Science
Column: RFK Jr. is dismantling trust in vaccines, the crown jewel of American public health
When it comes to vaccines, virtually nothing that comes out of Robert F. Kennedy Jr.’s mouth is true.
The man in charge of the nation’s health and well being is impervious to science, expertise and knowledge. His brand of arrogance is not just dangerous, it is lethal. Undermining trust in vaccines, he will have the blood of children around the world on his hands.
Scratch that.
He already does, as he presides over the second largest measles outbreak in this country since the disease was declared “eliminated” a quarter century ago.
“Vaccines have become a divisive issue in American politics,” Kennedy wrote the other day in a Wall Street Journal essay, “but there is one thing all parties can agree on: The U.S. faces a crisis of public trust.”
The lack of self-awareness would be funny if it weren’t so tragic.
Over the past two decades or so, Kennedy has done more than almost any other American to destroy the public’s trust in vaccines and science. And now he’s bemoaning the very thing he has helped cause.
Earlier this month, Kennedy fired the 17 medical and public health experts of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices — qualified doctors and public health experts — and replaced them with a group of (mostly) anti-vaxxers in order to pursue his relentless, ascientific crusade.
On Thursday, at its first meeting, his newly reconstituted council voted to ban the preservative thimerosal from the few remaining vaccines that contain it, despite many studies showing that thimerosal is safe. On that point, even the Food and Drug Administration website is blunt: “A robust body of peer-reviewed scientific studies conducted in the U.S. and other countries support the safety of thimerosal-containing vaccines.”
“If you searched the world wide, you could not find a less suitable person to be leading healthcare efforts in the United States or the world,” psychiatrist Allen Frances told NPR on Thursday. Frances, who chaired the task force that changed how the Diagnostic and Statistical Manual of Mental Disorders, or DSM, defines autism, published an essay in the New York Times on Monday explaining why the incidence of autism has increased but is neither an epidemic nor related to vaccines.
“The rapid rise in autism cases is not because of vaccines or environmental toxins,” Frances wrote, “but is rather the result of changes in the way that autism is defined and assessed — changes that I helped put into place.”
But Kennedy is not one to let the facts stand in the way of his cockamamie theories. Manufacturers long ago removed thimerosal from childhood vaccines because of unfounded fears it contained mercury that could accumulate in the brain and unfounded fears about a relationship between mercury and autism.
That did not stop one of Kennedy’s new council members, Lyn Redwood, who once led Children’s Health Defense, the anti-vaccine group founded by Kennedy, from declaring a victory for children.
“Removing a known neurotoxin from being injected into our most vulnerable population is a good place to start with making America healthy again,” Redwood told the committee.
Autism rates, by the way, have continued to climb despite the thimerosal ban. But fear not, gullible Americans, Kennedy has promised to pinpoint a cause for the complex condition by September!
Like his boss, Kennedy just makes stuff up.
On Wednesday, he halted a $1-billion American commitment to Gavi, an organization that provides vaccines to millions of children around the world, wrongly accusing the group of failing to investigate adverse reactions to the diptheria vaccine.
“This is utterly disastrous for children around the world and for public health,” Atul Gawande, a surgeon who worked in the Biden administration, told the New York Times.
Unilaterally, and contrary to the evidence, Kennedy decided to abandon the CDC recommendation that healthy pregnant women receive COVID vaccines. But an unvaccinated pregnant woman’s COVID infection can lead to serious health problems for her newborn. In fact, a study last year found that babies born to such mothers had “unusually high rates” of respiratory distress at or just after birth. According to the CDC, nearly 90% of babies who were hospitalized for COVID-19 had unvaccinated mothers. Also, vaccinated moms can pass protective antibodies to their fetuses, who will not be able to get a COVID shot until they are 6 months old.
What else? Oh yes: Kennedy once told podcaster Joe Rogan that the 1918 Spanish flu epidemic was “vaccine-induced flu” even though no flu vaccine existed at the time.
He also told Rogan that a 2003 study by physician scientist Michael Pichichero, an expert on the use of thimerosal in vaccines, involved feeding babies 6 months old and younger mercury-contaminated tuna sandwiches, and that 64 days later, the mercury was still in their system. “Who would do that?” Kennedy demanded.
Well, no one.
In the study, 40 babies were injected with vaccines containing thimerosal, while a control group of 21 babies got shots that did not contain the preservative. None was fed tuna. Ethylmercury, the form of mercury in thimerosal, the researchers concluded, “seems to be eliminated from blood rapidly via the stools.” (BTW, the mercury found in fish is methylmercury, a different chemical, which can damage the brain and nervous system. In a 2012 deposition for his divorce, which was revealed last year, Kennedy said he suffered memory loss and brain fog from mercury poisoning caused by eating too much tuna fish. He also revealed he has a dead worm in his brain.)
Kennedy’s tuna sandwich anecdote on Rogan’s podcast was “a ChatGPT-level of hallucination,” said Morgan McSweeney, a.k.a. “Dr. Noc,” a scientist with a doctorate in pharmaceutical sciences, focusing on immunology and antibodies. McSweeney debunks the idiotic medical claims of non-scientists like Kennedy in his popular social media videos.
Speaking of AI hallucinations, on Tuesday, at a congressional committee hearing, Kennedy was questioned about inaccuracies, misinformation and made up research and citations for nonexistent studies in the first report from his Make America Healthy Again Commission.
The report focused on how American children are being harmed by their poor diets, exposure to environmental toxins and, predictably, over-vaccination. It was immediately savaged by experts. “This is not an evidence-based report, and for all practical purposes, it should be junked at this point,” Georges C. Benjamin, executive director of the American Public Health Assn. told the Washington Post.
If Kennedy was sincere about improving the health of American children he would focus on combating real scourges like gun violence, drug overdoses, depression, poverty and lack of access to preventive healthcare. He would be fighting the proposed cuts to Medicaid tooth and nail.
Do you suppose he even knows that over the past 50 years, the lives of an estimated 154 million children have been saved by vaccines?
Or that he cares?
@rabcarian.bsky.social
@rabcarian
Science
14 propositions that could remake California taxes, housing, healthcare and elections
California voters will decide 14 statewide propositions in the Nov. 3 election, measures placed on the ballot mostly by either powerful interest groups or lawmakers that will affect the lives of millions of Californians.
While a proposed tax on state billionaires has dominated headlines, voters will also have a chance to weigh in on a number of consequential issues, from healthcare to voter identification requirements and more.
Californians are accustomed to legislating by the ballot and often face a list of propositions. But even by the standards of the state’s direct democracy process, the 2026 election stands out. The campaigns supporting and opposing the ballot measures have already collected more than $100 million in contributions, and are expected to use their money to inundate the television airwaves, livestreams and social media feeds and to flood mailboxes with glossy campaign mailers over the coming months.
Here are the measures on the Nov. 3 ballot:
Proposition 1: The Veterans and Affordable Housing Bond Act of 2026
Spurred by the state’s affordable housing shortage, state lawmakers are asking voters to approve an $11.25-billion bond to boost affordable housing construction around the state.
Advocates say the funds would help build more than 40,000 shovel-ready affordable homes that are unable to move forward because of a financing gap and help preserve thousands of other existing units.
Proposition 1 includes specific funding for high-need groups, including $1.25 billion for a veterans’ home loan program, $1.15 billion for supportive housing for homeless people, $350 million for student housing at state universities, $450 million for farmworker housing and $200 million for Native American tribes.
“In California, we don’t turn away from the needs of our people — we meet them head-on,” said Gov. Gavin Newsom in a statement about the measure. “We are giving voters the power to help shape the future of housing in our state. This bond is about building communities, expanding access and affordability in California, where every family has a fair shot at a place to call home.”
Some Republicans took issue with the measure’s title — “The Veterans and Affordable Housing Bond Act of 2026” — arguing that it included veterans to have broader appeal while doing little to actually help homeless veterans.
“It’s a sad thing to say that you have to use the veterans as bait to get the people of the state of California to approve an $11-billion bond, and I just think that’s shameful,” said Sen. Shannon Grove (R-Bakersfield), an Army veteran. “Call it what it is. It’s a homeless bond, and it does include some veterans’ benefits, but it is not a veterans bond.”
Proposition 2: Save for California’s Future Act
This measure would give California lawmakers more flexibility over state spending and allow them to save money that could otherwise go back to taxpayers.
The measure, supported by Newsom, seeks to exempt deposits into state savings accounts from a spending limit that voters adopted through a series of ballot measures dating back to the late 1970s, and to increase the share of tax revenue that can be put into the rainy day fund.
Under an existing state appropriations restraint, also known as the Gann Limit, lawmakers cannot spend more than an amount determined by a formula that takes annual tax proceeds, changes to the population and cost of living into consideration. Tax revenue above the limit must be divided between schools and refunds to taxpayers.
The measure could incentivize lawmakers to save more money because funds tucked away in the rainy day fund would no longer be considered expenditures counted toward the spending limit. By allowing lawmakers to set aside more money that is not subjected to state spending limits, it could also allow them to hold onto money that otherwise would be returned to taxpayers under current law.
This proposed constitutional amendment was placed on the ballot by state lawmakers.
Proposition 3: Fund schools and healthcare
If passed, this proposition would make permanent an existing tax on high-income Californians.
The existing tax, passed by voters in 2012 and extended in 2016, is set to expire in 2031. It applies to people who earn more than $360,000 for single filers, $721,000 for joint filers, and $490,000 for heads of household. It adds between 1% to 3% to these high earners’ personal income tax rates.
According to the initiative text, the funds are largely earmarked for local school districts and community colleges, with some portion of the money going to California’s rainy day reserves — which the state uses to prevent cuts to healthcare and other services when revenues decline. The measure says revenues cannot be spent on state bureaucracy or administrative costs.
The state’s nonpartisan Legislative Analyst’s Office expects the measure to bring in between $5 billion and $15 billion annually, depending on how the stock market is performing, with the amount expected to grow over time.
Proposition 4: Public financing of campaigns
This measure would allow the state and local governments to offer public campaign financing to candidates running for elected office. Candidates receiving the funding must abide by expenditure limits and adhere to the criteria set by statute, ordinance or charter to demonstrate broad support, such as demonstrate a large number of small dollar contributions.
None of the public campaign financing can come from funds designated for education, transportation or public safety. The financing cannot discriminate based on party or whether a candidate is a challenger or an incumbent. The public funds cannot be used for legal costs, fines or to pay back personal loans to a campaign.
This measure was placed on the ballot by the California Legislature and governor.
Proposition 5: Recall elections
This measure would change the way recall elections are conducted in California. Under this proposed constitutional amendment, during a recall election, voters would decide solely whether a politician should be removed from their elected position. If the recall is successful, that office would remain vacant until it is filled in accordance with existing law — either by a separate election or by appointment.
Under current law, voters make two separate decisions during a recall election: Whether to remove the subject of the recall from office and, if they are booted, which candidate running to replace them should fill the position. The candidate who receives the most votes wins, even if they receive far less than 50% of the vote.
The proposed constitutional amendment would also allow the recalled politician to run in the next election to fill the vacancy, though they cannot be appointed to their former post. Under the current system, office holders targeted in a recall are barred from being a candidate to replace themselves in that same election.
The proposal comes in the wake of the unsuccessful, Republican-led recall campaign against Gov. Gavin Newsom in 2021, which in part tested voter sentiment about his response to the COVID-19 pandemic. One of the sponsors of the recall-reform measure was Sen. Josh Newman (D-Fullerton), who was recalled from office in 2018 after he voted to increase gas taxes for road repairs, legislation pushed by then-Gov. Jerry Brown. Newman won back his seat in 2020.
This proposed constitutional amendment was placed on the ballot by the California Legislature.
Proposition 37: Homeownership loan program
Proposition 37 would create a down payment assistance program to help middle-class Californians buy a new home.
The measure, spearheaded by former state Senate Majority Leader Bob Hertzberg, would allow middle-class California residents — defined as anyone who makes less than 200% of an area’s median income — borrow most of their down payment for a new home that they plan to live in. It is designed to boost construction of single-family homes.
A down payment is traditionally about 20% of the purchase price of a home. If passed, the measure would create a state-administered loan program that offers qualified homebuyers a second mortgage of up to 17% of a home’s sale price.
The proposition would allow the California Housing Finance Agency to issue up to $25 billion in revenue bonds to administer the program.
The Legislative Analyst’s Office does not anticipate the measure to result in direct state or local costs because the costs are meant to be covered by homeowners’ mortgage payments.
Proposition 38: Immunology research bond
Proposition 38 asks voters to approve an $8.4-billion bond to support research in the burgeoning fields of immunology and immunotherapy, which study the human immune system and how it can be used to prevent, treat and cure diseases.
If approved, half of the funding would go toward the creation of a new immunology and immunotherapy research institute affiliated with the University of California. The other half would fund research grants for other California-based universities and nonprofit medical research institutions to study potential treatments for cancer, Alzheimer’s disease and heart disease.
The measure has a built-in discount program for Californians — it requires that any technology or drugs developed from bond-funded research be sold to California patients for a price at least 20% below the national average.
Backers of the proposal include the Alzheimer’s Assn., National Multiple Sclerosis Society and other healthcare groups. Supporters argue the funding would facilitate research that could save lives and save patients “billions of dollars in health care costs by preventing and curing a range of debilitating diseases and illnesses,” according to the initiative text.
Proposition 39: Voter identification
Proposition 39 would require Californians to show government-issued identification every time they vote at the polls.
Currently, Californians must affirm under penalty of perjury that they are U.S. citizens and provide information to verify their identity, such as their birth date, driver’s license or Social Security number, when registering to vote, but they don’t have to present identification when they cast their ballot.
Under this measure, voters would also need to present government-issued ID each time they vote in-person at the polls or, if voting by mail, provide the last four digits of a “unique identifying number from government-issued identification” that matches the one they provided when they registered to vote. California would be required to provide free voter ID cards on request, and state and county election officials would be required to verify registered voters are U.S. citizens by using government data.
The voter ID measure has support from Assemblymember Carl DeMaio (R-San Diego), who has framed it as necessary to prevent voter fraud and restore trust. It comes as President Trump is pushing for stricter voter identification requirements and severe limits on voting by mail.
Democrats and voting rights groups, including the American Civil Liberties Union, oppose the measure, saying California’s elections are already secure — voter impersonation and noncitizen voting cases are rare — and that it would make voting harder for many eligible voters, including people who have changed names, move frequently or face housing instability.
According to the Legislative Analyst’s Office, the measure would make election administration more expensive, costing state and local governments anywhere from tens of millions to low hundreds of millions of dollars annually, plus tens of millions in upfront implementation costs.
Proposition 40: Billionaire tax
This proposition, supported by a healthcare worker union, would impose a one-time tax of 5% on taxpayers and trusts with assets valued at more than $1 billion.
According to a state-prepared summary of the measure, 90% of the tax revenues would be spent on healthcare and 10% would fund food assistance or education-related programs. California’s richest residents would be able to spread the payments over five years.
The Legislative Analyst’s Office estimates it would generate “tens of billions of dollars” spread over several years, but would lead to an annual decrease in state income tax revenues of “hundreds of millions of dollars or more.”
Newsom has publicly opposed the tax, arguing it would lead wealthy residents to leave the state and lead to future budget problems. Other opponents include Planned Parenthood, the California School Boards Assn. and a nonprofit called Building a Better California that is backed by tech execs and venture capitalists.
Some billionaires have already proactively moved themselves or their businesses out of the state because of the proposal, which as written would retroactively apply to residents of the state as of Jan. 1.
Proposition 41: Requires limits and audits on new state special taxes
This is one of two ballot measures crafted by opponents of the proposed initiative to impose a new tax on California billionaires, and it would in effect undercut or curtail that wealth tax.
This proposed ballot measure would also prohibit any new state taxes from being excluded from the state’s current voter-approved spending limit. The proposed billionaire tax would have such an exclusion. If the billionaire tax proposal is approved by voters but this proposal receives more votes, the billionaire tax measure would be voided.
The measure would require the state auditor to conduct a financial and performance audit of proposed ballot initiatives and of the programs they fund. The measure would require audits of any program that would receive funding from the special tax in the proposed initiative to assess the efficiency of the program and recommend who ought to reduce its annual costs by 10%. If the measure passes, the costs of the audits would be paid via the revenues generated by the special tax.
This ballot initiative is one of two so-called poison pills to sink the billionaire tax that is being bankrolled by Building a Better California, which has raised well over $100 million from the state’s most affluent. The largest donor is Sergey Brin, a co-founder of Google, who has reportedly moved out of California because of the tax proposal. He donated at least $82 million to the group as of late June.
Proposition 42: Ban on new state personal property taxes
This is one of two ballot measures created by opponents of the proposed initiative to impose a tax on California billionaires, and it would in effect void that wealth tax.
This proposed ballot measure would prohibit new taxes on personal property, intellectual property, retirement accounts and other assets and would limit situations in which a ballot measure or state lawmakers can impose or raise taxes retroactively — both of which are essential parts of the billionaire tax initiative.
If the billionaire tax proposal is approved by voters but this proposal receives more votes, the billionaire tax ballot measure would be voided.
This ballot initiative is one of two so-called poison pills to sink the billionaire tax that is being bankrolled by Building a Better California, which has raised well over $100 million from the state’s most affluent. The largest donor is Sergey Brin, a co-founder of Google, who has reportedly moved out of California because of the tax proposal. He donated at least $82 million to the group as of late June.
Proposition 43: Voting thresholds for special taxes
The measure would prohibit local governments from imposing new special taxes unless the proposed tax receives approval from two-thirds of voters. The restriction also applies to citizen initiatives, which currently only need a simple majority vote to be approved.
The Howard Jarvis Taxpayers Assn. supports Proposition 43. The advocacy group has characterized the measure as an effort to “save” 1978’s Proposition 13, the landmark initiative that capped California property tax increases and required a super-majority of votes to approve most future tax increases.
Assemblymember Buffy Wicks (D-Oakland), who authored the legislation that became Proposition 43 — ACA 22 — opposes the measure and has urged Californians to vote against it. She said the only reason she crafted the bill was because it was a necessary bargaining chip to torpedo another ballot measure backed by the Howard Jarvis Taxpayers Assn. that would have devastated revenues for local governments and retroactively rescinded some local tax increases.
“I authored ACA 22 not because I wanted it to become law — but because it was the only path left to get the more dangerous initiative off the ballot before time ran out,” Wicks posted on social media.
Proposition 44: Regulate health clinic spending
If passed, Proposition 44 would require federally qualified health centers to spend 90% of their revenue on “program services advancing their charitable purpose” rather than management and overhead. Community clinics that fail to comply would be penalized, with fines placed in a state-managed fund to be spent on clinic workforce programs.
Advocates say clinics spend too much on executive pay and other administrative costs and not enough on patient care. The measure, which would dictate how clinics spend money, is designed to fix that. The measure is backed by the Service Employees International Union-United Healthcare Workers West, an influential healthcare workers union, which argues it will help hold clinics accountable.
In May, the California Primary Care Assn., which represents more than 2,300 community health clinics, sued to block the ballot measure. The state’s powerful doctors’ lobby, the California Medical Assn., also opposes the measure, arguing it would ban clinics from keeping funding in reserves and hamper their ability to upgrade equipment or expand to new locations.
The Legislative Analyst’s Office estimates that enforcing the measure would cost the government up to the low tens of millions annually, and that much of the cost would be paid for through penalties and fees charged to affected clinics. The office says the measure has “uncertain” impacts and could lead to clinic closures.
Proposition 45: CEQA reform
This proposition would amend the California Environmental Quality Act, or CEQA, and speed up the process for projects deemed “essential,” including certain housing, water, health, public safety, energy and transportation projects.
Jails, detention facilities and oil or natural gas production facilities would not be considered “essential” projects, according to the measure text.
If passed, the measure would set deadlines for public agencies to complete environmental review, allow expedited review of a project’s environmental impacts — currently, public agencies are required to consider a range of feasible alternatives to reduce environmental impacts — and establish deadlines for filing and resolving lawsuits.
CEQA lawsuits have often been used to block construction of housing in the state. For instance, in Berkeley, neighbors used CEQA — citing potential noise impact from partying students — to delay, for years, UC Berkeley’s construction of student dorms on People’s Park.
The Legislative Analyst’s Office estimates that the state and local government implementation will cost in the tens of millions of dollars for the first several years. It notes the legislation would probably result in net savings in the long term due to reduced administrative and legal workload.
Times staff writers Seema Mehta and Phil Willon contributed to this report.
Science
July Fourth fireworks may bring ‘hazardous’ air quality to Southern California. What you need to know
L.A.’s love of fireworks makes for a colorful Fourth of July, with dozens of official celebrations and countless illicit explosions expected for the holiday.
But as each sparkler, Roman candle, palm and peony dissipates, it leaves behind a cloud of noxious gases, soot and finely ground toxic metals — some of which ends up in the lungs of revelers and passersby below.
Hazardous levels of air pollution are expected across central and southern Los Angeles County, northern Orange County, and Riverside and San Bernardino counties from 5 p.m. Saturday evening through 3 p.m. Sunday, according to the South Coast Air Quality Management District. Unhealthy air quality is also expected in northern Los Angeles County and southern Orange County.
Pollution levels are expected to build from dusk onward Saturday, as light winds and increased firework activity lead to an increase in smoke, a South Coast AQMD advisory said. Soot and particulates will likely linger through Sunday afternoon before being dispersed by the wind.
Firework-related pollution can trigger coughs, breathing problems, asthma flares and heart attacks, according to Los Angeles County Public Health, and anyone experiencing severe or worsening cardiovascular symptoms like chest pain or difficulty breathing should seek medical attention immediately.
Pyrotechnics set off at home are even more likely to trigger cardiovascular problems, the American Lung Assn. says, as the burst of pollutants takes place closer to the ground.
July 4 and 5 are traditionally two of the worst days of the year for the region’s air quality, according to South Coast AQMD. This year’s celebration comes on the heels of a late June warehouse fire in Boyle Heights that released extraordinary amounts of soot and smoke across the county, on par with pollution generated by the previous year’s wildfires.
To limit negative health effects, the L.A. County public health department recommends avoiding strenuous physical activity and keeping doors and windows closed. As whole house fans and swamp coolers can suck additional pollutants inside, the department recommends using air purifiers or air conditioners as alternatives when possible.
Science
Contributor: Alcohol should be stigmatized like smoking
Few substances are as deeply woven into everyday life as alcohol. It is a fixture at holiday celebrations, work-related social gatherings, sporting events, airports, and brunch or dinner tables. All demonstrate how deeply alcohol has become embedded in social customs and cultural traditions.
Yet alcohol contributes to millions of deaths globally each year and is linked to cancer, liver disease, unintentional accidents, violence and, importantly, dependence and addiction. Despite this, the disconnect between alcohol’s cultural role and its serious health burden is striking. An estimated 2.3 billion people worldwide consume alcohol.
As a physician working in addiction medicine, I regularly care for patients whose alcohol use affects nearly every organ system. It is often not until these patients end up admitted to the hospital that they learn the effects of alcohol on various parts of their body besides their liver.
Newer evidence challenges assumptions about what was long considered “safe drinking.” Even moderate drinking carries risk and is not as harmless as people, including experts, once thought.
Many people associate alcohol risk primarily with addiction or dangerous behaviors such as driving while intoxicated. However, its effects extend far beyond this, into nearly every aspect of a person’s well-being.
While alcohol may transiently improve mood and ease social anxiety, long-term alcohol use can lead to a worsening of mood, cognition and sleep, which can further compound use.
A 2021 literature review found that consuming approximately two standard drinks roughly doubles the odds of sustaining injuries — with or without a vehicle involved. The review also found that heavy episodic (binge) drinking can increase the risk of injury by 50-fold, depending on the amount of alcohol consumed and the type of injury. While alcohol’s effects on the liver are well known, it can also lead to gastrointestinal complications and heart disease
The World Health Organization estimates that 2.6 million deaths each year are attributable to alcohol, accounting for nearly 1 in every 20 deaths worldwide.
While many people recognize the risks of alcohol addiction, people are generally much less aware of the links between alcohol use and cancer risk.
The World Health Organization classifies alcohol as a Group 1 carcinogen — the same category as tobacco and asbestos. In 2025, the U.S. surgeon general emphasized that alcohol increases the risk of at least seven cancers, including cancers of the breast, colorectal, liver, oral, esophagus and larynx. An advisory called for updated warning labels.
Yet fewer than half of Americans recognize alcohol as a risk factor for cancer, particularly for cancers such as breast cancer that are not commonly associated with alcohol use.
Throughout the 1990s and early 2000s, observational studies suggested that moderate alcohol consumption might offer cardiovascular benefits. Over the past decade, however, higher-quality studies have challenged these findings, suggesting that much of the apparent benefit may have reflected differences in the health and lifestyles of moderate drinkers rather than a protective effect of alcohol itself.
Current evidence increasingly suggests that even low levels of alcohol may increase cancer risk.
Federal guidelines acknowledge that adults should “consume less alcohol for better overall health.” However, the most recent version of the “Dietary Guidelines for Americans,” updated in January, removed the previous recommendation to limit intake to no more than one drink per day for women and two for men. It also omitted explicit discussion of alcohol’s links to cancer.
These changes have drawn criticism from public health experts, who argue that the revised language plays down the growing evidence of alcohol-related harms and provides less specific guidance to consumers. The current administrator of the Centers for Medicare & Medicaid Services characterized alcohol as a “social lubricant” that brings people together, rather than emphasizing its well-established health risks.
This may be true physiologically, at least temporarily, but obscures the fact that relying on it as a social lubricant can lead to chemical and psychological dependency. In my view, statements to that effect are shortsighted, prioritizing short-term social effects over more insidious and long-term issues, including addiction.
While many dangerous mind-altering substances are hidden from public perception, alcohol is often placed at the center of it – a trend that shows no sign of changing imminently.
Further, large companies often profit from ads that appeal to young people.
Looking back at the history of tobacco smoking provides some helpful insights. In 1965, 42.4% of the U.S. population smoked. By 2022, that figure had dropped to 11.6%.
This steep decline did not happen because of a single intervention, but through decades of accumulating scientific evidence, public education campaigns, warning labels, restrictions on advertising, smoke-free policies, higher tobacco taxes and shifts in social norms. Together, these efforts transformed smoking from a widely accepted social behavior into one broadly recognized as a major health risk and correspondingly, less socially accepted.
Although alcohol consumption has modestly declined in recent years, it remains deeply embedded in social life in ways cigarette smoking no longer is.
People often assume that if a substance is legal, common and widely socially accepted — even encouraged — it must also be safe. But public health history suggests those assumptions can and should change.
Emma Fenske is an addiction medicine fellow and internal medicine physician at Oregon Health & Science University. This article was produced in partnership with the Conversation.
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