Author: Haonan Liu
Editor: Altay Shaw
Regardless of what you study when you are at university, you will have encountered alcohol one way or another. Everyone will have their own understanding of what alcohol refers to. Is it part of your social life? The binge drinking culture? Or university life?
What about the word toxin? Nowadays, the public generally can recognise chemicals such as tobacco as toxins and make an effort to avoid them. However, it’s less intuitive to think of alcohol as one—at least not in the UK or Europe, where it has a heavy drinking culture. Yet, statistics reveal over 10,000 alcohol-specific fatalities in the UK from 2019 to 2022.
Since 1988, the International Agency for Research on Cancer has classified alcohol as a psychoactive toxin and a Group 1 carcinogen, establishing causal links to multiple types of cancer. Despite its limited dissemination to the general public, numerous studies published in leading scientific journals generally agree that heavy drinking has negative health effects. However, there is still significant debate about the impact of light drinking. While WHO has declared that “no level of alcohol consumption is safe for our health”, some studies show a decrease in the risk of certain diseases among the middle-aged who consume light or moderate amounts of alcohol.
Dangers to the body and brain
There is a general consensus that heavy drinking has caused significant harm. In 2023, a paper published in Nature Medicine found an association between alcohol consumption and the risk of over 60 diseases.
When ethanol is broken down by the enzyme alcohol dehydrogenase (ADH), it produces acetaldehyde, which is carcinogenic and causes damage to the DNA. Acetaldehyde can cause significant cell damage despite its rapid breakdown. For example, the liver receives most of the damage as it’s the main site of alcohol metabolism, which contributes to liver cancer. Meanwhile, metabolism also takes place in the pancreas, the brain, and the gastrointestinal tract, where tissues and cells are also exposed to the damaging effects, increasing the risk of at least 7 types of cancer.
After you take a pint, the alcohol goes through your oesophagus and arrives at the stomach. Here, the rate of absorption depends on alcohol concentration and several other factors such as whether the stomach is empty or the drink is aerated with carbon dioxide. The body generally exposes most tissues, including organs like the heart and brain, to the same concentration of alcohol as the blood. This is particularly bad for the brain because alcohol can reduce the blood-brain barrier’s ability to regulate its permeability, which could lead to cognitive dysfunction in the long term.
Moreover, it’s known that drinking is particularly harmful to young adults who have reached the legal drinking age but haven’t fully developed physiologically. Alcohol can quickly reach the brain in five minutes due to their rich blood supplies. As Ruud Roodbeen, author of Beyond Legislation, pointed out, the alcohol content in the blood will be higher in young adults compared to someone in their mid-40s. Furthermore, drinking at a young age is associated with a faster reduction of the grey matter and an interrupted development of the white matter, given that the human brain continues to develop until age 21. This is alarming because a recent WHO report reveals that English child alcohol usage ranks the highest amongst the 44 examined countries, where one third of the 11-year-olds and more than half of the 13-year-olds have experience of drinking.
Complexities regarding light and moderate drinking
WHO strongly advocates that there’s no safe level of alcohol consumption and dismisses the so-called healthy European drinking culture. WHO released a statement in 2023, establishing a causal link between one in ten cancer cases and conventionally considered ‘light’ alcohol consumption. To illustrate, that’s one large bottle of beer (500 ml), two glasses of wine, or only 60 ml of spirits. This conclusion was based on the study published in The Lancet, where it suggested alcohol to be the leading risk factor for people ageing from 15 to 49 and the top cause for older adults.
Nevertheless, the same study also found a 14% lower risk of heart attack and other cardiovascular disease for men drinking 0.8 drinks per day. Also, compared to nondrinkers, a study of four million adults in Taiwan published in Nature in 2022 found that non-smoking modest drinkers had an 8% reduced risk of mortality, diabetes, and respiratory system disease, although two to four times increased risks of oral cancer and esophageal cancer. Overall, that’s a gain of 0.94 years of life expectancy.
However, regular drinkers who only drink three times a week—more than 2 drinks each time—might have shortened life expectancy drastically for 6.9 years compared to those who don’t drink. This study mentions that the difficulty of running data analysis confounds factors such as smoking, as many drinkers also smoke.
Social aspects
Some researchers at the University of Oxford suggest that moderate drinking might be associated with better well-being due to the enhanced social interactions. While drinking indeed can be a good socialising activity, it’s worth mentioning that this paper received funding from Campaign for Real Ale (CAMRA), which is an organisation that promotes pub cultures and alcohol consumption.
Solutions and government interventions
Nevertheless, in the United Kingdom, where the alcohol consumption rate is higher than the average of OECD countries and consistently ranks highest on binge drinking culture, heavy drinking seems to be the priority to be tackled. Some strategies recommended by WHO are banning or restricting alcohol marketing across all media and reducing the availability as well as affordability of alcohol to the public. On an individual level, as the debate of healthy light drinking goes on, drinking mindfully and drinking according to the professional healthcare guidelines might be the best to do.
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