Why more Americans taking a pass on alcohol

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Once more of a standard in the U.S., 54% of Americans now say they drink alcohol — a 30-year low — according to a new Gallup poll [1]. This represents a significant drop for a figure that never dropped below 60% from 1997 to 2023. Meanwhile, a record 53% of Americans now consider moderate drinking harmful to health, nearly double the 28% who thought so in 2015 [1].

The data suggests Americans are acting on their growing health concerns by drinking less, marking a historic shift in both attitudes and behavior.

Changing perceptions about moderate drinking

The shift in health perceptions about moderate drinking among Americans has been prompted by several key factors. Many Americans are rethinking the once popular notion that moderate alcohol consumption, especially red wine, was healthy for the heart [2]. Past research suggested moderate alcohol consumption had cardiovascular benefits, but more recent and comprehensive studies show that even low levels of alcohol increase risks for several cancers (breast, mouth, throat), hypertension, arrhythmias and other conditions [2].

Meta-analyses have found no significant reduction in all-cause mortality from moderate drinking. The scientific consensus is moving toward recognizing that any level of alcohol intake carries risk, leading to more conservative drinking guidelines globally. Public awareness has increased through better health communication and media coverage highlighting the potential dangers of alcohol [3].

New evidence on risks

Recent federal research has found that men and women consuming more than seven drinks per week have about a 1 in 1,000 risk of dying from causes linked to alcohol, and this risk escalates at higher consumption levels [4]. Even moderate drinking — defined as about one drink per day for women and up to two for men within current U.S. guidelines — is associated with increased risks of:

• Cancer: Multiple types including breast, esophageal, oral, liver, colorectal, pharynx and larynx cancers. The risk of cancer rises even with low or moderate alcohol intake [4,5]
• Liver disease: Even moderate drinking raises the risk of liver cirrhosis and liver-related health issues [5]
• Cardiovascular issues: Hypertension and arrhythmias are associated with alcohol use [2,5]
• Injuries: Higher risk of accidental injuries and road accidents [5]
• All-cause mortality: The risk of dying from alcohol-related causes begins at low levels of consumption and increases progressively [4]

The National Academies of Sciences, Engineering and Medicine highlight that the association between alcohol and cancer risk is likely linear — there is no safe threshold [6].

Medical professionals’ recommendations

The medical consensus is that less alcohol is better for health [7]. Current guidelines emphasize that moderate drinking does not eliminate health risks. The 2020-2025 U.S. Dietary Guidelines recommend limiting intake to 1 drink or less per day for women and 2 for men if they choose to drink [2].

Certain populations should avoid alcohol entirely:

• People under 21
• Pregnant women or those planning pregnancy
• Those with certain medical conditions (e.g., liver disease)
• People taking medications that interact with alcohol

Older adults (65+) are recommended to limit themselves to 1 drink per day due to lower alcohol metabolism [7].

Medical guidelines do not advise nondrinkers to start drinking for health benefits and advice is becoming stricter on encouraging abstinence or minimization of alcohol intake [7].

Impact of recent government guidelines

Recent government guidelines have significantly influenced public perception by clarifying and emphasizing the health risks associated with even moderate alcohol consumption [8]. These guidelines have:

• Provided clear definitions and limits for moderate drinking
• Emphasized risks over potential benefits
• Offered additional recommendations for vulnerable groups
• Supported broader cultural health shifts, especially among younger adults [8]

The U.S. Surgeon General has issued advisories linking alcohol use and cancer, and called for improved warning labels on alcoholic beverages [5]. Public health leaders are calling for lowering recommended alcohol limits or greater emphasis on abstinence due to emerging research on health risks [4].

All generations abstaining more

Younger adults are leading the shift away from alcohol, both because they perceive moderate drinking as harmful and because they are drinking less overall [1]. This generation increasingly “passes on” alcohol compared with past ones, contributing to long-term changes in consumption patterns. Older adults are also increasingly adopting similar perceptions, resulting in fewer people drinking and reduced consumption among those who do [1].

Additional contributing factors to decline

The decline in alcohol consumption is not primarily driven by substitution with marijuana, despite legalization in many states. Instead, the reduction is more related to health concerns and changing social attitudes [9]. Economic considerations such as inflation and tighter budgets postpandemic, along with a broader trend of health consciousness, also contribute to the shift away from alcohol [1].

Sources

[1] https://news.gallup.com/poll/693362/drinking-rate-new-low-alcohol-concerns-surge.aspx

[2] https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/basics-defining-how-much-alcohol-too-much

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC10066463/

[4] https://www.statnews.com/2025/01/14/alcohol-health-effects-new-federal-report-says-single-drink-daily-raises-risk/

[5] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551

[6] https://www.nationalacademies.org/news/2024/12/new-report-reviews-evidence-on-moderate-alcohol-consumption-and-health-impacts

[7] https://www.prevention.va.gov/Healthy_Living/Limit_Alcohol.asp

[8] https://pmc.ncbi.nlm.nih.gov/articles/PMC3536464/

[9] https://apnews.com/article/drinking-alcohol-beer-wine-liquor-poll-health-091aa28c3375d30d728d48c628a9023a