Be Skeptical of 'Beneficially Coercive' New Rules for Booze
A New York Times essay helps illustrate why the surgeon general's new report on alcohol and cancer leaves out crucial context and nuance.
A new warning from Surgeon General Vivek Murthy that links alcohol to cancer ought to raise questions about the purpose of such public health edicts—especially in the wake of the COVID-19 pandemic, which saw a dramatic decline in Americans' willingness to trust such expertise.
Is the goal of public health to provide scientifically accurate information so Americans can understand the risks and trade-offs that are an inevitable part of life?
Or is the goal to change public behavior to eliminate risk, and to force that change if people are unwilling to go along?
Writing in The New York Times, physician Rachael Bedard argues for the latter. She likens Murthy's new warning about alcohol to vaccine mandates: A "beneficially coercive" policy that "can evolve over time as people get used to new expectations and restrictions."
"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," she writes—as if human beings were wild animals that the state is charged with domesticating, rather than rational actors with free will.
But Bedard is merely stating the quiet part out loud—even as she admits that "a majority of Americans might not be in the mood for the surgeon general's advice." Indeed, she also acknowledges that the surgeon general's report isn't meant to convince ordinary Americans to change their behavior—like her husband, who apparently rolled his eyes when told about the advisory. Rather, these "recommendations, like the one to change alcohol labeling to highlight cancer risk, are policy ideas."
In other words, they're not meant to convince you to do anything differently. They are meant to convince policymakers, who will then make the decision for you.
It's a safe bet that Americans are in no mood to be scolded by public health officials these days, when the noble lies, shifting science, and officially authorized misinformation from the pandemic is still fresh in mind.
That would be true even if Murthy's edict was based on sound science.
It's not. Murthy's report claims that drinking beer, wine, and liquor is "a leading preventable cause of cancer in the United States" and that "evidence shows that this risk may start to increase around one or fewer drinks per day."
The evidence actually tells a far more complex story. Of the more than 740,000 cases of cancer worldwide in 2020 that Murthy says could have been prevented by abstaining from alcohol, more than 75 percent were attributable to people who had more than two drinks per day.
In other words, Murthy is simply restating what's already well known: That drinking a lot of alcohol, and doing it routinely, is dangerous to one's health.
Drinking less than that, unsurprisingly, is not as bad. There are still risks, of course, but the distinction between moderate drinking and heavy drinking is an important one. As Reason's Ron Bailey pointed out: "Assuming that Murthy's figures are correct, then only about 3.2 percent of the annual 609,000 cancer deaths last year are attributable to drinking alcohol. Of those, moderate drinking contributed to 3,400 deaths last year, amounting to just 0.6 percent of all cancer deaths."
It's also notable that Murthy's report makes no mention of the recent National Academy of Sciences, Engineering, and Medicine (NASEM) report that found "no conclusion could be drawn regarding an association between moderate alcohol consumption and oral cavity, pharyngeal, esophageal, or laryngeal cancers."
The lack of nuance and the missing context in Murthy's report makes more sense when you consider Bedard's point of view. If the goal of public health is to be "beneficially coercive," then it becomes easier to justify leaving out data and information that run counter to the predetermined conclusion.
A more effective public health effort would remind people that excessive drinking leads to a wide range of negative outcomes, including a heightened risk of cancer, and that moderation is a healthier choice.
In rushing to convince everyone that a single sip of booze is dangerously risky, however, the public health establishment is likely to succeed only in getting more Americans to (rightfully) roll their eyes at this nonsense.
