Right now, you are someone who drinks 0, 1, 2, 3 or more drinks a day. These drinks might be tequila neat, Mad dog 20-20, an Oakville, Napa cabernet, or Bud Lite. Probably, you are not consistent. You might drink 1, 2 or 4 nights a week. You might drink before meals, or after dinner. You might drink a hazy IPA after a long run, a Corona after mowing your lawn, or sip a gin and tonic on a hot summer day.

Some of you are wondering if your habits are healthy— or should you drink fewer or perhaps more drinks? And what if you are starting from scratch: say you are a 16 year old who hasn’t yet had a drink, but thinking about it. Should you start?

The Surgeon General put out advice saying that even moderate drinking is linked to a series of cancers. He says at least 7 cancers are implicated.

He wants a warning on alcohol. Is that a good public policy decision? Is it supported by evidence?

In this essay, I will outline the evidence on alcohol. I will start with a large meta-analysis and then explore the underlying observational data. I will discuss the mechanistic science. I will provide a study that I think the US NIH should fund that will provide guidance, and finally I will end with my alcohol recommendations. Am I evidence based? I will end with a meditation on that question.