The tug-of-war for the future of booze

Major developments in the American public-health firmament took the American beverage-alcohol business to a high high and a low low in neck-snappingly quick succession on either end of what journalist Marie Le Conte calls “the merryneum,” that weird December doldrums between Christmas and New Year’s Day.

• First, the thrill of (qualified) victory: In mid-December, the National Academies of Sciences, Engineering, and Medicine (NASEM) published its “Review of Evidence on Alcohol and Health,” finding with “moderate certainty” that “moderate” drinking was associated with lower all-cause mortality than no drinking. (Also a higher risk of breast cancer than no drinking, and maybe colorectal cancer, too, but that made it into comparatively few headlines.)

• Then, the agony of (foreshadowed) defeat: In early January, United States Surgeon General Vivek H. Murthy issued an advisory tagging booze as a “preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States,” and renewing the call to include warnings about cancer on every bottle.

Naturally, the trade was thrilled about the NASEM result, and less so about the the Surgeon General’s announcement. Lest ye forget there’s a political dimension to all this, the Wall Street Journal’s right-wing Opinion section slammed Murthy’s advisory as a gambit to “advance the left’s goal of expanding government control over Americans.”

I expect to publish a lot of reporting and analysis on relationship between the alcohol trade and the public-health establishment in the coming year. Today, I want to share a framework I’ve found useful when thinking about it. The two developments above, and the corresponding reactions they provoke from the trade and its fellow travelers, are the latest in what I’ve come to see as a tug-of-war over alcohol’s place in American society.

On one side, you have public-health institutions like the World Health Organization and the Canadian Centre on Substance Use and Addiction pushing to reduce the amount of population-level drinking in hopes of dialing back all its attendant medical, social, and economic ills, plus a patchwork of advocacy orgs with small budgets and big ideas about why and how to curb the national habit.

On the other side, you have powerful bev-alc corporations with virtually limitless resources watching the frame of “individual choice” they painstakingly built over decades start to wobble at a moment when alternatives to alcohol are myriad and consumer interest in it seems to be waning. The powerful orgs that represent distributors, package stores, and restaurants/bars in statehouses and on Capitol Hill tend to pull the same direction. Not necessarily holding the rope, but looking on anxiously, are the nation’s craft brewers, microdistillers, and small-time winemakers, whose regulatory fates are shaped by the Big Booze multinationals even though they have very little to do with one another.

Of course, you’ve also got a bunch of politicians trying to figure out which side will pull it out, and what that might mean for them in this post-pandemic public-health landscape, what with an anti-vaxxer angling for control of the Department of Health and Human Services, a delusional deregulatory teetotaler headed for the White House, and a constituency drunk on medical misinformation of all flavors. Is alcohol for woke soybois or S-tier MAGA operators? Can a wine-country House Democrat still find common ground with a bourbon-addled Kentucky Republican in the Senate? These tea leaves have always been twisted, and now more so than ever.

The bigger charlatans, like Senator Ted Cruz, will carry water beer for industry as a matter of personal preference and political expedience, and this country’s political corps does not want for big charlatans. Still, some of Congress’ lesser clowns from both parties spent much of last year laying groundwork to challenge the NASEM report’s counterpart from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) on the basis of that panel’s composition, atypical involvement, and other procedural discrepancies. With so many jobs in so many congressional districts tied up in alcohol traffic—not to mention all those sweet campaign contributions—it’s hard to imagine them accepting negative findings for alcohol as good science prima facie.

You can loosely trace this tug-of-war back to America’s founding, and tightly to Prohibition, but for the sake of keeping this column email-length, I’ll just note that the rope is currently so taut for two major reasons.

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