WASHINGTON — A report on the health effects of alcohol, commissioned by the federal government but unpublished under President Trump, was published Tuesday in the journal Science. The study found that even low levels of alcohol consumption can increase the risk of various illnesses and death.
The Alcohol Consumption and Health Study began in 2023 and was conducted by the federal Substance Abuse and Mental Health Services Administration as part of an update to the U.S. Dietary Guidelines. However, the panel’s research quickly became embroiled in controversy, with some members of Congress and alcohol industry trade groups claiming that the scientists involved in the project had anti-alcohol leanings.
The group’s final findings have not been made public by the Trump administration. A House Oversight Committee report in January said the report was “irreparably flawed” and recommended that the authors of the dietary guidelines ignore its conclusions. Some study authors working outside the U.S. government argue that their findings were politicized and suppressed to the detriment of powerful special interests, including the beer, wine, and liquor lobby.
The researchers, scorned by Trump officials, submitted their review to the Journal of Alcohol and Drug Research, which published the paper, independent of SAMHSA funding. Among the findings: Even low levels of consumption, about one drink per day, increase Americans’ chances of death or serious illness.
“These findings are not radical; they are rigorous and commercially threatening,” Robert Vincent, SAMHSA’s former associate administrator for alcohol prevention and treatment policy who helped oversee the study, said in an accompanying editorial. Vincent lost her job last year as part of deep cuts across federal health agencies.
Emily Hilliard, a spokeswoman for the Department of Health and Human Services, said federal officials considered alcohol research “along with the extensive scientific evidence available” when updating the nation’s dietary advice.
New guidelines and an upturned pyramid were announced in January, surprising some as decades-old messages about alcohol were scrapped. Rather than telling Americans to stick to one or two drinks a day, they simply advised them to “reduce their alcohol intake to improve overall health.”
“The guidelines are informed by the entirety of the scientific record, not a single report or analysis,” Hilliard told STAT. However, a scientific appendix published with the dietary guidelines noted that the agency relied on another study, rather than the SAMHSA-led report, as the basis for its alcohol recommendations.
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Historically, it has been suggested that men limit drinking twice as much as women, due to biological differences in how quickly their bodies process alcohol.
However, the available scientific evidence supports a gender-neutral recommendation to reduce the risk for men, the SAMHSA report found, limiting adults who drink to one alcoholic drink per day. Another committee developing dietary guidelines reached the same conclusion in 2020, but the proposal was not adopted.
The science about alcohol’s health effects is especially relevant now, when Americans are drinking less and thinking more about their health, but alcohol-related harms remain at high levels. Alcohol causes an estimated 178,000 deaths each year in this country. Alcohol consumption, especially binge drinking, is associated with an increased risk of various illnesses and death.
However, scientific opinion is divided on how small amounts of alcohol affect health. Just last week, a large review published in Nature Health found evidence that low to moderate alcohol consumption is associated with a lower risk of some cardiovascular diseases, type 2 diabetes, and dementia. However, research has found that even very low levels of alcohol consumption are associated with an increased risk of cancer. The authors write that “current evidence does not support sex-specific thresholds” for federal alcohol guidance.
The Trump administration’s decision to withhold taxpayer-funded alcohol reports has public health implications, but also raises new questions about scientific independence under the administration. Authorities are already threatening or withdrawing research funding on topics deemed illegal, such as gender diversity and racial inequality. Most recently, the administration proposed changes to the way scientific grants are awarded to give political appointees greater control over federally funded research.
“The public health consequences of setting aside evidence-based alcohol policy are immediate and cumulative,” Vincent wrote in an editorial.
In the end, Trump officials relied on a study on alcohol led by the National Academies of Sciences, Engineering, and Medicine at the request of Congress. That review by 14 external researchers found moderate evidence that moderate drinking is associated with lower all-cause mortality. The group’s analysis was not specific to alcohol-related causes of death. The review also found that moderate drinking increases the risk of breast cancer. (NASEM’s committee was criticized by watchdog groups and outside researchers for including people with financial ties to the beverage alcohol industry.)
In contrast, the SAMHSA committee found that alcohol has no net health benefits and carries risks even in moderate amounts. One drink a day is “associated with an increased risk of death from liver cirrhosis, esophageal cancer, oral cavity cancer, and trauma-related death. For women, these risks extend to liver cancer,” the paper says.
Researchers used meta-analysis and data modeling to estimate alcohol-specific risks for various diseases and injuries and compared those risks to those of people who have never drank alcohol. (Former drinkers were excluded to control for potential bias in people who stopped drinking after getting sick.) The study focused on U.S. data that was representative of the national population, including from surveys, the Injury Surveillance System, and the Vital Statistics Repository.
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The lifetime risk of death from one drink a day is about 1 in 1,000, but increases with the amount of alcohol consumed. Data shows that if a man drinks 14 drinks a week, he has a 1 in 25 chance of dying from alcohol over his lifetime. Women’s risk increases sharply as they drink more: At two drinks a day, women’s relative risk of dying from serious liver disease is more than double that of men who drink the same amount, the analysis found.
The small protective effect researchers observed with up to three drinks per week was not statistically significant. However, the researchers found that women who drank up to one alcoholic drink per day had a reduced risk of diabetes, a finding echoed in other studies, but said the risk was “not evenly distributed across individuals.”
Binge drinking, defined as five or more drinks at one time for men and four or more for women, increases the risk of heart attack, heart disease, stroke and injury, the study found.
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