Should Canada put cancer warnings on alcohol? Doctor says we have a right to know the risks
U.S. surgeon general recommends new labels and guidelines for booze
As the U.S. debates whether it should put cancer warnings on alcohol, a Canadian public health adviser says Canadians also have a right to know the risks of what they're drinking.
U.S. surgeon general Vivek Murthy on Friday called for alcoholic drinks in his country to include labels warning people that alcohol consumption is linked to a higher risk of developing cancer. He also called for the guidelines on alcohol consumption limits to be reassessed to reflect those risks.
Canada already reassessed its guidelines in 2023 when the Canadian Centre on Substance Use and Addiction (CCSA), the organization that advises the government on alcohol consumption, dramatically changed its recommendations to reflect the growing body of research connecting booze to several common forms of cancer.
Under previous guidance, the CCSA recommended a maximum of 10 standard alcoholic drinks per week for women and 15 for men. Now, it says no amount of alcohol is completely safe, and recommends a maximum of two drinks a week to stay within the lowest risk threshold.
CCSA CEO Dr. Alexander Caudarella, a family physician, spoke to As It Happens guest host Stephanie Skenderis about the U.S. surgeon general's advisory, and why he believes Canada should put cancer warning labels on alcohol.
This warning from the U.S. surgeon general, it may cause a lot of people to cringe when they think about their consumption over the holidays. Was it music to your ears?
It is good news because it's about helping people understand things better. It's about letting people know. And, ultimately, they can do what is best for them.
Most people don't understand, actually, even in Canada and in the U.S., that there is a link between alcohol and cancer. So having something that's clear and consistent is really, really important.
This is all about trying to get the most important information into people's hands.
A few years ago, there was this public health experiment into the effectiveness of warning labels on alcohol in Yukon liquor stores. Researchers said the labels were successful in that context, but there was a lot of industry pushback to that pilot to the point that that project was actually paused. So, I mean, how optimistic are you that we will see something like labels used more broadly across Canada?
What I think is different now, and I think will be a big changing point, is that this is coming from the public as well.
I'm a family doctor and I can't tell you how many times people have come in with questions or surprised about something that they read. And increasingly, people are really standing up and saying: I have a right to know what I'm putting in my body.
Do you think a label is the best way to get that message across or is there a better way?
Labelling can be a really important tool…. You want people talking around the dinner table. You want people learning about it where they can learn about it. And then you want people going, for example, to their family doctors. That's something we're working on, too, is helping primary-care practitioners be there with the answers.
People don't need to cut alcohol entirely out of their lives. Any reduction can make a significant difference. And the sooner we can get that information into the hands of people that are asking those kinds of questions, the further it goes.
When the Canadian Centre on Substance Use and Addiction released those guidelines last year, it became a huge conversation. So how do you get that message through to people who hear a guideline like that and might roll their eyes at it, might think it's too drastic?
We actually didn't go and say it has to be two [drinks per week]. What we said if you want to be in that low or almost no risk [category], it's two drinks per week or less.
What the guidance actually asks people to do isn't to hit the target CCSA is identifying. It's just to say: consider reducing your alcohol consumption. Find out what risk is acceptable to you.
It used to be we said, if you drink less than X, we were telling you you were safe. Now we're saying there's probably no completely safe amount.
There's actually a lot of things in life — let's say driving a car, for example — that come with some risk. It doesn't mean that we need to avoid all risk at all costs. It just means you need to be comfortable and be able to live with the amount of risk you're setting for yourself.
The second part that's really important is that risk goes up exponentially. So no matter where you find yourself on that curve … any reduction is good.
And what about for you, personally? How has the work that you've done informed your own choices about alcohol consumption, particularly around this time of year?
I started talking about it to folks, people around me. And when I go to have a drink now … I always just kind of think: Am I doing this because of the alcohol, or am I doing it because I'm kind of used to it?
This is one of the reasons why things like dry January were really popular. It gives you a month to kind of explore: Is it the alcohol I like, or is it the social circumstance? Do I need to be drinking as much, or not?
This is really having me have a conversation with myself and say, OK when I was grabbing that glass of wine or beer with some friends: Do I need it? Was it the beer? Was it the friends? What was the most important part for me?
We've talked a bit about how this conversation went when those guidelines came out in Canada. How do you think this is going to go down in the States?
Even if people have a reaction where they're a bit upset, that's OK, because alcohol around health does better when we talk about it more.
For the most part, the calls we get are very, very positive. Even some of the angriest things we got at the beginning, a number of people reached out six or eight weeks later and said: "You know what? I thought about it a bit more, and I did cut back on my alcohol."
Sometimes we need to ask ourselves: Why is it that we have such a strong reaction to news like this? Why are we so emotionally tied to this? And just take the science for what it is.
The surgeon general, CCSA, no one is telling you to not drink alcohol at all. He's just saying you, as a consumer, have a right to be informed of the most up-to-date science in a way that you can understand it so that you can make the decisions that are right for you.
Interview produced by Sarah Jackson. Q&A edited for length and clarity
