America’s puritans are back Is there a moral panic around alcohol?

Of the many unpleasant truths about humanity that the Covid pandemic brought to light, one of the more astonishing was how many people seemed to have forgotten they were going to die. A more philosophical age might have been grateful for this reminder to consider, and do justice to, the things that make life worth living; a more religious one might have taken the opportunity to settle accounts with God. In our own time, which combines à la carte the blindest faith in scientific progress with nigh-medieval superstitions, many seemed to conclude that a confrontation with mortality could be staved off indefinitely through the right combination of paranoia and sanitary overkill. QR code menus, floor mats soaked in sanitiser, plexiglass barriers, outdoor masking — what mattered wasn’t efficacy, it was showing membership in team prudence.

Hygiene theatre is mostly gone now, but the habit of policing others’ choices has proven too hard to quit, and now one of its preferred targets is alcohol. This has been in the offing for some time: the temperance movement, which had struggled to shed the air of puritanism surrounding it since the repeal of prohibition in America, has refashioned itself in recent years through an emphasis on health. The first rumblings of alcohol hysteria could be detected in the relish of the abstemious when it turned out resveratrol, an antioxidant found in red wine, might not be the elixir of life it was once touted as. Then there was the clawing-back of guidelines for moderate drinking: in 2023, for example, Canada dropped its so-called “low-risk threshold” from 10 drinks per week for women and 15 for men to two or fewer for either sex.

More recently, the progressive press has jumped on the anti-alcohol dogpile, with headlines calculated to horrify. “There is No Such Thing as a Safe Level of Alcohol Consumption,” The Guardian warns us, while The New York Times, now a surrogate parent for those who stopped talking to their own parents because they voted for Trump or refused to tack a land acknowledgement onto the end of the Thanksgiving dinner prayers, chides readers virtually every day with articles like “Even a Little Alcohol Can Harm Your Health,” “Alcohol Carries New Risks in Middle Age,”  and the condescending “Is That Drink Really Worth it to You?”

And worldwide, health authorities have responded. In 2026, Ireland will become the first EU country to place warning labels on alcoholic beverages. In 2024, the World Health Organization published its “Global Alcohol Action Plan” a masterpiece of bureaucratic jargon that employs the stock aims of “empowering people and communities”, “ending poverty”, and “achieving gender inequality” to encourage member states to monitor their citizens’ alcohol use, engage in anti-drinking campaigns, and ultimately reduce consumption by 20% by 2030. Finally, this past January, the US Surgeon General issued an alarmist report entitled “Alcohol and Cancer Risk”. I will not contest the Surgeon General’s findings, though they fail to include alcohol’s possible protective effects against kidney cancer, non-Hodgkin’s lymphoma, dementia, and other diseases. What I will not accept is their significance. In America, it appears, alcohol “contributes” to 100,000 cancer diagnoses and 20,000 cancer deaths each year. Putting aside that the nature of such a contribution is indeterminable — and that confounding factors, which there are in virtually every case, should be a motive for caution, rather than conclusiveness — this means that alcohol is deemed to be a factor in 5% of cancer diagnoses and 3% of cancer deaths per year. These deaths constitute .006% of all deaths in the United States — significantly lower than mortality due to influenza or unintentional falls.

The report goes on to state that alcohol is the third leading cause of preventable cancers, after smoking and obesity. But smoking is the only one of these where the link is clear-cut: around 14% of smokers will develop lung cancer, with the number higher for men than for women. For everything else, it’s a guessing game, because the factors are too difficult to disentangle: if an obese drug user who binges on processed food comes down with cancer of the colon, who is to say whether one or all of these, or none, caused those first cells to mutate?

Of course, cancer isn’t the only thing you can die of, and a mere month before the Surgeon General’s doomsaying appeared, the National Academies of Sciences, Medicine, and Engineering released its own report on moderate alcohol consumption and health outcomes, the findings of which reconfirmed two things: first, that moderate drinking is associated with a lower risk of heart attack and stroke, and second, that compared with abstinence, it also correlates with a lower risk of mortality. This last datum in particular is a source of consternation to the new temperance advocates, who have tied themselves into all sorts of interesting knots to explain it away. Most entertaining of these is the “sick quitter” theory which suggests that the pool of hale teetotallers is befouled by the wrecks of ex-drinkers who gave up the bottle too late, and remain ravaged by their years of sin; if only their numbers could be excluded, the appearance of any health benefits of alcohol would vanish.

This hypothesis is nonsense, and has been shown to be nonsense in repeated studies of lifetime abstainers; likewise, the faddish notion that moderate drinkers owe their health to their generally better socio-economic standing is not borne out by statistical data. Whence, then, the moral panic?

A hint, paradoxically, lies in the near absence of heavy drinking from these discussions. Because an alcoholic is an addict, and over the past several years, the addict has been configured as a powerless object of pity and solidarity, the alcoholic lies beyond censure; his “disease” is the likely product of trauma, and following the precepts of “harm reduction”, he must be coddled until he chooses to get better. The moderate drinker, on the other hand, is a being self-possessed, one who consciously takes a drink or two or five in full awareness of the minuscule danger, because he is enjoying himself, and would like to enjoy himself more. Contemporary progressive dogma is fundamentally anti-responsibility, placing the blame for social ills anywhere but on the subject; and the calculated risk-taker is a constant and exasperating reminder that maybe all that is bullshit, and that accepting the consequences for one’s possibly unwise actions is a basic criterion for participating in society. Moreover, as the editorialising classes have fallen for a “standpoint epistemology” according to which one’s measure of illness or trauma determined how much of a right one has to speak, the mere fact of self-composure has acquired the illiberal stink of “privilege”.

I would put down the bottle if what I were offered in return were worthwhile, but I fear the antidote is worse than the poison. I am aware of drinking’s association with violence, sexual assault, deaths on the road, liver disease, and a host of other problems; this is what makes it a vice, though unlike the slow-motion disaster of legalised marijuana, at least it’s one we have lots of practice in handling. The harms of not drinking are harder to track, but that doesn’t mean they’re not there, and their consequences are ominous for our societies. In a 2010 study, Charles Holahan, a psychologist of the University of Austin, found associations between abstinence and an enormous suite of problems: obesity, depression, avoidance coping, poor social engagement, lack of support from friends, significantly decreased likelihood of marriage. He concluded: “All of these factors that were associated with abstention significantly predicted mortality.”

Why harp on these benefits, though? The social neurosis surrounding alcohol is no more concerned with health than Covid vaccine-shaming was five years ago (I say this as a believer in vaccines, but one who feels intransigence was a moral and policy failure). And even if we take others’ alleged concern for our bodies at face value, what is health, and what is the point of it? To quote Nietzsche, “In order to determine even whathealth involves for your body, what matters is your purpose, your horizon, your powers, your impulses, your errors and in particular the ideals and phantasms of your soul.” Life in itself is not an unalloyed good; it is only worthwhile to the extent that it is lived; and much of what people mistake to be health is preparation for a life they never get around to starting. “Is it not,” the Swiss novelist Hermann Burger wrote about his own weakness, tobacco, “far worse, more frustrating, to have to renounce life’s most sublime pleasure hundreds of thousands of times over than to pay for decades of wishes granted with a narrowing of the vessels in old age?” Quite so, I’d say, and if you’ll excuse me, I must step away to pour myself a glass.

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Adrian Nathan West is an essayist, author of the novel My Father’s Diet, and a literary translator.

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