Nikki Crowley, Penn State

Many people use the new year to reflect on their relationship with alcohol. Just-released government guidelines are giving Americans another reason to consider a “dry January.”

Over the past few decades, mounting scientific evidence has shown that as little as 1-2 alcoholic drinks per day can lead to increases in the likelihood of several cancers. This prompted the U.S. surgeon general, Dr. Vivek Murthy, to release a new Surgeon General Advisory on Jan. 3, 2025, warning about the link between alcohol and cancer. This report highlighted the evidence and included a call for new cancer warning labels on alcoholic beverages.

The association between alcohol and cancer isn’t new news – scientists have been trying to determine the link for decades – yet most people aren’t aware of the risks and may only associate drinking with liver disease like cirrhosis. In a 2019 survey from the American Institute for Cancer Research, less than half of Americans identified alcohol as a risk factor for cancer.

Alcohol is the third-most preventable cause of cancer in the U.S, putting it just behind tobacco and obesity. As the surgeon general’s report highlights, alcohol is associated with approximately 100,000 cancer cases and 20,000 cancer deaths every year, playing a role in breast, liver, colorectal, mouth, throat, esophagus and voice box cancer cases. Alcohol-induced cancer deaths outnumber alcohol-associated traffic crash fatalities every year.

The report included the suggestion to add warning labels to alcohol similar to what is already required for tobacco products – another substance of abuse known to cause cancer.

As a neuroscientist specializing in the neurobiological effects of alcohol use and binge drinking, I am glad to see the call to action for reducing alcohol consumption in the United States.

Key takeaways of the report

With so few people aware of the links between alcohol consumption and various cancers – and the fact that the vast majority of people consume some alcohol every week – it’s easy to see why the surgeon general is calling for greater awareness. The 22-page report highlights what scientists know about the relationship between alcohol and cancer, and suggests actions for moving forward. Those include label changes on alcohol, which have not been updated since they were created in 1988.

Somewhat strikingly, breast cancer carries a large portion of this risk – making it particularly worrisome in the face of increased alcohol use among women.

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These numbers don’t only apply to heavy alcohol drinkers. While less alcohol is better, 25% of these cancer cases were in people classified as moderate drinkers – consuming, on average, fewer than two drinks per day. This means that anyone regularly drinking alcohol, even small amounts, should know about and understand the risks.

Surgeon general’s advisories are the primary way that the Department of Health and Human Services, where the Office of the Surgeon General resides, communicate health issues of great importance to the public. Surgeon general’s advisories are not necessarily breaking news, but they take the opportunity to bring public awareness to science surrounding big public health issues.

The science behind the link between alcohol and cancer

The relationship between alcohol and cancer has been clear to scientists for decades. In fact, it was highlighted in a 2016 surgeon general’s report as well, which focused on addiction more broadly.

The new report outlines the different types of evidence supporting this link. One way is through epidemiological science, which tries to understand patterns and relationships between the rates of cancer and how much alcohol people consumed. Another is through experimental animal studies, which allow scientists to understand the mechanism and causality of these connections as they apply to specific cancers. Together, studies conclusively show a link and pathway between alcohol consumption and cancer.

The surgeon general’s report highlights four key pathways through which alcohol can cause cancer. These largely focus on the ways alcohol can negatively affect your DNA, the building blocks of cells. While the healthy cells in your body divide all the time, their abnormal growth can be driven by aberrant factors like alcohol-induced DNA damage.

This DNA damage leads to uncontrollable growth of tissue instead of healthy, normal tissue growth. This abnormal tissue growth is cancer. The four pathways through which alcohol can lead to cancer highlighted in the report are:

1. The body naturally breaks alcohol down into acetaldehyde. Acetaldehyde can damage and break DNA, leading to chromosomal rearrangements and tumors. This link is so strong that acetaldehyde has been classified as a carcinogen since 1999.
2. Alcohol creates reactive oxygen species. Reactive oxygen species, sometimes called “free radicals,” are unstable molecules that contain oxygen and can further damage DNA, proteins and fats.
3. Alcohol can influence hormones, like estrogen. Alcohol can raise the amount of estrogen in the body, which may explain its link to breast cancer. This increased estrogen can influence breast tissue by causing – you guessed it – DNA damage.
4. Alcohol is a solvent, which means other things can dissolve in it. This makes it easier for carcinogens from other sources – like cigarettes and e-vapes – to be absorbed by the body when the two are consumed together.

Is any amount of alcohol safe?

The biggest question on people’s minds right now is likely “how much alcohol can I safely drink?” and the answer to that might disappoint you – probably none.

Alcohol use remains one of the most preventable risk factors for cancer. And even moderate alcohol consumption – one or fewer drinks per day – may elevate cancer risk for some types, such as breast, throat and mouth cancers.

But none of these studies can tell you what your individual risk for cancer is. The relationship between alcohol and cancer can be influenced by your genes, such as those that control the enzymes that metabolize alcohol, and other lifestyle factors that influence the rates of cancer broadly, like diet and inflammation. All of these lifestyle and personal health factors can influence how risky alcohol consumption is for you.

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The Centers for Disease Control and Prevention notes that if you choose to drink, consider sticking to less than one, for women, or two, for men, standard servings of alcohol per day – which might be smaller than you think, and don’t binge drink alcohol at all. The surgeon general is also suggesting a rethinking of these guidelines to include updated limits on daily alcohol consumption and greater educational efforts around the link between alcohol and cancer.

The National Institute on Alcohol Abuse and Alcoholism has similar recommendations around limiting alcohol consumption and advises that for people who choose to drink alcohol, “the less, the better.”

The institute offers tips on its website for managing your alcohol consumption or abstaining from alcohol consumption altogether, including finding alternative hobbies and activities, identifying what leads to your urges to drink and having a plan to handle urges, and identifying a strategy for saying “no” to an alcoholic beverage in social settings.

Nikki Crowley, Assistant Professor of Biology, Biomedical Engineering and Pharmacology, Penn State

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Optimize Humidity
Turn on your furnace’s humidifier to maintain proper indoor humidity levels and adjust your dehumidifier settings to match winter’s low humidity. This helps keep your home comfortable while preventing moisture-related issues.

Clear Debris Around the House
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Manage Snow and Ice
Leaving snow and ice on concrete surfaces can erode and weaken the material over time. Regularly shoveling snow from driveways, sidewalks and patios helps prevent ice buildup and protects the concrete from long-term damage.

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Photo courtesy of Shutterstock (teens shoveling snow)
Photo courtesy of Thrasher Foundation Repair (contractor checking gutters)

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Steven Wolterning, Texas A&M University and Paige Williams, Texas A&M University

The “choking game” has potentially deadly consequences, as players are challenged to temporarily strangle themselves by restricting oxygen to the brain. It sounds terrifying, but rough estimates suggest that about 10% of U.S. teenagers may have played this type of game at least once.

There’s more, unfortunately: The Skullbreaker Challenge, the Tide Pod Challenge and Car Surfing are but a few of the deadly games popularized through social media, particularly on Snapchat, Instagram, TikTok, YouTube and X – formerly Twitter. Many of these games go back more than a generation, and some are resurging.

The consequences of these so-called games can be deadly. Skullbreaker Challenge, for example, involves two people kicking the legs out from under a third person, causing them to fall and potentially suffer lasting injuries. Swallowing detergent pods can result in choking and serious illness. A fall from car surfing can lead to severe head trauma.

Coming up with an exact number of adolescent deaths from these activities is difficult. Data is lacking, partly because public health databases do not track these activities well – some deaths may be misclassified as suicides – and partly because much of the existing research is dated.

A 2008 report from the Centers for Disease Control and Prevention found that 82 U.S. children over a 12-year period died after playing the Choking Game. About 87% of the participants were male, most were alone, and their average age was just over 13. Obviously, new, updated research is needed to determine the severity of the problem.

A 2008 report from the Centers for Disease Control and Prevention found that 82 U.S. children over a 12-year period died after playing the Choking Game. About 87% of the participants were male, most were alone, and their average age was just over 13. Obviously, new, updated research is needed to determine the severity of the problem.

Peer pressure and the developing brain

We are a professor of educational neuroscience and a Ph.D. student in educational psychology. Both of us study how children regulate their behaviors and emotions, why teenagers are particularly vulnerable to dangerous games, and how social media amplifies their risks.

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Risk-taking is a necessary part of human development, and parents, peers, schools and the broader community play an integral role in guiding and moderating risk-taking. Children are drawn to, and often encouraged to engage in, activities with a degree of social or physical risk, like riding a bike, asking someone for a date or learning how to drive.

Those are healthy risks. They let children explore boundaries and develop risk-management skills. One of those skills is scaffolding. An example of scaffolding is an adult helping a child climb a tree by initially guiding them, then gradually stepping back as the child gains confidence and climbs independently.

Information-gathering is another skill, like asking if swallowing a spoonful of cinnamon is dangerous. A third skill is taking appropriate safety measures – such as surfing with friends rather than going by yourself, or wearing a helmet and having someone nearby when skateboarding.

The perfect storm

During adolescence, the brain is growing and developing in ways that affect maturity, particularly within the circuits responsible for decision-making and emotional regulation. At the same time, hormonal changes increase the drive for reward and social feedback.

All of these biological events are happening as teenagers deal with increasingly complex social relationships while simultaneously trying to gain greater autonomy. The desire for social validation, to impress peers or to attract a potential romantic interest, coupled with less adult supervision, increases the likelihood of participating in risky behaviors. An adolescent might participate in these antics to impress someone they have a crush on, or fit in with others.

That’s why the combination of teenagers and social media can be a perfect storm – and the ideal environment for the proliferation of these dangerous activities.

Social media shapes brain circuits

Social media platforms are driven by algorithms engineered to promote engagement. So they feed you what evokes a strong emotional reaction, and they seem to prioritize sensationalism over safety.

Because teens strongly react to emotional content, they’re more likely to view, like and share videos of these dangerous activities. The problem has become worse as young people spend more time on social media – by some estimates, about five hours a day.

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This may be why mood disorders among young people have risen sharply since 2012, about the time when social media became widespread. These mood disorders, like depression and conduct issues, more than double the likelihood of playing dangerous games. It becomes a vicious cycle.

Rather than parents or real-life friends, TikTok, YouTube and other apps and websites are shaping a child’s brain circuits related to risk management. Social media is replacing what was once the community’s role in guiding risk-taking behavior.

Protecting teens while encouraging healthy risk-taking

Monitoring what teens watch on social media is extraordinarily difficult, and adults often are ill-equipped to help. But there are some things parents can do. Unexplained marks on the neck, bloodshot eyes or frequent headaches may indicate involvement in the choking game. Some social media sites, such as YouTube, are sensitive to community feedback and will take down a video that is flagged as dangerous.

As parents keep an eye out for unhealthy risks, they should encourage their children to take healthy ones, such as joining a new social group or participating in outdoor activities. These healthy risks help children learn from mistakes, build resilience and improve risk-management skills. The more they can assess and manage potential dangers, the less likely they will engage in truly unhealthy behaviors.

But many parents have increasingly adopted another route. They shield their children from the healthy challenges the real world presents to them. When that happens, children tend to underestimate more dangerous risks, and they may be more likely to try them.

This issue is systemic, involving schools, government and technology companies alike, each bearing a share of responsibility. However, the dynamic between parents and children also plays a pivotal role. Rather than issuing a unilateral “no” to risk-taking, it’s crucial for parents to engage actively in their children’s healthy risk-taking from an early age.

This helps build a foundation where trust is not assumed but earned, enabling children to feel secure in discussing their experiences and challenges in the digital world, including dangerous activities both online and offline. Such mutual engagement can support the development of a child’s healthy risk assessment skills, providing a robust basis for tackling problems together.

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Steven Wolterning, Associate Professor of Educational Psychology, Texas A&M University and Paige Williams, Doctoral student in Educational Psychology, Texas A&M University

This article is republished from The Conversation under a Creative Commons license. Read the original article.