Alcohol use in the U.S. has been in decline since the late 1970s—54% of U.S. adults today say they consume alcohol—the lowest number in nearly 90 years and a 13% drop since just 2022. Fifty-three percent say moderate drinking, or “one or two drinks a day,” is bad for a person’s health; that number is even higher—66%—among young adults ages 18 to 34.
“We’re seeing a major cultural shift in the U.S.,” says Johannes Thrul, PhD, MS, an associate professor in Mental Health. “Young people are drinking much less, and less frequently, than previous generations, and social pressures to drink are weakening.”
The rate of drinking among young adults has dropped from almost 60% to 50% since 2023, according to Gallup, and the Monitoring the Future survey, an annual national poll tracking substance use, has shown a marked decline in young people’s drinking over the last decade.
“Overall, this [younger] generation seems to be more selective about how, when, and why they drink, and alcohol seems to play a smaller role than it did in previous generations,” Thrul says.
It’s an encouraging trend. But while young people are drinking less, “public awareness still lags behind the evolving science on the health effects of alcohol,” Thrul says. And excessive alcohol use is still responsible for the deaths of 178,000 Americans a year. Raising that awareness and helping people make more informed choices about alcohol consumption are essential to further reducing alcohol’s toll on America’s health.
Even Low Levels of Drinking Are Harmful
The idea that alcohol has medicinal qualities dates back to ancient times. For decades research has pointed to potential health benefits, such as a reduced risk of cardiovascular disease and type 2 diabetes in moderate drinkers, and the now debunked “French paradox”—the concept that French people have lower rates of coronary heart disease, despite a diet high in saturated fats, due to high red wine consumption.
But many of these early observational studies had methodological flaws and failed to consider that people who consume low to moderate amounts of alcohol may have other habits, like a healthy diet and regular exercise, that could account for their overall health. Older studies also often compared moderate drinkers to a group of “abstainers” that included “sick quitters”—people who had stopped drinking due to poor health—making the moderate drinkers appear healthier by comparison.
Recent large-scale studies tell a different story, indicating that alcohol consumption in any amount raises health risks. As Elizabeth Platz, ScD, MPH, a professor in Epidemiology, puts it: “The safest amount of alcohol is none.”
“Even just one drink a day adds health risk,” says Thrul. “Alcohol might feel relaxing in the moment, but physiologically, it disrupts restorative sleep, increases anxiety the next day, and can contribute to long-term mental health problems.”
Consuming alcohol has been shown to increase the risk of self-harm, suicide, and addiction. Twenty-eight million, or 1 in 10, Americans ages 12 or older had alcohol use disorder in the last year, according to the National Survey on Drug Use and Health.
Drinking also carries health risks like high blood pressure, weakened immune system, brain damage, heart disease, stroke, liver disease, and at least seven types of cancer. Alcohol consumption is the third-leading preventable cause of cancer in the U.S., after tobacco and obesity, causing about 100,000 cancer cases and 20,000 deaths from cancer each year.
“The risk of cancer increases with the amount of alcohol consumed,” says Platz. “For some cancers, like breast cancer, the risk is increased at even one drink per day.”
Decreasing Drinking Brings Health Dividends
Just as health risks rise with increased alcohol consumption, cutting back on drinking even just a few days a week yields health benefits.
“In Dry January studies, participants often see lower blood pressure, better energy, stronger concentration, and reduced anxiety within a few weeks,” says Thrul. “Abstinence or reduced drinking not only prevents future disease but also improves how you feel tomorrow morning and next month.”
Many participants in Dry January have also been shown to reduce their alcohol consumption and the number of drinking days after the challenge ends. Quitting drinking can also improve the appearance of skin, help weight loss, and save you money. And, not drinking or reducing the amount of alcohol you consume can reduce the risk of cancer, says Platz.
There are a few evidence-based steps that can help reduce consumption, Thrul adds. “Keep an account of your drinks. Eat before drinking, take alcohol-free days, and alternate alcoholic drinks with water or other non-alcoholic beverages.”
The latter is made easier thanks to the booming market for non-alcoholic beer, wine, and spirits, which Thrul says reflects a broader societal change. Driven by “the sober curious” movement and an increased consumer demand for healthier alternatives, the non-alcoholic drink industry is outperforming the alcoholic beverage market in growth, with global sales doubling in the last five years, according to The Economist.
“More people want the social experience without the physiological downsides of alcohol,” Thrul explains. “Not drinking is becoming just as normal as drinking.”
While mocktails are a good alternative to alcohol, Platz says they should still be consumed in moderation. “Mocktails can be highly caloric. If you have interest in switching to a non-alcoholic beverage … make sure you look at the nutrition label.”
Getting the Word Out About Alcohol’s Risks
“Experts have known for decades that alcohol is a risk factor for certain cancers,” says Platz. “While public health experts are aware of this risk, much of the public is not.”
An October 2025 report found that only 37% of adults in the U.S. know that alcohol increases the risk of cancer; more than half, 53%, said they didn’t know about the risk.
“We need clear communication to make sure consumers know the risks and can make informed decisions,” says Thrul. “We can also emphasize the immediate, tangible benefits of cutting back.”
Labeling could be a start. Earlier this year, then-U.S. Surgeon General Vivek Murthy issued a health advisory highlighting the connection between alcohol and cancer and recommended that the warning label on alcohol containers be updated to reflect the link.
Policy shifts could also help, such as “making alcohol less affordable through taxes or minimum prices, making it less available by limiting the hours it’s sold and outlet density, and making it less appealing by restricting marketing and promotion,” Thrul explains.
Lawmakers could learn from policies that helped curb the use of cigarettes. “We have been treating the alcohol industry differently from the tobacco industry,” says Thrul, when we should “double down on those evidence-based alcohol policy strategies, and that includes limiting and restricting alcohol advertisements.”
“In the U.S, the prevalence of smoking used to be very high, but through public health strategies, we’ve reduced smoking rates,” adds Platz. That same approach, she says, should be taken with drinking.
Incorporating alcohol awareness into medical training could give consumers a more personal source of information. “Alcohol carries serious health risks, yet many people never hear this message from their doctors,” Thrul notes. “Primary care providers have a lot to cover in a relatively short amount of time … [but] getting alcohol awareness into primary provider care training or continuing medical education would [help] to get the message out there.”
Changes to the alcohol intake guidance in the 2025–2030 Dietary Guidelines for Americans would also be valuable. “If the U.S. guidelines adopt a similar limit [to the one in Canada’s 2023 guidance], the implications would be quite substantial for how we counsel patients, for how we design interventions to reduce drinking, how the public sees alcohol, and how we design policies as well.”
It would mean changing the norms of what moderate drinking is, Thrul says. “The bottom line is, if the guidance shifts downward, the burden isn’t just on individuals to drink less, it’s on the entire system—including public health, medicine, and the alcohol industry—to support that change.”
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