Intended for healthcare professionals

Rapid response to:


Alcohol must be recognised as a drug

BMJ 2018; 362 doi: (Published 20 September 2018) Cite this as: BMJ 2018;362:k3944

Rapid Response:

Alcohol must be recognised as a carcinogen!

“May God defend me from my friends: I can defend myself from my enemies.” Voltaire.

Kypri and McCambridge, to promote alcohol control, pledged for recognizing alcohol as a drug.(1) This deserves comment.

Almost everyone knows alcohol is a drug, and many are using it for this characteristic. This is why people consume serial drinks and it explains the success of new products with higher levels of alcohol than usual, from beer to liquors, or the success of new patterns of use such as binge-drinking.

In fact, the main characteristic of alcohol is it is a human carcinogen (Class 1) even at a low level: there is a dose-related increase in the prevalence of several cancers either exponential (eg. oral cavity, pharynx cancers) or linear (eg. esophagus, breast) beginning at the 1-2 drink/day level.(2) For some cancers there is a threshold effect (eg. liver, colorectal). Most people are not aware of this characteristic.(3)

Yukon, a territory in Canada, implemented in November 2017 mandatory labels warning of an elevated risk of cancer on alcoholic beverages. This genuine step forward was abruptly followed by one backward: the labelling initiative stopped just before Christmas after push-back from the alcohol industry.(4)

Given that mass hysteria is the main threat from biohazards,(5) even when no risk exists for health,(6) mandatory labels warning about alcohol carcinogenicity would be most efficient. Maybe too efficient to be implemented?

1 Kypri K, McCambridge J. Alcohol must be recognised as a drug. BMJ 2018;362:k3944.

2 Rehm J, Shield K: Alcohol consumption. Stewart BW, Wild CB, eds. World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer; 2014.

3 Gulland A. People lack awareness of link between alcohol and cancer, survey finds. BMJ 2016;353:i1881


5 Moscrop A. Mass hysteria is seen as main threat from bioweapons. BMJ 2001;323:1023.

6 Watts G. Genetic manipulation of crops could offer healthier food, say scientists. BMJ 2012;344:e2030.

Competing interests: No competing interests

26 September 2018
alain braillon
senior consultant
university hospital. 80000 Amiens. France.