A long road ahead for alcohol cancer risk conversations: Viewpoint

The alcohol advisory released by Surgeon General Vivek Murthy, MD, is "likely only one in an evolving history of landmark public health documents about the dangers of drinking; it's a document for the archives as well as the moment," Rachael Bedard, MD, a geriatrician and palliative care physician, wrote in an op-ed piece published Jan. 13 in The New York Times.

The first surgeon general's report linking smoking to lung cancer was released in 1964 and was the start of a cultural change. This advisory could inspire similar changes.

The recent advisory that drinking alcohol raises cancer risks is "something of a gamble," Dr. Bedard wrote. It relies on people doing less of something they enjoy, and reactions are mixed. Some interpret the advisory as confirmation that no amount of alcohol is safe, while some commenters have responded with scorn. Dr. Bedard said her husband rolled his eyes when she asked him about the advisory, and a group of women she talked with said the recommendations seemed like "scolding BS." Although some patients have been concerned about the advisory and their consumption of alcohol, others said it did not make a difference to them.

"The surgeon general's report isn't only, or even primarily, intended to speak to individual Americans, however," she wrote. "The majority of its recommendations, like the one to change alcohol labeling to highlight cancer risk, are policy ideas. The way that public health most effectively helps people change their habits is by changing the incentives, pressures and opportunities in the culture around them: Vaccine mandates help the hesitant decide to get shots, and speed limits help people inclined to drive fast to slow down. These types of policies are beneficially coercive, and they can evolve over time as people get used to new expectations and restrictions."

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