—The National Association of Wine Retailers Responds to the
Los Angeles Times Opinion Piece calling for the Social Stigmatization of Alcohol—

On July 2nd, the Los Angeles Times published an opinion piece in their “Voices” section by Dr. Emma Fenske entitled “Alcohol Should Be Stigmatized Like Smoking.” Dr. Fenske argued that alcohol ought to be treated exactly as tobacco is treated. The Los Angeles Times published this irresponsible piece without any rebuttal.

National Association of Wine Retailers’ Executive Director Tom Wark has issued the following statement on behalf of the Association:

AN OBJECTIVE EVALUATION: WHY EQUATING ALCOHOL
TO TOBACCO OVERSIMPLIFIES AND DAMAGES PUBLIC HEALTH EFFORTS

On July 2, a commentary titled “Alcohol Should Be Stigmatized Like Smoking” was published in the Los Angeles Times by Dr. Emma Fenske, an addiction medicine fellow. The article posits that society must rapidly shift its cultural acceptance of alcohol, utilizing the same playbook of stigmatization, taxation, and warning labels to do so.  While the piece accurately highlights the severe consequences of alcohol abuse and chemical dependency, its core idea and primary recommendation—that alcohol is functionally equivalent to tobacco and should be treated as such—is so out of touch with lived experiences as well as science that it must be challenged.

When we consider the physiological effects, the data regarding moderate alcohol consumption, and the historical context of tobacco stigmatization, it becomes clear that Dr. Fenske’s claims and prescriptions can’t be considered anything other than propaganda.

THE UNSTATED BIOLOGICAL REALITY—ALCOHOL IS NOT TOBACCO
A foundational difference between alcohol and tobacco lies in how the human body interacts with the substances. The human body has evolved specific pathways to process alcohol. Enzymes such as alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are present in the liver and stomach precisely to metabolize small amounts of alcohol, breaking it down into acetaldehyde, and subsequently into harmless acetate and water. Because ethanol occurs naturally in trace amounts through the fermentation of sugars in fruit and within the human gut microbiome, the body is biologically equipped to manage it in moderate amounts.

Tobacco presents an entirely different circumstance. The inhalation of burning tobacco introduces the lungs and bloodstream to over 7,000 chemical compounds, hundreds of which are known to be toxic, and roughly 70 of which are definitively linked to cancer. The human respiratory system possesses no way to safely metabolize the tar or carbon monoxide generated by smoking. Consequently, science has shown that there is no safe level of tobacco smoke inhalation. When a product is lethal when used exactly as intended at any dose, its treatment from a public health perspective must surely be different from a substance the body can metabolize in moderation. Nowhere in her Los Angeles Times diatribe does Dr. Fenske note this key difference between alcohol and tobacco. Worse, she understands this difference and doesn’t mention it. 

CATEGORIZING HAZARDS VS RISKS
In her commentary, Dr. Fenske does, however, note that the World Health Organization classifies alcohol as a Group 1 carcinogen, explicitly stating it is in “the same category as tobacco and asbestos.” While factually accurate, presenting this classification without context often leads to public misunderstanding of the magnitude of the risk.

The International Agency for Research on Cancer (IARC), which determines these classifications, evaluates hazard, not risk. A Group 1 classification simply means there is sufficient scientific evidence that a substance can cause cancer in humans under certain circumstances or at certain doses. It is not a measure of the likelihood of developing cancer at typical exposure levels. To illustrate, alongside tobacco, asbestos, and plutonium, IARC’s Group 1 carcinogen list also includes processed meats (like bacon and hot dogs), wood dust, and solar radiation—yes, sunlight is considered a Group 1 carcinogen also. 

Equating alcohol to asbestos or tobacco based solely on their shared Group 1 status conflates hazard identification with risk assessment. And Dr. Fenske knows this too. A person smoking a pack of cigarettes daily faces an exponentially higher absolute risk of developing lung cancer than a person consuming one alcoholic beverage daily faces of developing breast or liver cancer or any other cancer. 

THE REALITY OF ALCOHOL DATA AND SCIENCE
Dr. Fenske does accurately point out that newer guidelines have challenged the long-held assumption that moderate drinking provides cardiovascular benefits. For decades, the “J-shaped curve” suggested that moderate drinkers had lower cardiovascular mortality than both heavy drinkers and strict abstainers. Recent methodological critiques suggest that some of this apparent benefit was skewed by the “sick quitter” effect—where individuals who stopped drinking due to underlying health issues were grouped with lifetime abstainers, making moderate drinkers appear artificially healthier.

However, acknowledging the flaws in older studies does not inherently validate the opposing extreme that moderate consumption is a severe public health crisis and should be addressed the same way we address smoking. While the World Health Organization has recently stated there is “no safe amount” of alcohol consumption regarding cancer risk and while Dr. Fenske is quick to point this out, this framing of the issue does not speak to the real absolute risk of cancer from drinking and only speaks to the “relative risk. For example, if a baseline absolute risk of a specific cancer is 1% over a lifetime, a 10% relative increase in that risk due to moderate drinking raises the absolute risk to 1.1%. A 10% increase in risk sounds frightening. But going from a 1% risk to a 1.1% risk doesn’t seem quite as alarming. And it shouldn’t. That’s why people with Mr. Fenske’s attitude never mention absolute risk. They want to frighten us.

Dr. Fenske also highlights in her commentary a 2021 literature review stating that consuming two standard drinks roughly doubles the odds of sustaining injuries. While accurate, this statistic is highly context-dependent. The risk of injury after two drinks in a high-risk environment is vastly different from the risk of injury when consuming two drinks in the safety of one’s home. Blanket statistics without situational context further her and others’ alarmist narrative.

But even more notable about this irresponsible article is what is not in it; what Dr. Fenske chooses not to highlight. For example, a recent study by the National Academy of Sciences, Engineering, and Medicine showed that those who consume alcohol in moderation showed less mortality from all causes than those who abstain from drinking. The American Heart Association recently confirmed a reduction in heart disease among those who drink in moderation compared to those who abstain. Finally, meta-studies published by the National Institute of Health show a reduction in stroke, diabetes, Alzheimer’s disease, dementia, kidney disease, and many other ailments associated with moderate alcohol consumption.

These facts, that go unmentioned in Dr. Fenske’s LA Times editorial, are part of the story of alcohol and health. What they are not is support of the assertion that a glass of wine is like a cigarette.

THE MECHANICS OF ALCOHOL STIGMATIZATION
Dr. Fenske argues for the social stigmatization of alcohol, leaning heavily on the success of the anti-tobacco movement. Yet, it is vital to understand why smoking became successfully stigmatized.

The turning point for tobacco was the indisputable evidence regarding secondhand smoke. Smoking was not driven out of restaurants, airplanes, and public spaces merely because it harmed the smoker; it was banished because it caused measurable harm to the innocent bystanders breathing the shared air. The stigma was rooted in the violation of others’ bodily autonomy.

There is no such thing as second-hand moderate alcohol consumption. A person enjoying a glass of wine with dinner does not passively impair the liver function of the person sitting at the adjacent table.

It is entirely true that the behavioral consequences of severe alcohol abuse—drunk driving, domestic violence, and public intoxication—cause immense harm to others. However, society already heavily stigmatizes and criminalizes those behaviors. Advocating for the stigmatization of the substance itself, across all levels of consumption, unfairly conflates the moderate, culturally embedded use of alcohol with the dangers of addiction.

EDITORIAL MOTIVATIONS AND MEDIA FRAMING
It’s worth asking why the Los Angeles Times would choose to run such a flawed, obviously biased, and manipulative editorial. The media landscape has increasingly favored absolutist health narratives over nuanced risk assessments. Articles and opinion pieces like Dr. Fenske’s declaring that an accepted social norm is actually a hidden, deadly crisis reliably generate high engagement and clicks.

When major newspapers publish pieces that aggressively compare a complex dietary and cultural object like alcohol to tobacco, they prioritize sensationalism over truth. This trend can inadvertently damage public trust. When the public is told that a daily glass of wine is as dangerous as smoking or asbestos exposure—a claim that defies both lived experience and absolute risk statistics—the general public begins to tune out vital, evidence-based public health warnings regarding problems like binge drinking and dependency.

Alcohol is not a harmless substance. Its toll on human health, primarily through dependency and binge drinking, is severe and demands robust public health resources, addiction treatment, and education. It is also true that individuals have a right to know the accurate risks regarding alcohol and cancer.

However, translating these legitimate concerns into an illegitimate campaign to stigmatize alcohol is an overreach unsupported by comparative data, science, and commonsense. Moderate alcohol consumption, which is practiced by 90% of those who drink, remains a deeply ingrained facet of human culture precisely because, for the vast majority of consumers, it is enjoyed safely, does not lead to addiction, and has minimal impact on health risks. True public health relies on empowering individuals with accurate, proportional data, not manipulating them through false equivalencies and orchestrated stigma. Dr. Fenske and the Los Angeles Times should know better.

ABOUT THE NATIONAL ASSOCIATION OF WINE RETAILERS
Founded in 2006, NAWR represents specialty wine retailers, wine auction houses, and wine of the month clubs across the country. Its mission is to advance its members’ interests through education, lobbying, and litigation when necessary. For more information, see www.nawr.org

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CONTACT:
Tom Wark, Executive Director
707-246-6451 • [email protected]