Despite inconclusive evidence, neoprohibitionists press their anti-drinking agenda

By Andrew Stuttaford

In a recent article for National Review on neoprohibitionism, I touched on the controversy over a report on alcohol and health that had been commissioned by the Joe Biden administration.

The story begins with the World Health Organization:

In January 2023, the World Health Organization stated that, in the absence of any detectable threshold at which the carcinogenic effect of alcohol kicked in, it could not identify a “safe” level of consumption. Coming to a conclusion that will delight the temperance groups with which it has closer ties than it should, the WHO declared that alcohol’s risks start “from the first drop.” Allegedly, the harms of alcohol outweigh any potential protection that moderate consumption might offer against heart disease and type 2 diabetes — the ‘contentious’ J-curve thesis loathed by the nanny state’s health-care establishment and the rent-seekers who feed off its work.

More of the same was to come in January 2025 when Vivek Murthy, the outgoing surgeon general, issued a report in which alcohol was listed as “the third leading preventable cause of cancer in the United States, after tobacco and obesity.” The risk of certain cancers “may start to increase around one or fewer drinks per day.”

However, the National Academies of Sciences, Engineering, and Medicine cheered things up a bit. NASEM had been recruited to help draw up the next edition of the Dietary Guidelines, and its findings (published in December 2024) were, I related, less bleak:

[It] concluded with ‘moderate certainty’ that ‘compared with never consuming alcohol,’ moderate alcohol consumption (immoderately defined as two drinks a day for men and one for women) is “associated with lower all-cause mortality” but, less happily, an increased risk of breast cancer. Contrary to the logic of the surgeon general’s report, moderate consumption was not associated with an increased risk of mouth or throat cancers.

The Biden administration, however, also asked a relatively obscure body — the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD; emphasis added) — to weigh in on the effects of adult consumption of alcohol. A draft of its report was released in January 2025. The authors agreed with the surgeon general that “increased risk” for seven types of cancer begins with any alcohol consumption. Yes, alcohol provides limited J-curve-adjacent protection against ischemic stroke and diabetes, but there was no significant net benefit on all-cause mortality.

Fewer scientists worked on the ICCPUD report, and unlike its NASEM counterpart, it was not peer-reviewed. There were suspicions that it had been snuck in to advance a more militantly anti-alcohol agenda, and in September its authors were told that it would not be submitted to Congress.

The House Committee on Oversight and Government Reform has now published a report on the ICCPUD report. Congress had already appropriated $1.3 million for NASEM (and only NASEM) to carry out its task. So why bring in ICCPUD?

Well, commented the committee:

A review of the ICCPUD AIH [Alcohol Intake and Health] study group membership shows all six selected members were anti-alcohol advocates with beliefs predating the study that no amount of alcohol consumption is safe, contrary to several accepted studies in the field. Congress made clear in the 2016 Appropriations Act that NASEM must include “a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information” in the study to inform the Dietary Guidelines. Here, the ICCPUD AIH group included three individuals from Canada whose research backgrounds show a dedication to eliminating the use of alcohol through dietary guidelines and a belief that no amount of alcohol consumption is safe. The other three ICCPUD group members from the United States are academics who have strong anti-alcohol beliefs, as evidenced by their research, publications and published statements. . . .

Based on the Committee’s review of the internal documents and communications provided by HHS, it is clear the ICCPUD had a predetermined goal: recruit biased researchers who were anti-alcohol advocates and believed in the “Canadian model” that no amount of alcohol was safe.

The committee concluded that the ICCPUD study not be considered in the 2025-2030 Dietary Guidelines.

And it clearly wasn’t. The new guidelines were somewhat more relaxed than their predecessor, replacing specific recommendations (no more than two standard drinks a day for men, one for women) with general advice to cut back on drinking. Pregnant women and people with alcohol problems should not drink at all. People with a history of alcoholism in the family were advised to be careful.

In her (generally disapproving) commentary, the New York Times’ Roni Caryn Rabin noted that:

The guidelines also no longer include a warning that was in the last set issued in 2020: that even moderate drinking may increase the risk of cancer and some forms of cardiovascular disease, as well as the overall risk of dying.

I was surprised, especially given the NASEM report, that there was no reference to any cancer risk. The omission of cardiovascular disease may reflect support for the J-curve.

I don’t know how much attention people pay to the government’s dietary guidelines, but I am confident — and data showing falling drinking rates, particularly among the young, would seem to back this up — that Americans already know alcohol is far from risk-free. Any doctors they see will reinforce and flesh out that message.

Commenting on the guidelines, Dr. Oz (these days the administrator of the Centers for Medicare & Medicaid Services) said that, “in a best case scenario” people shouldn’t drink, but he did add that that alcohol provides “an excuse to bond and socialize, and there’s probably nothing healthier than having a good time with friends in a safe way.” We hear a lot about the social harms that alcohol can bring, but a nod to the social good was not amiss at a time of concern about a “loneliness epidemic” which comes with its own health risks.

The debate over alcohol and health will rage on, but the ICCPUD saga is both the tale of a near miss and a reminder that neoprohibitionists have powerful backing — and no intention of going away.
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Credit: National Review