Is moderate drinking bad, actually?

Unrecognizable female friends celebrate and drink red sparkling wine.

There is a lot of advice out there about how much alcohol one should drink. There is research suggesting that drinking could be dangerous, and research that indicates drinking is good for you.

Which is it? Obviously, too much drinking is bad for one’s health — and drinking to excess can destroy the human body. But is moderate drinking good — or, at least, fine?

Dylan Scott, Vox’s senior health reporter, has been looking into this matter for some time, and I recently asked him to sum up what he’s learned. Here’s what he had to say:

You’ve done some reporting on alcohol recently and whether it’s safe. Is it?

There is widespread agreement that heavy drinking is not good for you — doctors and scientists have known for literally centuries that a lot of drinking is dangerous. 

And the more you drink, the greater your risk. Your risk starts to increase pretty exponentially once you’re having more than one or two drinks at a given sitting, especially if you’re drinking every day. 

There is still a lot of debate about the safety of drinking small amounts of alcohol and whether it can have very small health benefits. On that front, studies can seem to contradict themselves.

I talked to one scientist who has published some research documenting cardiovascular benefits from drinking a little bit of alcohol, and I also recently talked to the author of a 2017 statement from the leading cancer physician medical society, which was basically intended to be a wake-up call to the public that alcohol is a carcinogen. 

Yet those two people, despite appearing to be on opposite sides of the debate, would basically be in total agreement, about the negative consequences of more than one drink for a woman every day or more than two drinks for a man every day. 

Alcohol is a carcinogen? 

Yes, but let me take a step back. 

What has stuck out to me in reporting about alcohol is that the problem isn’t so much the substance itself as it is widespread misunderstanding about what moderate drinking means.

That’s 12 oz. of a 5 percent beer, 1.5-oz. glass of 80-proof liquor, and 5 oz. of a 12 percent glass of wine. 

There’s a trope among doctors that most people think they’re moderate drinkers but aren’t thinking about those numbers as they drink. I might pour a glass of wine and think I’m having one glass of wine, but a doctor would see two glasses of wine if it’s a really generous pour.

Coming back to your question, if you didn’t know alcohol is a carcinogen, you’re not alone. I learned in my reporting that only 40 percent of people know alcohol is a carcinogen, which shows there’s still a lot of work to do in educating people about the health risks.

Public health experts told me that they want to be more vocal about some of alcohol’s risks, especially about it being something that builds a dependency. Between that, and alcohol being a carcinogen, you can start to see why knowing what levels of drinking are actually moderate is really important.

That’s interesting, and it makes me wonder about those headlines that claim a new study has found a glass of red wine a day is the key to longevity or something like that. Is there anything to those?

After my reporting, I do think there is some room for debate about whether a very modest amount of alcohol consumed in a very particular way might confer some small cardiovascular benefit.

That said, even the doctor I talked to who’s authored studies finding some benefit, said, “This is not an elixir.” He was clear that his work shouldn’t be read as saying, “Alcohol is going to reduce your chance of diabetes, improve your heart health, or what have you.”

So, you’re saying I shouldn’t start drinking, hoping it will make me a healthier person.

Yes. The doctors I’ve spoken to have said things like, “I would never tell somebody to start drinking because it’s not going to help you.”

The basic thing to remember, though, is if you’re a light drinker, any potential problems caused by alcohol aren’t something worth worrying about. 

People should be aware of the risks but shouldn’t panic about them. Really, my two big takeaways on alcohol are: Heavy drinking is dangerous, and it’s easy to drink too much. Those are the things to watch out for. 

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