreover, some research-based charities like the U.K.-based Wellcome Trust actually invest in alcohol beverage makers, says the Lancet commentary.31
“The Wellcome Trust, which announced a major commitment of £200 million to transform research and treatment for mental health, has also invested £171 million in Anheuser-Busch InBev as of 2017.
No global health charity has allocated substantial resources or prioritized investment in alcohol control, despite the fact that this neglected issue needs leadership.”
We have long seen how junk food manufacturers like Coca-Cola have skewed research about the health effects of their products and tried to form partnerships that made them look health conscious. It is no surprise that alcoholic beverage makers would sink to the same dirty tricks. It’s important to take their messages with a grain of salt.