A new national study finds that more than half of U.S. adults do not know alcohol can raise cancer risk.

Researchers analyzed answers from almost 7,000 adults across the country, offering a clear snapshot of beliefs right now. The work comes from scientists in Houston.

The work was led by Dr Sanjay Shete at The University of Texas MD Anderson Cancer Center (UT). His research focuses on statistical genetics and cancer prevention in population health.

This was a cross-sectional study, a snapshot of the population at one point in time. It identifies patterns – not causes or future changes.

The link between alcohol and cancer

Overall, 52.9 percent of adults did not know that drinking affects cancer risk, while 37.1 percent recognized the link. A small share answered that alcohol decreases cancer risk.

Only one percent believed drinking lowers risk – a small but telling group. People who had consumed alcohol recently were especially likely to think drinking has no effect.

Beliefs also varied by background and behavior, revealing gaps that matter for prevention. Current cigarette smokers, Black adults, and people with less education were more likely to be unaware of the link.

Those who do not believe cancer is preventable were more likely to say alcohol does not influence risk. Respondents ranged widely in age, with an average age of 48.

How alcohol causes cancer

There is strong evidence that drinking alcohol causes several cancers in people. These include cancers of the mouth, throat, esophagus, liver, breast, and colorectum.

Alcohol is a carcinogen, a substance proven to cause cancer in humans. By 2019, alcohol accounted for about five percent of U.S. cancer cases and about four percent of cancer deaths.

Researchers have mapped several biological routes. One involves acetaldehyde that damages DNA and proteins.

Another involves reactive oxygen species, highly reactive oxygen molecules that can harm cells. These mechanisms help explain why risk is not confined to heavy use.

Risk rises with more drinking because exposure adds up over time. Even low levels raise breast cancer risk, while heavy drinking pushes the risk much higher for several sites.

Beliefs shape choices

“It’s concerning that people who drink alcohol are the ones most likely to believe it has no effect on cancer risk,” said Dr. Shete. That misunderstanding can dull motivation to cut back.

Recent patterns do not help. One U.S. analysis found sustained increases in alcohol use after the pandemic period.

When people underestimate a hazard, they are less likely to support policies that limit harm. Misbeliefs can also blunt the impact of warnings and clinical counseling.

What this means for guidance

In January 2025, the U.S. Surgeon General issued an advisory, an official public health notice, that explains the cancer link and offers steps.

The recent notice highlights the need for clear messages so consumers can factor cancer risk into decisions.

The advisory urges plain labeling and consistent counseling in routine care. It also notes that even low levels of drinking carry risk for cancer.

For adults who choose to drink, expert guidance still emphasizes modest amounts and alcohol-free days. People with a personal or family history of certain cancers may want to reconsider any drinking at all.

The new findings point to a simple priority. Correct the belief gap before asking the public to change behavior.

How public education can help

Public health campaigns have successfully shifted beliefs about tobacco, sunscreen use, and seat belt safety, but alcohol still lags behind.

Experts say part of the issue is that alcohol is woven into social norms, making it harder to challenge through standard messaging.

When people see drinking as a symbol of relaxation or reward, warnings about cancer can feel abstract or irrelevant.

Changing this perspective requires consistent education that connects alcohol not just to addiction or liver disease, but to long-term cancer risk.

Clear messages about alcohol and cancer

Schools, health systems, and media outlets could help bridge this gap by presenting facts in simple, visual formats.

Studies show that plain-language warnings and visual labels on bottles can shift risk perception more effectively than text-heavy advisories.

As more states consider new labeling policies, researchers see an opportunity to recalibrate public understanding the way anti-tobacco efforts did decades ago.

Messages should avoid mixed signals. Replace vague words like moderate with specific amounts measured in standard drinks.

The study is published in the journal JAMA Oncology.

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