Drinking wine is not good for you. But are we sure it's the biggest evil? What research doesn’t say

by Mattia Ferraresi

Let's start with an indisputable fact: drinking alcohol, in any quantity, is harmful to health. Those who do not drink protect their health more than those who do. And beyond the daily controversies (and crusades) against alcohol, it is true that for a long time, scientific studies have shown a very clear correlation between heavy alcohol consumption —three or more glasses of wine per day—and severe diseases such as liver cirrhosis. More recently, research has begun to highlight that even moderate drinking is a significant risk factor. Even those who drink just a few glasses a week are more exposed to cancers of the oral cavity, pharynx, larynx, oesophagus, stomach, colon-rectum, liver, gallbladder, and pancreas.

Alcohol can damage DNA in various ways, making cancerous mutations more likely. The ethanol molecule also alters hormone levels, increasing the risk of breast cancer, making it particularly dangerous for women. The Istituto Superiore di Sanità estimates that around 4 per cent of cancer-related deaths in Italy are in some way associated with alcohol consumption. The wave of studies on the topic has led many public health bodies to revise their guidelines.

The WHO Alert

The World Health Organisation states that "any level of alcohol consumption, regardless of the quantity, increases health risks," while Vivek Murthy, the outgoing U.S. Surgeon General—the official responsible for public health—has formally proposed adding more alarming warnings to bottles, similar to those on cigarette packs, to discourage consumers.

The clear evidence that not drinking alcohol is a good health choice becomes more complicated when trying to precisely estimate the damage caused by moderate alcohol consumption—for example, three glasses of wine a week. This is a problem of risk estimation, and since almost all life decisions result from a delicate balance between harm considerations and individual preferences, quantification is crucial.

Soft drugs, which have been widely legalised in the West in recent years, are accepted not because they are harmless (they are not, as studies confirm) but because, on balance, their benefits are deemed to outweigh the negative effects, with the realistic awareness that consumption will happen regardless of laws.

Daily Life Is Full of Harmful Experiences

The question "Is drinking good or bad for you?" has a clear answer, but at the same time, it is a question that makes sense only in scientific papers and laboratory investigations, not in the real-life experiences of people, which involve countless risky activities: eating junk food, driving, mountain climbing, or building swimming pools.

A more realistic question might be: "Is the risk associated with moderate alcohol consumption acceptable?" Posed in this way, the matter becomes more complex, even for scientists. Let’s see why.

Debunking the French Paradox

The increasingly widespread awareness that alcohol is harmful in any quantity is replacing the old consensus that an occasional glass of wine is not harmful and may even be beneficial.

In the 1990s, the famous "French Paradox" emerged when scientists observed that French people who drank a daily glass of red wine lived longer and healthier lives. It was all false.

Such results were the product of what statisticians call "confounding variables." The confusion that led scientists to believe in the supposed benefits of alcohol was due to the fact that moderate red wine drinkers in France tend to be affluent and, therefore, exercise more, have healthier diets, and have better access to healthcare and preventive medicine. It wasn’t the wine but their socio-economic profile that statistically granted them longer and healthier lives compared to heavy drinkers, for obvious reasons—but also, in less intuitive ways, compared to non-drinkers.

This latter group, in fact, is not homogeneous but includes people who became ill due to excessive drinking in the past and then quit alcohol, but only after their health had already suffered serious damage.

One of the scientists leading the debunking of the French Paradox is Tim Stockwell, a professor at the University of Victoria in Canada. When he and his team purified the statistics from misleading variables and spurious correlations, they found no paradox. The "J-shaped curve" drawn in these types of graphs disappeared, showing that any amount of alcohol is harmful.

For 25 years, Stockwell has been a reference point for public health authorities, who, based on data, have progressively tightened recommendations and regulations. However, other scientists point out that even the methodology of the studies debunking the French Paradox risks being contaminated by similar confounding variables—this time, producing false results in the opposite direction.

Errors in Alcohol and Cancer Research

Vinay Prasad, a haematologist and oncologist at the University of California, San Francisco, has written that today’s studies are still based on "old, messy, confounded data, weak definitions, measurement errors, multiplicity issues, time lag problems, and illogical results"—the typical statistical flaws that undermine a study’s credibility.

For example, observational studies link alcohol to breast cancer, but at the same time, moderate alcohol consumers generally belong to socio-economic classes that are also more likely to undergo frequent mammograms and other diagnostic tests.

Even the biochemical effects of alcohol, according to Prasad, are still poorly understood. The claim that alcohol modifies DNA and increases the risk of cancerous transformation is proven only in animal experiments, and no public health decision or drug authorisation is made without human testing.

Be careful how risk is quantified

Then there is the problem of risk quantification. It is crucial to distinguish between absolute and relative risk: the former indicates the overall probability of an event occurring, while the latter compares probabilities between groups with different characteristics.

When the U.S. Surgeon General states that one drink a day increases the relative risk of breast cancer by 10 per cent, this means that, against the backdrop of the disease’s overall incidence in the population, the absolute risk of developing it rises from 11 per cent to 13 per cent.

When the director of the National Alcohol Observatory of the Italian National Institute of Health, Emanuele Scafato, writes on social media that for breast cancer, “the risk increases by 27 per cent for a woman already with a second glass,” he is making a considerable claim based on two omissions: the first is the absence of the adjective relative, and the second is that this +27 per cent (relative) refers exclusively to the (fortunately small) subset of cases in which the mammary gland tissue presents oestrogen receptors. In general, the increase in relative risk is 7 per cent. This is not about downplaying the risk but about quantifying it as precisely as possible, knowing not only what the data say but also what they do not say.

Three glasses of wine a day = 10 minutes less of life

Recently, Tim Stockwell, the father of alcohol debunking, summarised a lifetime of research with a risk estimate understandable to the public: "One drink a day reduces average life expectancy by about three months." This means that each glass of wine subtracts five minutes of life from a moderate drinker, while for heavy drinkers (two or three glasses a day), the minutes lost per drink rise to at least 10 and then increase exponentially with quantity.

The social dimension of drinking

There is, finally, another aspect of the issue that studies on the harms of alcohol tend to overlook: the social dimension of drinking. Alcohol consumption has been declining, especially among young people, even before awareness of its harmful effects became widespread. Young people are not cutting back or quitting because they are more conscious of the risks than their parents were at their age, but for other reasons.

Which ones? The answer is complex and has no single cause, but what we do know for certain is that younger generations are experiencing loneliness and a lack of social connections in a way never before seen in history. The same Surgeon General who is calling for tighter restrictions on alcohol in the United States has, for over a decade, described loneliness as the most serious health crisis of our time—an existential distress linked to a myriad of illnesses, from depression to cardiovascular disorders.

He estimates that lacking strong social bonds is as harmful as smoking 15 cigarettes a day (for comparison, scientists say that one cigarette takes an average of 20 minutes off a person’s life). And where is this loneliness often expressed and amplified? On smartphones and devices, particularly on social media, which, incidentally, the same Surgeon General has identified as a major driver of the mental health issues that disproportionately affect adolescents.

"Teenagers who spend more than three hours a day on social media have double the risk of experiencing symptoms of anxiety and depression," Murthy wrote last year, proposing to introduce warnings and restrictions to educate a public that continues to underestimate the dangers of these platforms.

Giving up wine and suffering from loneliness

Now, alcohol is evidently not a remedy for social isolation, but it is a fact that for several millennia, human beings have tended to drink in company. Alcohol is linked to celebrations, meals shared with others, special occasions, enjoyment, joy, the sharing of a moment of life’s celebration, reconciliation, clarification, and difficult yet necessary conversations. Some religions prohibit alcohol, but many more incorporate it as a central element in their rituals. The vast majority of faiths advocate moderate consumption rather than abstinence.

In short, in human experience, alcoholic beverages play a role, especially where people gather and share something meaningful. While giving up alcohol for health reasons is undoubtedly a good choice in absolute terms, there is no clear indication that this is currently the primary motivation driving the growing number of abstainers. Many are forgoing the exhilaration of a drink in company in favour of other forms of intoxication consumed in solitude—a condition that, in turn, harms health.

In laboratory conditions, stating that drinking is harmful is certainly true, but in the messy complexity of life, things are far more complicated.