Let’s dive into a hotly debated topic: Is moderate drinking good for your health?

If you google this question you’ll likely find articles with titles like “surprising ways alcohol is good for you” with outdated information (often a decade old) based on flawed studies that imply there are both health benefits and risks to drinking, or that it’s an open question if moderate drinking is good for you. 

Here’s the truth: there are no health benefits to drinking and it’s not an open question if moderate drinking is good for you.

But there are lots of people who don’t want you to know that or are just writing articles with clickbait headlines.

And yes, I’m looking at you WebMD, with your super sketchy article on “the surprising health benefits” of alcohol, including that alcohol “helps your brain, helps your heart and gets you more active!” You might want to update your information because the studies you reference were written back in 2011 and 2005 (18 years ago!).

Despite data that’s been available for many years that moderate drinking has no health benefits, the vast majority of drinkers have bought into the popular narrative that having one or two drinks a day is healthier than not drinking at all or that drinking red wine is good for your heart. 

The truth is that even moderate consumption of alcohol, defined by the National Institute on Alcohol Abuse and Alcoholism as no more than one drink per day for women and no more than two drinks per day for men, is associated with many harmful effects.

The Washington Post reported in a recent article titled “Sorry, wine lovers. No amount of alcohol is good for you”, that studies have linked moderate alcohol consumption to numerous types of cancers involving the mouth and throat, voice box (or larynx), esophagus, colon and rectum.

Light to moderate drinking has also been associated with a significant increased risk of breast cancer for women. 

But few Americans know about these risks. In fact, nearly 70 percent of Americans don’t realize alcohol consumption increases their risk of cancer. 

And most consumers are certainly not aware that drinking a single bottle of wine increases the risk of developing cancer over a lifetime by the equivalent of 10 cigarettes for women.

While you’ll continue to see arguments in articles and debates online about whether or not moderate drinking is good or bad for you, in January 2023 The World Health Organization released a definitive statement on the subject: No level of alcohol consumption is safe for our health.

We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink – the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is,” explains Dr. Carina Ferreira-Borges, acting Unit Lead for Noncommunicable Disease Management and Regional Advisor for Alcohol and Illicit Drugs in the WHO Regional Office for Europe. 

She added,

So, when we talk about possible so-called safer levels of alcohol consumption or about its protective effects, we are ignoring the bigger picture of alcohol harm in our Region and the world. Although it is well established that alcohol can cause cancer, this fact is still not widely known to the public in most countries. We need cancer-related health information messages on labels of alcoholic beverages, following the example of tobacco products; we need empowered and trained health professionals who would feel comfortable to inform their patients about alcohol and cancer risk; and we need overall wide awareness of this topic in countries and communities.

So if the harms of consuming even a moderate amount of alcohol are well established, and the data exists that moderate drinking is not good for you, why are we not aware of this? 

One big reason is that the alcohol industry has spent an incredible amount of time and money in lobbying, advertising and funding confusing and misleading research studies (including studies run by the National Institutes of Health) to make sure that the vast majority of drinkers are unaware of the harms of even moderate alcohol consumption. 

And as countries like Canada change their health guidance around drinking and countries like Ireland propose cancer warnings on wine, beer and spirits the alcohol industry is aggressively trying to stop them

I’m hoping that today’s episode and the research we’ll discuss will help you understand the health risks of drinking, including moderate amounts of alcohol, so that the next time you tell someone that you’re taking a break from drinking and they encourage you to “just have one because red wine is actually good for your heart!”, you can set them straight.

My guest today, Dr. Christina Mair, author of the article Alcohol’s health benefits are hard to prove, but harms are easy to document is here to share her research.  

Dr. Mair notes in her article, “Thanks to lobbying by the powerful alcohol industry, alcohol’s dangers may be underplayed and its benefits exaggerated. There are many well-established problems with drinking even at moderate levels that likely outweigh any potential benefits.

Alcohol is the third-leading cause of premature death in the U.S. and one of the leading modifiable causes of death worldwide, while receiving some of the least media and policy attention.”

Not only is alcohol consumption a risk factor for cancer, but alcohol also affects women differently than men. 

The CDC reports “Although men are more likely to drink alcohol and consume larger amounts, biological differences in body structure and chemistry lead most women to absorb more alcohol and take longer to metabolize it. After drinking the same amount of alcohol, women tend to have higher blood alcohol levels than men, and the immediate effects of alcohol usually occur more quickly and last longer in women than men. These differences make women more susceptible to the long-term negative health effects of alcohol compared with men.”

Beyond physical health risks, alcohol can also have negative effects on your mental health, including increased risk of depression and anxiety and impaired cognitive function. 

In this episode, we’ll explore the latest research on moderate drinking and its health risks, the science behind these risks and why they are often overlooked or misunderstood by the general public.

If you’re currently trying to quit drinking or are considering making a change, this episode will provide you with valuable insights and information to help you make an informed decision about your health and wellness.

Tune in to learn about:

  • The popular narrative that red wine is good for your heart and moderate drinking is healthier than not drinking at all – and why it’s false
  • The little known fact that consuming one bottle of wine increases a woman’s risk of developing cancer equivalent to smoking 10 cigarettes
  • Why 70 percent of Americans don’t realize alcohol consumption increases their risk of cancer of the breast, head, neck, esophagus, liver and colon
  • Research that a single glass of wine decreases a woman’s sleep quality by 24% (and anything over one drink decreases your sleep quality by over 39%)
  • The reason the alcohol industry is freaking out about Canada’s new drinking guidelines and Ireland’s proposed health warnings on wine, beer and spirits
  • The fact that wine or beer is not less harmful to your health than hard alcohol or spirits
  • The alcohol industry’s ties to research on the “health benefits” of drinking
  • Ways to substantially decrease the public health risks of alcohol at a population level

The World Health Organization’s Statement that no level of alcohol consumption – or type of alcohol – is safe for our health [January 2023] 

It is the alcohol that causes harm, not the beverage

Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer. Ethanol (alcohol) causes cancer through biological mechanisms as the compound breaks down in the body, which means that any beverage containing alcohol, regardless of its price and quality, poses a risk of developing cancer.

Research and articles on the health risks of alcohol and links to cancer, decreased sleep quality and the negative impact of moderate drinking on your physical and mental health

Ready to drink less + live more?

If you’re ready to change your relationship with alcohol join The Sobriety Starter Kit

It’s my signature sober coaching course for busy women to help you drink less + live more. 

To enroll go to www.sobrietystarterkit.com.

Grab the Free 30-Day Guide To Quitting Drinking, 30 Tips For Your First Month Alcohol-Free

Connect with Christina Mair

Dr. Christina Mair is an Associate Professor and Vice Chair for research in the Department of Behavioral and Community Health Services at the University of Pittsburgh School of Public Health. Her research seeks to understand the structural and contextual influences on substance use related problems with the goal to reduce these problems in the community.

To learn more about Dr. Mair and the work she does, head over to https://www.sph.pitt.edu/directory/christina-mair

Want to read more of Dr. Mair’s academic articles? Head over to Christina Mair – Google Scholar

Follow Dr. Christina Mair on Twitter @stinamair

Most people are not aware of the effects of amount of alcohol consumption affecting the quality of sleep.

The Sleep Foundation Org illustrates the effects of alcohol consumption to the decreased quality of sleep in the image below.

Small Amounts Of Alcohol Decrease Sleep Quality. Sleep Foundation Org Graph

Below is an image of the Health warning on Alcohol and Cancer proposed by Irish Regulations on wine bottle. 

Ireland is adding new health warnings on bottles of wine, beer and spirits. They address for the first time alcohol as a public health issue in the Irish legal framework. The law requires alcohol products to have mandatory health warnings added to their labels, like those on tobacco products.

Connect with Casey

Take a screenshot of your favorite episode, post it on your Instagram and tag me @caseymdavidson and tell me your biggest takeaway!

Want to read the full transcript of this podcast episode? Scroll down on this page.


Are you looking for the best sobriety podcast for women? The Hello Someday Podcast was created specifically for sober curious women and gray area drinkers ready to stop drinking, drink less and change their relationship with alcohol.

Host Casey McGuire Davidson, a certified life and sobriety coach and creator of The 30-Day Guide to Quitting Drinking and The Sobriety Starter Kit Sober Coaching Course, brings together her experience of quitting drinking while navigating work and motherhood, along with the voices of experts in personal development, self-care, addiction and recovery and self-improvement. 

Whether you know you want to stop drinking and live an alcohol-free life, are sober curious, or are in recovery this is the best sobriety podcast for you.

A Top 100 Mental Health Podcast, ranked in the top 1% of podcasts globally, The Hello Someday Podcast is the best sobriety podcast for women.

In each episode Casey will share the tried and true secrets of how to drink less and live more.

Learn how to let go of alcohol as a coping mechanism, how to shift your mindset about sobriety and change your drinking habits, how to create healthy routines to cope with anxiety, people pleasing and perfectionism, the importance of self-care in early sobriety, and why you don’t need to be an alcoholic to live an alcohol-free life. 

Be sure to grab the Free 30-Day Guide To Quitting Drinking right here.

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Is Moderate Drinking Good For You? with Dr. Christina Mair


alcohol, drink, people, alcohol use disorder, risk, cancer, wine, alcohol consumption, health, problem, years, harms, absolutely, smoke, life, research, link, healthy, talk, label,

moderate drinking

SPEAKERS: Casey McGuire Davidson + Dr. Christina Mair


Welcome to the Hello Someday Podcast, the podcast for busy women who are ready to drink less and live more. I’m Casey McGuire Davidson, ex-red wine girl turned life coach helping women create lives they love without alcohol. But it wasn’t that long ago that I was anxious, overwhelmed, and drinking a bottle of wine and night to unwind. I thought that wine was the glue, holding my life together, helping me cope with my kids, my stressful job and my busy life. I didn’t realize that my love affair with drinking was making me more anxious and less able to manage my responsibilities.

In this podcast, my goal is to teach you the tried and true secrets of creating and living a life you don’t want to escape from.

Each week, I’ll bring you tools, lessons and conversations to help you drink less and live more. I’ll teach you how to navigate our drinking obsessed culture without a buzz, how to sit with your emotions when you’re lonely or angry, frustrated or overwhelmed, how to self soothe without a drink, and how to turn the decision to stop drinking from your worst case scenario to the best decision of your life.

I am so glad you’re here. Now let’s get started.

Hi there. Today’s episode is about a question that I get asked about all the time and is coming up more and more in the news.

The question is, Is moderate drinking good for you?


My guest today is Dr. Christina Mair. She’s an Associate Professor and Vice Chair for research in the Department of Behavioral and Community Health Services at the University of Pittsburgh School of Public Health. Her research seeks to understand the structural and contextual influences on substance use related problems with the goal to reduce these problems in the community. And I actually reached out to Christina to Dr. Mair. After I read an article, she had written in salon where the title was, Alcohols’ Health Benefits Are Hard To Prove, But The Harms Are Easy To Document. Alcohol is part of American life, but its health risks are underplayed, she wrote, maybe underplayed but after being in this world for seven years since I quit drinking, and I’ve learned so much, they’re absolutely underplayed all the time for a million reasons.


So, Christina, welcome. Thanks for coming on the podcast.



Thanks so much. I’m looking forward to this conversation today.


Casey McGuire Davidson  02:49

Yeah, and I reached out to you because I had been wanting to have this conversation for a very long time. But I wanted to find the right guest. And after reading your article, and all the news coming out, I thought it was the perfect time to have this conversation.



Yeah, I think sort of, as I said before, a lot of these are not new health effects that we’re learning about. But I think that there’s sort of a groundswell around having these conversations, particularly around moderate alcohol use. So, I’m happy to see it gaining a lot more recognition and a lot more people talking about this.


Casey McGuire Davidson  03:27

Yes, I mean, the stat that blew my mind, because I used to unless I was trying to moderate or take a break, I used to drink about a bottle of wine a night. And the stat that blew my mind was that for women, drinking a bottle of wine is the cancer equivalent risk of smoking 10 cigarettes.



That’s exactly right. They say about you know, you have about one drink a day is equivalent to one to two cigarettes a day, so that math checks out.


Casey McGuire Davidson  03:59

It’s incredible, because I would never smoke 10 cigarettes a day, like in my mind, that would be awful for my lungs and my body and my cancer risk. And yet alcohol is so glamorized. And we think that a glass or two of wine a day is actually good for us, you know, more healthy than someone who doesn’t drink at all. And it is just factually completely untrue.



Exactly. And I think, you know, there was a lot of media when I was growing up in the 80s and the 90s, sort of about, you know, the French and they drink a glass of wine a day and there’s so much healthier than everyone else. Right. It was really in the popular culture, that it was protective in particular for heart health. And, you know, the evidence does not back that up. So yeah.


Casey McGuire Davidson  04:50

I remember vividly and it’s in popular culture now. I think it was 60 Minutes did a big story on the French pair. Dogs. And the idea that drinking a glass of wine a day really makes them much more healthy, ignoring how much they walk and their diet, and you know, the way that we consumed food and what’s inside our food. But it really took off and took hold.



Yeah, there’s something called the sick quitter effect that I think is really important when we think about why it appears that people who have one or two drinks a day are quote unquote, healthier than others and refers sort of exactly to what you were talking about.


So, if you think about, who does not drink at all, there are people who have deliberately chosen to not consume alcohol, maybe they never drank alcohol. But there are also a not sort of, there’s a pretty large group of folks who, at some point in their life, consume alcohol and maybe stop drinking, for health reasons, or their health complications, maybe they have cancer, other chronic conditions, or they just feel healthier when they don’t drink. And so, what that means is that those who fully abstain from alcohol, at baseline for reasons completely unrelated to their drinking are potentially slightly less healthy, right? They’ve made choices to improve their health, by stopping consuming alcohol.


So, that sort of, it had this false impression that those who drink one or two drinks a day are healthier. And that’s just really, for reasons completely unrelated to alcohol consumption.


Casey McGuire Davidson  06:22

Yeah, absolutely. And yet, once the studies come out, however flawed, they’re pushed, quite a bit, obviously, by the alcohol industry, but also just by the media and popular culture, and all of us, because we want to believe that our favorite drug is healthy. You know, I even went to an eye doctor and was talking to him about the fact that like, there were some blood vessels in my eye that were kind of bred and asked him about it. And I was like, and by the way, I don’t drink. As in, this red effect in my eye is completely unrelated to bloodshot eyes. And, you know, he was 65 years old, and was like, oh, maybe that’s the problem. And I was like, I didn’t say anything for like, 10 minutes. And I was like, sitting there, like, do I say anything? Do I say any? And finally, I was like, Can we go back to what you said, XYZ. And he was like, well, some drinking is healthy for you. And he got a lecture from me, like I am that girl. Now, that was like, that is factually untrue. And as a medical professional, you should know that.


So anyway, I made that go back, because he may not want to see me, but it bothers me, when people who should know better perpetuate that idea?



Well, I mean, you know, it’s so common, right? 70% or so of American adults consume at least one drink per month, right. So, the majority of people do, and the majority of people, you know, have not seen necessarily the bigger, broader, larger sort of acute impacts of their alcohol use. So, they feel uncomfortable, I think when you start to point out to them that moderate alcohol consumption does have these other health effects attached to it. And, you know, in my field, I’m an epidemiologist, I’m in public health. And it’s one of the things we struggle with the most.


And actually, it’s something the alcohol industry has sort of tried to continue to perpetuate. And it’s this idea of sort of individual risk versus population risk. So, in public health, we’re trying to sort of, we call shift the curve, right? So, the idea is that if every single person even just had two fewer drinks a month, right? If everyone just slightly moderated or reduced their alcohol use, we will see a huge impact, right? But the alcohol industry likes to sort of point out that, Oh, these are only individual behavioral choices, you’re choosing to do this, you’re healthy. So, you don’t need to worry about these larger risks related to alcohol consumption. And then it fully and solely about individual responsibility, individual blame, if you can’t handle your alcohol, that is your fault. Right? It becomes an individual level thing where really, you know, it’s cultural, it’s structural, we can think about sort of, at the population level of everyone in the United States the impact of alcohol on industry, but that doesn’t serve their best interests, right? So, we tend not to think of it that way.


Casey McGuire Davidson  09:21

Finally, and I’m hoping articles like you, write studies, that you work on things in popular culture on this podcast, are starting to change the conversation from like, struggling with alcohol is a problem, meaning these people over here, too, it’s a wee problem. And I think that during the pandemic, when drinking, binge drinking among women in the US actually spiked 40% and drinking with parents of children under the age of five went up by 323%. I’ll link to all the studies.


Not only that I saw in one study that the increase in death rates from alcohol related causes went from during the pandemic, an average increase annually of 2 to 5%. To like, 25%. That was the jump. And that’s so, at least in the media, people are starting to not be like, Oh, my God, you’re a problem drinker, you’re an alcoholic, you can’t handle it. All you need to do is drink responsibly, to wow, we have a public health issue here. And it’s actually the substance that is sort of universally a problem to anyone, versus you are somehow uniquely damaged and you’ve lost your privileges.




Yeah, you know, alcohol, there was a study that came out maybe 20 years ago that pointed out that alcohol is in the top five we call actual causes of death, right? Those are modifiable behavioral choices that we make tobacco, of course, leads the way but alcohol is not far behind that. And during the pandemic, they there are many different ways of sort of categorizing what is an alcohol attributable death versus not? Because it does contribute to so many different chronic health conditions.


So, one way you can sort of calculate that is to say, well, you know, 20% of risk from breast cancer, for example, I don’t know the exact number is attributable to alcohol. And so, you can sort of, you know, you partition out all the deaths, and I think it was 120,000, alcohol attributable deaths, during the first year of the pandemic, which had gone up by 20,000 30,000, it was a pretty big jump. And they say that there are maybe 19,000 cancer deaths directly attributable to alcohol every year in the United States, and 75,000 cases. And that’s not an insubstantial number, and I don’t think that when it comes to cancer, people typically link alcohol use or that that connection is not as clear for many people.


Casey McGuire Davidson  11:58

Yeah, I think that’s completely true. And I truly hope I mean, honestly, like, a lot of my friends drink my husband drinks. I was a huge drinker, like I am not judging anyone. And I feel like if more people knew the impact, we clearly with cigarettes now, I think people choose to smoke that is perfectly fine. But nobody is like, oh, yeah, that’s actually good for your heart. Everybody is like, Okay, you could choose to smoke, but you should, you know, you should really not smoke because I care about you. And I want you to be around.



Yep, you’re totally right. I think that, in particular tobacco sort of that took hold in some ways, because of secondhand smoke, environmental smoke, there’s this obvious link where you could say, you are harming me directly every time you smoke a cigarette. And of course, you know, you’re harming your own health, you are harming others. And there are harms to others, as we all know, that sort of accumulate around alcohol consumption, think about child abuse and neglect and partner violence. And, you know, driving after drinking, I mean, there.


Yeah, I mean, there are all sorts of things there, right, but it’s a little bit less like obvious and direct. And even in the alcohol research world, we always sort of say that alcohol researchers are like 30 to 40 years behind tobacco researchers in terms of our partnerships with the alcohol industry and how we’ve tried to separate ourselves, and the influence that the alcohol industry has on alcohol researchers, even federally funded alcohol researchers, it that’s another thing that we have not been paying close enough attention. And just recently, I feel like we’re starting to have a groundswell within the alcohol research community to understand the importance of trying to separate industry influence from the work that we do.

Casey McGuire Davidson 

Hi there. If you’re listening to this episode, and have been trying to take a break from drinking, but keep starting and stopping and starting again, I want to invite you to take a look at my on demand coaching course, The Sobriety Starter Kit.


The Sobriety Starter Kit is an online self study sober coaching course that will help you quit drinking and build a life you love without alcohol without white knuckling it or hating the process. The course includes the exact step by step coaching framework I work through with my private coaching clients, but at a much more affordable price than one on one coaching. And the sobriety starter kit is ready, waiting and available to support you anytime you need it. And when it fits into your schedule. You don’t need to work your life around group meetings or classes at a specific day or time.

This course is not a 30 day challenge, or a one day at a time approach. Instead, it’s a step by step formula for changing your relationship with alcohol. The course will help you turn the decision to stop drinking, from your worst case scenario to the best decision of your life.

You will sleep better and have more energy, you’ll look better and feel better. You’ll have more patience and less anxiety. And with my approach, you won’t feel deprived or isolated in the process. So if you’re interested in learning more about all the details, please go to www.sobrietystarterkit.com. You can start at any time and I would love to see you in the course 

Casey McGuire Davidson  13:46

Yeah, I completely agree. And I think, you know, like many other things, there has actually been in terms of funding. It has been squashed funding for a lot of alcohol research.



Yeah, I mean, we have an AAA right, which is the National Institute for alcohol, it currently is called for Alcohol Abuse and Alcoholism, they’re probably going to change the name based on our, you know, are redefining of language right around. We don’t really say alcohol abuse anymore. But that’s what it’s called. And so, it’s funded by the National Institutes of Health. It’s a separate research organization from NIDA, which is the National Institute on Drug Abuse.


So, alcohol has its own little, you know, it’s separated out from drug abuse that has its own agency. And of course, the budget is much smaller, even though alcohol in many ways. I mean, you know, there’s it’s debatable is it opioids or alcohol that has the biggest public health impact in this country, but it’s, you know, they’re neck and neck? And it depends on sort of what kinds of harms you’re looking at. And it’s, you know, it’s a socially acceptable substance, right? More than any other one.


Casey McGuire Davidson  14:55

And so, definitely. I mean, even though I live in Washington State, I know many, many states I have the marijuana legal. I drive around my town. I live just outside Seattle in probably past 10 Marijuana shops in my general neighborhood. At the same time, I don’t know any parents who sit around at dinner or after dinner and smoke marijuana in front of their children. Do you know what I mean? Like, that is just not a thing that anyone I know is comfortable doing. Now that may be different for younger people. But I mean, as a 47 year old, I certainly know people who smoke pot. Nobody does it around their children where their children can see it. And that’s just an indication of like, alright, this may be legal, but I don’t necessarily want to influence my kids, or I don’t want them to do this. You know what I mean?



Yeah. But it will be interesting for me to sort of see over the next 2010 to 20 years what happens with the cannabis industry, right? Does it fully integrate and become sort of akin to and aligned with alcohol? Or does it sort of stay in this middle gray zone in some sort of way? I think it will be generational, as you say that, you know, high school students these days use cannabis just as much as alcohol as much as they drink alcohol. Right. So, it’s an interesting shift.


Casey McGuire Davidson  16:21

Well, so let’s. One of the things. One of the reasons I was, I am going to put this in the links as well. But the Huberman Lab podcast, which is a huge podcast and has a huge following. It’s science based, not about alcohol in particular, definitely not about sobriety, but did an episode on alcohol and its impact on your mind, your body, your health. What I think is really interesting about that two things, one, he did not, you know, in terms of the that’s a “they” problem, he focused on what was at the time, and is probably still is, it’s just starting to shift, the “recommended guidelines” for drinking, which is like, one drink. No more than one drink a day for women or two drinks a day for men, no more than seven drinks a week for women, or 14 drinks a week for men, which I know if you are a drinker, my friends are drinkers. Many, many, many people drink at that level that is not heavy, “heavy drinking” in society, and looked at the health effects of what that level of drinking the recommended level does to your mind, body, and health. And I want to talk about that.


And what was interesting was in the podcast, Huberman was literally apologizing for sharing this information, like, I am sorry to have to tell you this. I know it’s not what you were going to want to hear XYZ like apologizing to his audience for illuminating them. Of this fact, like, I just thought, I mean, he is a medical professor researcher has a huge platform has talked about all the subjects. I haven’t heard him apologizing for telling people about medical facts ever before in my life.



That’s interesting. Yeah. And in fact, those numbers that you cited is seven for women and 14 for men. Canada, actually, just recently, this year, they revised their guidelines. And now they’re saying no more than two drinks per week for everyone. But that’s the best the safe level that anything over two drinks per week is associated with increased harms. So that’s a that’s an even more drastic change. Of course, the US revises their guidelines every decade or so. So, I’ll be interested to see the next time this comes around, you know, if the United States follows in the footsteps of Canada and other countries and lowers that those levels even more, yes, and not only did Canada do that, but Ireland also did that recently.


And I mean, very real labels like required on individual packaging of alcohol products, think bottle of wine can of beer, very specifically and not tiny warnings on alcohol. And what’s interesting is that the Italian winemakers are super upset about it a link to the articles but are like, Oh my God, if this health information about alcohol gets out, it is going to damage consumption of our product and they were like why don’t you label spirits? And maybe beer but definitely not wine. And I mean, Ireland also I believe I’ll have to check but I’m on an 80% Sure was the first country to outlawed indoor smoking in bars and restaurants. And at the time, there was huge pushback that this people will rebel. This is awful. I mean, you think of drinking in Ireland, and smoking is like part of the culture. And yet, there wasn’t a huge push back. And now it’s adopted in so much of the world that there’s no indoor smoking.



Yeah, norms can really shift quickly. I mean, I remember going to bars and college and graduate school and you take the shower, the day after that tobacco smoke smell would just come out of your hair, you know. And now if I walked into any sort of bar restaurant or any place like that, and there were indoor tobacco smoke, I would be shocked, right? I mean, it’s that number has completely shifted over a pretty…


Casey McGuire Davidson  20:52

Yeah, I also remember. I was a kid, my parents are foreign service, we lived overseas, we would fly to Brazil, from the US, which is a very long flight. And there was a smoking section of remember that nonsmoking like in the front of economy. So, I’m an eight year old kid, and the person behind me is just smoking packs of packs of cigarettes in this tiny, closed air container. And now, I mean, I cannot imagine, I think if people did that people would turn around and be like, what the actual, you know, thing are you doing?



Yeah, although when vaping first took hold, I were being on a plane and seeing someone vape on a plane because you know, the flexions weren’t fully in place, and no one knew to tell them not to. Luckily.


Casey McGuire Davidson  21:43

We talked about it briefly like alcohols linked to cancer or health issues at what’s going on again. Can you share? Like, exactly if someone’s listening to this? They’re part of the 70% of the population that doesn’t understand the risk of alcohol to your mind and body? Can you share what that is?



Sure. So, I’m thinking like one step backwards first, to sort of situate why Canada made that change, and sort of the evidence that they were using that was really linked to that cancer link that I was talking about. So, the idea here is that we know there’s a dose response relationship between the amount of alcohol that you consume, and your risk for many cancers, as I said, including breast cancer. So, with breast cancer, I believe that it is each additional drink per day that you consume, increases your risk for breast cancer by 10%. So, that’s not insignificant, right? And that you think about how much people are trying to modify lifestyles to reduce risk for cancer. And this seems like a pretty obvious link. So, the reason that sort of historically, those levels were set out one drink per day for a woman and two drinks per day for men, that was really around cardiovascular disease risk.


So, we used to talk about what we call the J shaped curve. So, the idea here is that your risk for a lot of cardiovascular health outcomes slightly elevated with no alcohol consumption at its very lowest with one drink per day. And then you sort of went up rapidly, that J shape, right, and for the reasons that I talked about the beginning of the podcasts or on the Sick Quitter Effect, they’re all sorts of what we call confounding factors, right? They’re really sort of explain why you have that slight uptick with zero drinks per day. In fact, they went so far as an AAA, the National Health Institute’s on health institute that studies alcohol research, funded a randomized control trial. And this was only five or six years ago, that they were going to randomize people to have one drink per day and zero drinks per day, those who are people who already drink to compare their cardiovascular disease risk over the course of a year, they were trying to prove causally, that drinking low amounts of alcohol one drink a day was associated with lower risk for cardiovascular disease. And this goes to that, why can you recommend one drink per day and the French drinker paradox? Well, that trial was halted after it had gone on for maybe only one month. And really, it was because of this cancer risk. Right? So, this idea that we know that one drink per week, even its associated with an increased risk in cancer, there’s no safe level of alcohol consumption when it comes to cancer.


So, even if there were there’s very slightly protective effects, that really there’s no solid evidence at this point, that it exists with cardiovascular disease, because of your risk of other health complications. That’s never, you know, we’d never recommend someone have one drink a day for their health. So, sort of the where to start with what are the risks? I think it’s pretty safe. As you said, I sort of moderated it in the article that I wrote because they want you to you know, not come all the way out right and say it completely, but like, you know, the safe the safest level of alcohol consumption isn’t that and men You have these things are dose responsive, right? So, if you do have one drink a day that is better for your health than five drinks a day, six drinks a day, I am a full advocate of harm reduction approaches, right? So that if you are currently having four drinks a day, and you reduce that to two or three, or maybe twice a week, instead of five times a week, that’s all beneficial for your health. That’s better. Right?


So, this idea, you know, I, many of these things have this this response relationship, so sort of to go back to what are the, you know, what are the health problems that occur around alcohol use that cancer, right, any level and any increasing amount increases your risk for a whole range of cancers, cardiovascular disease, there’s really no good evidence to summarize that one drink a day is better for your health. And once you get to two to three drinks per day there, there’s lots of evidence that it increases your risk for cardiovascular disease. So, you know, that’s really well established mental health. Of course, when we think about mental health, it’s complicated and bidirectional, because of course, drinking more can cause, you know, sort of exacerbation of mental health symptoms. But of course, having depression or other mental health disorders, of course, can increase your risk for alcohol consumption. So, it can be a cycle, right, that’s bidirectional, but they’re, you know, they’re very clear links for, you know, almost any mental health outcome, right associated with alcohol and other substance use. A lot of the work that I do is around community violence, gun violence, intimate partner violence, child abuse, and neglect. We know all of these things are linked with alcohol use. I mean, once again, sexual violence is another big one. So, I have a study right now, looking at alcohol involved sexual violence on college campuses, and that’s a huge problem.


So, you know, this really, it spans from chronic diseases are classic chronic diseases, that many of them are linked to alcohol to mental health, to other kinds of, you know, violence and behavioral health outcomes. So, it really spans and none of the, you know, all of these are linked to alcohol consumption, even at low risk, low levels, and the risk continues to increase the more that you drink.



Yeah, absolutely. That’s a long answer.


Casey McGuire Davidson  27:12

That is literally, exactly, what I wanted to know. And I think, sometimes, I’m so glad I have a son and daughter, who I can’t believe my son only is three years before it goes to college. But I’m so glad you’re doing that study on alcohol and college campuses, and all the risks associated with it. And I also think that the working mom who comes home and opens a bottle of wine every night and has three glasses is like, of course, you shouldn’t drink and drive. And of course, you shouldn’t, it is a big risk for my kids in college. And I don’t want my daughters to drink it. I also don’t want my son’s to drink too much, you know, because of XYZ. And of course, it contributes to domestic violence and sexual abuse and other abuse. But that’s not in my family in my home, I would never, which is wonderful and amazing. And also, I think because of the way we’ve been marketed to, we think so as long as you’re not pregnant, and as long as you’re not drinking and driving. And there’s a very good reason we think that’s right, that’s what’s on the bottles, that’s what’s on the bathroom door in bars and restaurants, then this is perfectly fine. This might actually be good for me, you know?



Absolutely. And another large part of my research and something that I’d like to bring up, because I think it’s really important is what a sort of, we refer to as alcohol inequities. And what I mean here is that, in particular, people who have minoritized, racial, ethnic identities, minoritized, sexual gender identities, the number of problems that accrue at the same level of alcohol consumption look really different. Right?


So, a lot of this, like, I can have three drinks a day, I’m fine. You know, there are many people. I have a former mentor, who’d always talk about sort of the, you know, the older, wealthy white man who’s had a bottle of wine a day for his whole life, and has really never experienced major consequences from that alcohol consumption, right? If he goes out of the blue bar and gets too drunk, he can call a taxi, finish take a day off of work he can write, so there may be this chronic health conditions, but really, he continues to live his life because he’s buffered from some of these acute consequences.


When you have additional stressors in your life, you know, the whole range, right? When you have some of these minoritized identities, you know, your stress response, all of this looks very different. So, the risks that accrue around one to two drinks a day that you sometimes don’t see in other groups, and here I’m not talking about cancer, right the physiologic response will be the same, but you know, there are a It doesn’t impact everything in the same way at the same level of, “moderate consumption”. And I think it’s important to point that out to people who, maybe, don’t have any of these minoritized identities and are unaware of this. Right.


So, this is again, like thinking about it from a population level, sort of. All of us together, who is impacting, who is shouldering the burden of consequences? And is it really fair for the rest of us to not understand that, right? I think, I just, I always like to point that out.


Casey McGuire Davidson  30:27

Yeah, absolutely. And when you talk about sort of the impact, it’s not that it’s not clearly, you know, disrupting sleep, causing issues with their body causing issues with their brain with their memory, you know, going, it’s like, they can financially afford it, they can get through it, they can get help. I actually, just yesterday, talked with someone who runs an inpatient treatment center. They contacted me. They’re sort of interested in post care and resources for people in different areas. And I am a huge fan of inpatient. If Coaching groups, support, meetings, whatever it is, is not enough for you. And for very, very many people, they do need to be removed from their current situation removed from alcohol, have time to heal, etc., etc. But when you’re talking about resources, I mean, this facility is top of the line, it is gorgeous. It is a former Hotel Resort, the one you can have time to do meetings, lots of CEOs go here and other people, right. I asked how much it cost. $75,000 for 30 days. I mean, my god, I almost choked. And I was like, I get it. That’s incredible. I am glad that people who say anyone who struggles with alcohol can get the care they need. But oh my god, you know what I mean?



Absolutely, yes. And I think, yeah, when you think about cost effectiveness as well, I always like to sort of put in a plug for prevention and primary prevention. And so, this is once again, where the public health perspective comes into things.


So, you know, we have known for 40, 50 years, there are structural policy, community state level things we can do to reduce the risk of developing an alcohol use disorder, or this impact and you know, getting to this place with this really expensive treatment where not everyone can access it, and it exacerbates inequities, right. These are simple things like taxes, right, increasing taxes on alcohol, decreasing the hours, the bars are open, decreasing the number of bars and off premise outlets that sell alcohol. You know, they’re pretty straightforward things. And you see, once again, shifting that curve, they make a really big difference. We saw this when the legal drinking age, from 21, down to 18. And then to 21, again, had a big impact.


In the UK, they recently, they use their bars. Used to close much earlier, a lot of them had rules about midnight, or 1:00a.m. And they extended it to 2:00a.m, 3:00a.m. And all sorts of problems started popping up at the end of the night, right, like violence related problems. So, you know, people may not like these because they like their alcohol to be convenient, right? The majority of us drink. And so, the majority of us want to have cheap, easily accessible alcohol. But these are all choices that we made that have a big impact.


Casey McGuire Davidson  33:41

I’ve talked to doctors on this podcast before and one of the things that I think definitely could help, I mean, everything you mentioned, absolutely. But also, when you go into your primary care doctor, they do early screening for diabetes, they do early screening for high blood pressure. They literally are not taught to do any screening for alcohol use disorder in the mild, moderate, or severe stages. I’ve talked to them that said, on their rotations, you have to specifically opt in to learn about addiction medicine. There was otherwise a total of two hours in medical treatment that touched on this. And that’s incredible to me when you talk about it being one of the you know, one of the five most preventable causes of death, essentially.



Absolutely, yeah. And, you know, even when they do say, oh, there’s screening sort of in parallel with this, I don’t know if this has ever happened to you. But it sort of became the norm in the last maybe 10 to 20 years that particularly when you go See your OB GYN? They’re supposed to ask about, you know, partner violence. And I can’t tell you how many times they’ve said to me, Oh, well, like your I didn’t ask you this question, right? Like, you and your husband are fine. Right.


So even when they have screening questions, they you know, so they will take you take a look at me as like a nice white lady. And so even if they were assessed with alcohol, my guess is most of them would say, I don’t need to ask that question.


Right. Fine. And we’ll make assumptions. And they don’t even do the basic screening when they’re supposed to.


Yeah, definitely.


Casey McGuire Davidson  35:29

And also, I mean, yes, I went to doctors for years, and completely downplayed how much I drank? Absolutely. But there are ways to ask questions to uncover, especially in the early phases, like, do you ever not remember stuff after you drink? Do you ever wake up in the middle of the night? You know, do you have increased anxiety, one of the first steps you can take is to remove alcohol and see what that does for your anxiety and sleep. You know, we are much more likely to be prescribed Ambien. When you say you wake up in the middle of the night, and I’m talking from personal experience, then to ask, okay, does that happen more when you’re drinking before I prescribe you Ambien? I’d like you to stop drinking for a period of time, because then I was drinking a bottle of wine a night and taking Ambien because that was, you know, my solution to the problem. Could be deadly to do that.



Yeah, absolutely. And yeah, we have so many really short, basic screeners for alcohol use disorder that includes right like the audit, it has mild, moderate, severe. So, it classifies those. And there’s different ways. And almost everyone scores mild, right? Anyone who consumed any alcohol to see just like the beginning of social consequences, for example, right? Or the basic physiologic consequences, like, oh, I had a hangover last month, right?


I mean, you start to see it at pretty low levels of alcohol consumption. And in the research and in some clinical settings, see screeners have been used for decades, and are very well established and really do a great job picking up on alcohol use disorder.


So yes, they should be in primary care settings. I mean, I know that our primary care physicians are already greatly overburdened. But this seems to be a place that would really, you know, that basic screening, it’s like a basic health screening seems, if that were more widely implemented, I think that’d be very beneficial.


Casey McGuire Davidson  37:32

Yeah. And I know many people who have finally worked up the nerve to say something to their primary care doctors or to their therapists, that they are concerned about their alcohol use, or they’re worried about it. And personally, and from women I’ve talked to, I mean, it is so brave, and takes probably years to ever broach that with a medical provider just because of the society we live in. And many times, I’ve heard people say, you sound fine. That’s not that much. Why don’t you just cut out the last drink? Or will you’re not an alcoholic? Right, which isn’t even a medical diagnosis? It’s not even in the DSM?



Yes. And I think it’s, it’s missed much more often in women than in men. Right? It’s not picked up on and I think a lot of that is for some of the reasons you’re talking about here, sort of culturally, and then our friend groups as we think about it, right? What’s considered normal, or you’re still functioning, you’re fine, right? I found it very interesting that, from my larger sort of extended social network, the friends of mine who are, you know, recovery and sober now, many of them are gay men. And a lot of that’s because, you know, they drink more heavily in their 20s, some of my friends, but they were really became in their friend group, I’m thinking of friends in New York City, a norm around, you know. Okay, many of us are sober, and we don’t drink and we’re just fine. And once that sort of becomes accepted, and the conversation is normal, and they know, the physicians they can go to and sort of where they can get that help.


You know, it’s like this tipping point. And once that sort of becomes more well established, I think it’s easier for people to access the care they need. I don’t hear those kinds of conversations around my mom friends. And most of them drink and I that there’s no norm like that.


Casey McGuire Davidson  39:28

Yeah, and most drinkers to be fair surround themselves with other drinkers. I mean, obviously, when you mentioned like, you know, X percent of the population has one drink a month, I was like, Oh my God, who are those people? I’ve never even heard of them. Like, I don’t know anyone, either. I mean, obviously, I have a lot of sober friends now. But when I was drinking, I didn’t know a single person who was sober and like, no one I was having one. But like, that’s insane to me. But I love the idea of the tipping point. And I think I’m hoping one of the reasons I wanted to do this episode is because I have a lot of clients, I hear from a lot of women is that, you know, the easiest way to tell someone you you’re not drinking is okay. I always say, like, tell them you’re doing a health challenge, tell them that, you know, you’ve decided to see how you feel with a period of time without alcohol, it impacts you know, you sleep worse, you have more anxiety, you’re more prone to depression, you have less energy, you’re more content when you don’t drink.


And by the way, it’s there’s no question, it is bad for your health. And even when women say that, they’re told, often by the friends and family, like, why everything in moderation, it’s no big deal, I run a 10k. And I drink, you know, which is totally fine. But like you said, in terms of the tipping point, I just want people to have the information out there.

So, for the 70% of Americans who actually believe that

moderate drinking is good for you,

and has no idea about the link to cancer, like, just share this information, like no judgment, but be informed.



Exactly. And as I said earlier, you know, I am all about like a harm reduction approach. And I understand, you know, reducing is better and monitoring again, I mean, I’m not a super person, I don’t drink that much. But I, you know, I drink alcohol on occasion. And those are choices I make. I mean, we do all sorts of things, all of us that increase, you know, health risks, but I agree, like, where I really want this conversation to go is for people to be comfortable with whatever choice they make, and to be aware of the choices that they’re making, right? That these are not health neutral decisions and choices that we are making. And for so long, I just feel like people didn’t know. And I just want the conversation to be more open.


And that’s also how I feel about it shedding light on the alcohol industry. And these things like it’s never going to go away. It’s a multi hundreds of billions of dollars industry. But I want people to understand what is happening, right. And I just think that’s not the final solution to all these problems. But it’s a really important part of the conversation. And so, I’m so happy to be able to talk about these, these things.


Casey McGuire Davidson  42:16

Yeah. And when you think about all the things that people do, that are featured on like People Magazine every January to improve their health, I’m cutting out sugar, I’m cutting out gluten, I’m doing XYZ, and I’m very anti diet culture, right, everyone, you know, it’s like I do intermittent fasting. And I’m like, Yeah, you want to get healthier by cutting down on alcohol, like that is awesome. You’re cutting out gluten for like gut health issues or taking some supplements, but like, want to fix some gut issues, like, by the way, so I mean, but people really think like, oh, red wine is good for my heart. Like, you know, it’s just crazy. And one thing I wanted to mention, we talk about Canada, and Ireland, and yet, I mean, I do see very minimal progress in the US like but in the spirit of nope, no, no shit too little too late.


In June 2020, was the first time that the American Cancer Society made a change to its guidelines on cancer reduction and prevention, saying it’s best to cut alcohol out completely from one’s diet. Finally, they said it’s best not to drink alcohol. Previously, the frigging American Cancer Society in January 2020, recommended limiting alcohol consumption to one drink a day for women and no more than two drinks a day for men. And yet, they have known that alcohol use is one of the most preventable risk factors for cancer for years and years and years. Right.



Right. Yes, absolutely. It certainly backs up what you were saying about the red wine, which one of my pet peeves in alcohol research or even how alcohol is talked about is people saying, well, red wine is better for you than beer or, you know, the worst for you is hard liquor. Right?


Like, alcohol is alcohol, a lot of ways making these distinctions about like healthy alcohol versus not healthy alcohol, or you know, fewer calories. So, it’s better for you or you know, comes from a great so it’s better for you, you know, I just have like, little to no tolerance.



I mean, it’s amazing. So, I know you’ve done research, or you have your personal perspective on this, but like, Why the hell did it take till June 2020. For the freaking American Cancer Society to stop recommending an amount of alcohol that is directly associated with cancer risk?



Good question. It’s hard to answer, right, of course. But I’m sure that part of it is this, you know how embedded alcohol is in our culture and people worry about messaging that totally misses the mark. Right. So, like, I feel like they probably thought that, you know, we should talk about what we’re left with alcohol consumption. And that matches what the FDA and the federal government and NIH, what everyone is telling us is in terms of healthy alcohol consumption, and so much of it right, when you talk about like, low level exposure comes down to animal models, understanding, it’s hard to measure precise risks, right, with like, low levels of exposure to anything. So, I’m sure, part of it was just, like, what were is better or matches everything else. No one wants to go on the limb and be that person, because they’re also there’s going to be a lot of pushback, right?


Casey McGuire Davidson  45:54

So, I’m having medical evidence to the contrary, and being the American Cancer Society, you have one job, literally one job, which is to research and communicate risk. So anyway, that’s just, I’m happy. But it kind of pisses me off.



Yeah, no, absolutely. And, you know, I guess it’s good. They’re going in that direction. But it just was so unknown as well, right. Like one of the reasons that I wrote this article this winter, I had written this similar one, maybe four or five years ago and sort of updated it. And one of the reasons was, this article had just come out showing that was something like only 30% of American adults knew that alcohol was associated with cancer.


I mean, it was well under 50%. Right. People just don’t even know. And so yeah, I wanted to just begin to talk about like to point that out.


Casey McGuire Davidson  46:45

Yeah, absolutely. The one thing about the American Cancer Society I would say that they’re still considering their mandate not scaring people too much and literally in their guidelines it says quote, unquote, it’s best not to drink alcohol. They’re not exactly like scary this shit out of people, although the CDC in the frequently asked questions about alcohol. Now states, drinking is associated with numerous health problems. I just want to read these off. Chronic diseases such as liver cirrhosis, damage to liver cells, pancreatitis, inflammation of the pancreas, various cancers, including liver, mouth, throat, larynx, the voice box, and esophagus. Also, breast cancer, of course, high blood pressure and psychological disorders like, yeah, totally cool. Just good to know that, that’s something to look at.


I was actually in the airport. I was flying back from Africa. So we were in Europe, Germany, and I went through the duty free shop. And I was taking pictures because in duty free, they sell just tons of alcohol, right without the tax, that there’s just giant spirits and wine and beer, and they also sell cartons of cigarettes. So, on the cartons of cigarettes, I should put this with this episode. There were just these like, cigarettes cause cancer, like literally is associated with preventable death, like huge. So, I was taking pictures of them husband’s like, What the hell are you doing? You’re going to get in trouble. I was like, why would I get in trouble for taking pictures of these warning labels, but just the fact that the amount of marketing dollars that go into glamorizing alcohol, as required. It’s, it’s just amazing. And I get it, I used to be in marketing, and I actually strongly considered working for a wine company in their marketing department. There’s one three miles from me, before I quit drinking. I mean, I get it, but like, also, I think just not having the information is problematic. Or when you do have the information being told by the people in your life, like, Yeah, that’s actually not true. You know?



Yeah. And actually, part of the Canada is discussing right now adding warning labels similar to tobacco labels to alcohol products in Canada. And I could imagine that eventually, in the, you know, five to 10 year time horizon in this country eventually happening as well, right, those tobacco warning labels were not there for a long time. But as I said, we’re like 30 years behind, you know, alcohol and tobacco. They should sort of be in parallel, but they are not in terms of the interventions and where we are and what’s happening and what the conversation is. There are discussions about it, right, but it’s still in the early phases. So, we shall see where that goes.

Casey McGuire Davidson  49:57

And I definitely, you know, kudos to Canada in Ireland for leading the pack, I found the article I was looking for. So, in Ireland, there was strong public support for the labeling regulations where 72% of consumers agreed that they have the right to be informed in advertising, of public health risks from alcohol use, which feels so basic. But that’s cool. The guy in charge of Italian wine, the industry, expressed grave concerns. The President said that the proposals risk opening the door to alarmist and unjustified legislation capable of negatively influencing consumer choices (a.k.a. if you’re told that alcohol causes cancer, you might choose not to buy it). And the article says if the legislation negatively influences consumer choices, that will be based on hard evidence that is often swamped by glossy expensive marketing campaign.



Yep. And I think it goes back to that initial point I was making about seeing alcohol use as a public health as a population level problem, right? The alcohol distributed very happy for us all to consider everyone, you know, we can say some harms, but it’s up to everyone’s individual choice, it’s just an individual behavioral choice has nothing to do with the context of our lives and how alcoholic glamorized and how easily available it is, and how inexpensive it is. Right? And people, you know, they want us to keep seeing it that way. And someone with an alcohol use disorder, they want you to label that as a personal failing, right, that was a choice that you made, and that is your fault. And your problem, and you alone can fix it, right? Like you can spend $75,000 on treatment, that is just, you know, just simply not the case. You know, like, of course, toys, the UK, everyone makes individual behavioral choices, but that’s within the structures of our lives, the context of our country, the policies that we have, right, sort of the, our social networks and our norms. And, you know, I just, it also breaks my heart that people see it as just individual responsibility and failing, right, this is a, we’re all in this together, right? We live in contexts and cultures, and there are things that we can do collectively, to reduce the impact of alcohol.



And it’s addictive, right? That is the only thing you have to add is not communicated that if you go down the road of drinking more, and drinking more often this substance is working as designed. It is the substance itself that causes you to go into withdrawal and then want to drink to get back to your normal. It’s insidious. It’s progressive. It’s almost imperceptible, at times. And



it’s almost as addictive as any other substance in the world. Right. Yeah.


Casey McGuire Davidson  52:53

So, can you talk a little bit about the addictive nature of alcohol? How it works?



Oh, yeah, I mean, I’m not I’m not a neuroscientist, right. So, like, I’m not the person to go into all those details. But, you know, in terms of physiologic dependence, right, like withdrawal from alcohol, when you have alcohol dependence, right, which is all the way sorter the far and have an alcohol use disorder. You know, detox, it’s worse than heroin, right? I mean, it’s the absolute sort of, like, most physiologically addictive.


So, as I said, I don’t study this, but my father actually was a neuro psychologist, and he taught a class on drugs and behavior. And so, he taught like, exactly these things. So, he would always tell me about different substances and like what to worry about, and what sort of be the consequences. And so, not only is it just like the dependence, the physiologic dependence element of alcohol, it also is so it’s ubiquitous, right? It is everywhere.


So, talk about like, cues, and triggers, and staying sober. It is much harder to do that with alcohol than almost any other substance as well, because it’s everywhere. And probably most people most of us know, drink. And don’t see the bigger problem don’t understand those consequences. So, you know, at that end of it, the alcohol use disorder spectrum, it’s really serious. And people. Yeah, I don’t think that it’s like fully acknowledge that that’s the case. It’s not just the, you know, the unstable the house person you see on the street, and, you know, like we have these, these, these visions in our heads that are just completely false, you know, don’t match the reality.



Yeah. And I think that’s, you know, really important to both share, that moderate drinking does have risks, right. And the risk is not just I’m going to drink too much and drink and drive or I’m pregnant and will damage my unborn child. It has longer term risks that you’re probably not aware of. But also, when you get the point of severe alcohol use disorder. Actually, just stopping is incredibly dangerous and can be fatal.



Absolutely. Yes. That’s a wonderful point. Exactly. It’s a spectrum, right. And you know, risks get higher, and consequences get more the farther you are along that spectrum. But yeah, so I think, you know, both pointing out these risks, especially with moderate alcohol use and understanding, you know, shifting the population curve, a tiny bit has these big overall impacts on cancer and other things, while also acknowledging that, you know, alcohol use disorders are so common, I think it’s something like 30% of all Americans, at some point in their life would have qualified for an alcohol use disorder, I mean, many of us, right, have symptoms of absolutely be moderate alcohol use disorder in our 20s. Right, that’s a not uncommon thing at all. So, there’s, you know, natural recovery, people change their drinking patterns and behaviors, sort of, because their contexts change, right. And they’re not around people drinking as much. But that, of course, is not the case for many, many millions of people as well. And so, keeping all of these risks in mind, I think is really important across the spectrum.


Casey McGuire Davidson  56:03

Yeah. And now we just, I mean, it’s not a medical term, but we talk about in sort of culture and society, gray area drinking, which is sort of on that spectrum, which I think the vast majority of Americans fit into that category where you are not, quote unquote, fine, or an alcoholic, I actually hate that word. But there is a spectrum of alcohol use disorder that most of us fall into that this gray area problematic or unhealthy drinking, although we just talked about that no drinking is actually healthy. And, you know, I think that’s good to know.


So, the one thing I wanted to say is, if you’re listening to this, and you are worried about detoxing, please, please, please go to a medical detox, it can be very, very dangerous to do it on your own if you’re actually physically addicted to it. I’m looking right now at the warnings, labels that Ireland is proposing for like the actual bottles and packaging for spirits, including wine or beer. It literally says drinking alcohol causes liver disease period, there is a direct link between alcohol and fatal cancers, period. I mean, that is true. And amazing.


Why? when I was drinking, I would hate that I would have been like, Please, this isn’t true. This can’t be right. Why the hell are you showing this to me? This is making my wine bottle on taking a picture of look significantly less sophisticated in my Instagram photo, like you’re killing me here. The one thing I don’t see on the label that would also be helpful is just alcohol is addictive period. Like those three things, you know?



Yeah, I mean, there’s a lot of in the alcohol research world right now. It’s not my area of expertise, but many people focus on marketing and communications. And so, there are studies going on right now about what is the most effective message to put on a label because people are hoping right that the US will be moving in this direction or specific states. So, they are doing great research on exactly this, like what are the most effective messages and usually is some sort of rotation of three to five different distinct messages.


Yeah, exactly that sort of span that risk I think some about you know, the harms of moderate alcohol consumption, some about the harms of severe alcohol use disorder, right? And but simple to the point you can read it, you know, just see your like, funny mom juice label or whatever. I have a friend who’s an anthropologist who studies sort of studies like, you know, Wine Mom culture and all the bottles, you know, at the front of target with like the funny labels on them, and you introduce me to your friends.



Absolutely! Learn more about her work and I think I was a Sociology in American history. I think it was made up major American Cultural Studies major in college. And so, I’ve looked at this a lot through sociological lens, never through an anthropology approach. So, I would,



yeah, I have several anthropologists alcohol and apologist friends who study alcohol use, and we often will take when we serve see it out in the wild, these funny things will take pictures and send them to each other of like, oh, it’s like what targets doing now? Like,


Casey McGuire Davidson  59:27

oh, my god, please introduce me. I love Target, but fascinating. Well, it’s not just target in Trader Joe’s. In September, you walk into any Trader Joe’s, and they literally have hanging from the ceiling immediately when you walk in back to school supplies here in a cute little sign with an arrow down in a huge case wine display like multiple cases of wine. And of course, I used to love Trader Joe’s because they have like, two Buck Chuck like, literally. We can get a bottle of wine for like 299, 399.



Well, that shows you how the different policies there’s a difference and Pennsylvania, only three years ago did they start paying to be able to sell any alcohol in grocery stores, you could only get them from state controlled stores. So, Trader Joe’s here do not sell alcohol. And then of course, you know, to buck Chuck was $2 in California and $3. Elsewhere. We finished this. We did a study over the last five years or so. And a big part of it was went into every single store that sold alcohol on the East Bay in California. So, Oakland, Berkeley, that area. And we talked to people about also, where do you most often buy alcohol? And by far, like 20% 25% of our sample, which was a random population sample, there alcohol most often at Trader Joe’s was the hotspot.


Casey McGuire Davidson  1:00:47

What was that percent?



Oh, if our sample was like 20%, plus, and 10%, were in this one in Rockland, this one Trader Joe’s that I used to go to when I lived in Oakland. And it’s because of, you know, what we call bundling. So, this idea that, like, want to buy alcohol, where it’s convenient, and inexpensive, right, so you’re going to Trader Joe’s to buy your groceries and like up there. So, you know, $5.06 pack of beer, I’ll just grab one of those while I’m here. So, it’s not these like corner liquor stores like that, glamorize that sort of the


Casey McGuire Davidson  1:01:16

path to like, go into the gas station in a bad neighborhood or whatever goes in the whole foods. Yeah. So, I used to go to the grocery store in early sobriety, which is so hard. And honestly, before I quit drinking, and I often said, Oh, never mind, let me just buy a bottle of wine, you know, because I don’t want to drink more than a bottle. And then, you know, three days later, I would be like, let me get the six pack in the cute little bag for the 10% off. And then, I would go up to the checker and be like, I’m having a party. I was not having a party, like, it was just so uncomfortable. But I used to go into the grocery store. I would put on my headphones and listen to a sobriety podcast, or something, to remind me not to buy that shit. I used to sing in my son, I’m totally dating myself. But when I was a kid, there was a sunk poison, there was like a whole dance associated with it. I used to walk by wine displays, and be like, That shit is poison, like, I would think to myself. And it’s insane that as a mom, going to a grocery store, these are the things, you know, a career woman at a fortune 500 companies, they are all the things that I personally had to do to not pick up an addictive drug when I was buying food for the week, right?



Well, and this is why being in a state that has a state controlled, you know, non-privatized liquor control system, alcohol control board actually makes a huge difference. Because then Pennsylvania gone to the grocery store, and you don’t see that right, you have to go to the State liquor store to buy your alcohol. And that makes a big difference.


Casey McGuire Davidson  1:03:00

That was one change, that could make a huge difference, because my husband still drinks beer. And now I actually go into the section a lot because I’m, I love nonalcoholic beer. It’s like my favorite. I love athletic Brewing Company. But for a good year, I would not buy my husband beer, I would just be like, I mean, I was kind of pissed at him because I still wanted to drink. So, it’s like, you know what, by yourself, like if you want it, but I also was like, I don’t want to go down that aisle. And you know, now, I’m fine with it. But I’m also seven years alcohol free, probably fine with it over the last, you know, after the first two years, but it’s hard. And then also you’re confronted with it, where you would not expect to, so I go into our drugstore to get my prescriptions and like, I don’t know, make up tissues, something I’m checking out, there is a display at checkout of wine in a can touting like recyclable, convenient, you know, like, and people are putting hands of wine in their purse, you know, to go to Washington was one of the last states to privatize actually, they used to have a state controlled liquor system until not that long ago. And so, you know, it used to be most states were run through state because it was great for state income taxes.


I mean, I grew up in New Hampshire and people would drive over the border because alcohol was so much cheaper. But you could only buy it at like two different stores. Right? There was one place you had to go 20 minutes away to get your alcohol it was slightly less expensive, but imbalanced. It was totally worth it right because it wasn’t everywhere. But because of the alcohol industry and their partnerships, right like they tend to, they’ve been knocking them down one after another and Pennsylvania was one of the last states that had a fully state run Liquor Control Board, and they still are that way with hard alcohol. But beer and wine are now in grocery stores since I moved here nine years ago.


So, you know, everyone’s going the wrong direction, not the right direction, unfortunately, because there’s tons of evidence. So that makes a big difference.


Casey McGuire Davidson  1:05:08

But yeah, here we are. I mean, it is what it is right. But it is interesting. And I also read that I don’t remember what country it might have been Japan, it might have been somewhere else was actually doing an ad campaign to get people to drink because younger generations were not drinking, and it was impacting their revenue, their tax revenue base. So, it was like, take one for the team, buy some alcohol so that we can pay for your schools. I don’t know what the campaign was. But I mean, it’s amazing.


So, we are definitely like Pennywise, and pound foolish in terms of $1 here for the tax revenue this year, versus huge public health risk and cost to mass population level issues that will cost the state’s the country a lot of money, right, that’s a problem, just double the taxes on alcohol, and then the people buying alcohol will make up the revenue, right? Like that’s the solution.


Casey McGuire Davidson  1:06:12

Yeah. Right, because 20% of the drinkers drink 80% of the alcohol consumption, right. And if they can’t afford quite as much, that’s not a bad thing. That’s a good thing. Right?


So, but, you know, taxation is the easy solution. It just becomes more special more of a treat something you’re exactly X amount of the time versus daily bottle and a half. And I think that’s that would be amazing too, as well as not selling it in grocery stores drugstores. And as I’m saying that people are probably getting pissed, and I get it, I would have been pissed. If you raise the taxes on my wine, it didn’t sell it at Trader Joe’s and at the pharmacy, but just saying hopefully the world will change. And then more people will have early intervention, right? High blood pressure, oh my gosh, if you stop earlier, or harm reduction, right, if you drink less, because you are aware of the health implications. If you don’t think three glasses of wine every night is innocuous, you will be healthier, you just will and you’ll be happier, because you’ll have less anxiety and depression and better sleep. And you’ll look better, because drinking alcohol is horrible for your skin. So, if you stopped drinking purely for vanity, you would look younger.


You’re very convincing.


All right, good.


Well, thank you. Is there anything else you want to share? Before we end this?



No, I think that we covered everything I was hoping to talk about. So, I really appreciate it. This was really fun conversation.


Thank you for letting me talk about all of this, that you know it. As I said, it feels like something that I didn’t get a chance to do very often. And now with a Dry January has been marketed right. And people started to have these conversations, I’ve been having some more opportunities to just, you know, talk basics. And I’m really appreciative because I think it’s really important. And I enjoy doing it. And yeah, I just hope that more and more people sort of are aware of all the nuances and contours of this conversation. Because obviously alcohol is so ubiquitous. It’s such an important part of our culture that I think we all need to be more thoughtful about it.


Casey McGuire Davidson  1:08:25

Yeah. And thank you. I know, I read your article, and I messaged you out of the blue, I searched out your email address, but it was it was exactly what I wanted to talk about. And just so everyone knows, this isn’t just opinion, there are so many scientific articles. There’s so much research backing up every single one of these points that we’re talking about. And I’m going to link to every single one in the show notes of this episode, because there’s a lot of misinformation out there.


And of course, do what you will with it. I am not going to apologize like Huberman Lab, even though I adore him. I’m so happy that I am not going to apologize for telling you scientific information about your health. But you know, when you know more, you can change things if you want to.


Exactly. All right.


Thank you so much.



Thank you for listening to this episode of The Hello Someday Podcast. If you’re interested in learning more about me or the work I do or accessing free resources and guides to help you build a life you love without alcohol, please visit hellosomedaycoaching.com. And I would be so grateful if you would take a few minutes to rate and review this podcast so that more women can find it and join the conversation about drinking less and living more. 


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