No amount of drinking is without risk of cancer, surgeon general finds. What does that mean for Spokane?

Even one drink a day carries a substantial cancer risk.

That is the finding of a new report from the U.S. Surgeon General released earlier this month. But as the risk of even moderate drinking becomes clear, the role alcoholic beverages play in daily life will likely remain.

“Beers in a healthy pub scene can bring people together to enjoy a social environment. Used responsibly, it can bring people together in dialogue,” said John Bryant, the owner of No-Li Brewery in Spokane.

While he does not dispute the varied risks of drinking, Bryant has also seen the positive force a social beer can have in people’s lives.

Though society seems to be fraying, Bryant has seen spaces centered around alcohol being one of the only places where people can easily connect with one another in the real world.

“You can’t just look at a cancer risk and that’s the be-all and end-all,” he said. “You have to look at it holistically and what it can bring to an individual’s mental and physical health and society as a whole.”

The social benefits of drinking have always bumped up against negative consequences – whether that be hangovers, drunk driving, liver damage, alcoholism, bad behavior or more. Now, cancer is being added as another risk to be factored with having drinks.

Breweries and distilleries will comply with whatever new rules or societal norms might become established in the wake of the surgeon general’s warning.

Surgeon general advisory

The warning by Surgeon General Dr. Vivek Murthy does not change government policy regarding the sale or consumption of alcohol. Instead, it raises awareness that alcohol at any level does bring with it a substantial risk of cancer.

Alcohol use causes about 100,000 cancer cases and 20,000 cancer deaths in the United States each year, according to an analysis of 26 studies cited by the Surgeon General’s report. The chance of contracting mouth cancer increases by 40% for those who have a drink every day.

Despite this, only 45% of Americans believed alcohol use is a cancer risk when polled in 2019 by the American Institute of Cancer Research. That number dropped further when Americans were asked if moderate alcohol use causes cancer.

“The majority of Americans are unaware of this risk,” Murthy said in a statement. “This advisory lays out steps we can all take to increase awareness of alcohol’s cancer risk and minimize harm.”

Cancer risk does increase substantially with the amount of alcohol consumed.

“A glass of wine or a beer with friends or family on the weekends is not going to have as much risk as someone who consumes alcohol on a daily basis, and the risk goes up if you drink more than four ounces of alcohol a day,” said Dr. Bret Gourley with the MultiCare Cancer Institute.

A direct link between alcohol consumption and cancer has been established for cancers of the breast, colon/rectum, esophagus, liver, mouth, throat and voice box. According to the report, the cancer risk remains the same regardless of the kind of alcohol consumed, including beer, wine and hard liquor.

When alcohol is broken down by the body, it creates a formaldehyde-like byproduct that is carcinogenic. While this is the primary way alcohol can cause cancer, it also can alter estrogen levels – causing breast cancer. For women, breast cancer accounts for more than 60% of alcohol-related deaths.

Murthy recommends the creation of a health warning label on alcoholic beverages – much like the cancer warning labels on cigarettes. The surgeon general cannot unilaterally make such a requirement; congressional action would need to mandate such a warning.

Gourley likens the cancer risk of alcohol to that of tobacco. While the risk from regular use of cigarettes is “definitely stronger” than that of alcohol, Gourley believes the two risks “mirror” one another.

“This is a good opportunity to evaluate your use of things like alcohol or tobacco that have an increased risk of causing health problems down the road,” the Spokane cancer physician said. “Every person has to make an individual decision on the risk they are willing to accept.”

Rise of the nonalcoholic beverage

Nonalcoholic beverages have become increasingly popular in recent years as an alternative – or an addition – to alcoholic drinks.

Patera Temperance Lounge aims to provide the Spokane community the space and social interaction of a bar without the alcohol. Co-owner Annie McGuiness hopes her patrons are able to find the same type of connection alcohol can bring.

“What people truly love about drinking is meeting people while having a beverage that makes them feel special,” she said.

Nonalcoholic beverages are a growing part of the industry. In 2023, sales of nonalcoholic beer and cocktails increased by 29% compared to the year prior, per alcohol industry database International Wine and Spirits Record.

Black Label Brewing Company owner Dan Dvorak said the nonalcoholic beverage market has been “blowing up” in the past several years. Like many if not most breweries and restaurants, Spokane-based Black Label now offers NA beer alongside alcoholic offerings.

Dvorak called his NA beers “very popular” and an aspect of the business he plans to expand soon. He sells the beer in cans made by other breweries but hopes to start his own nonalcoholic brew in the next six months.

The brewery owner points to the COVID-19 pandemic as a big cause of the popularity of nonalcoholic beer.

“COVID made us all a lot more health-conscious. It’s also a generational thing,” he said. “For my younger customers, drinking isn’t about the buzz.”

Dvorak said he was “not surprised” by the surgeon general’s report.

“I figured that was the case. Alcohol in itself is not really a healthy thing. But a lot of good can come out of it,” he said.

McGuiness, who stopped drinking alcohol in 2022, said a greater understanding of the risks of drinking was long overdue.

“I have known for a long time how detrimental alcohol is. Not long ago, people didn’t think there was anything wrong with smoking,” McGuiness said. “And now there’s definitely still smokers, but many people now make different choices. I think alcohol is going down the same route.”

While she doesn’t expect alcohol to go away, McGuiness hopes this understanding will make nonalcoholic beverages more normalized.

“Right now in Spokane, it can be difficult finding a good mocktail. You have to go to a special place, and even then, not as much time or dedication is put into that beverage as an alcoholic one,” she said. “I see having that option becoming a standard and not so much of a niche.”