• The US Surgeon General announced that alcohol causes cancer.
• The "1-2-3 rule" can help you cut down on drinking, especially in social settings.
• Limit yourself to 1-2 drinks a day, never exceeding three.

The US Surgeon General Dr. Vivek Murthy issued a warning Friday, saying alcohol causes cancer and no amount of alcohol is safe.

Still, going fully sober doesn't always work for everyone.

Katherine Metzelaar, a registered dietitian, told Business Insider that, unless a client has experience of substance abuse, she usually recommends drinking in moderation over participating in events like Dry January.

"Cutting it out entirely often leads to the cycle of restricting alcohol and then binging alcohol," Metzelaar told Business Insider.

To make alcohol moderation less vague, some people follow the "1-2-3 rule," a rough guideline on how much to drink each day. According to the US Coast Guard, the 1-2-3 rule is:

• No more than one standard drink per hour
• No more than two standard drinks per occasion
• No more than three drinks a day (more than three constitutes binge drinking, according to the National Institute on Alcohol Abuse and Alcoholism)

Metzelaar says there "isn't a one-size-fits-all answer" to alcohol consumption, but the 1-2-3 rule roughly falls in line with the CDC's advisory of no more than a drink a day for women and two drinks a day for men.

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She said not a perfect rule, especially since drinking notoriously makes it tougher to control impulses or always keep track of drinks.

For some, it can be a helpful starting point for cutting down on alcohol, particularly in social settings.

Set an intention before drinking

Metzelaar said guidelines like the 1-2-3 rule can help some people stick to a plan. At the same time, drinking can make you lower your inhibitions and go for that third drink every time.

To make the most of the rule, she recommended setting an intention before a social event, such as only having one drink that evening, drinking water between each alcoholic beverage, or ordering mocktails all night.

Knowing your triggers

To really keep up the habit of alcohol moderation, Metzelaar suggests journaling how much you drink every day to "get a sense of what the patterns are."

Because the rule isn't foolproof, she said it's helpful to know the emotions behind wanting to drink more, such as social anxiety. "That's worth getting really curious about," she said.

Caroline Susie, a registered dietitian who primarily works with women, said her clients have tracked patterns like work stress or coping with childcare responsibilities. That can help them know when they're more tempted to go over the 1-2-3 rule.

You still shouldn't drink every day

Even if you follow the 1-2-3 rule each time you go out, you should also be mindful of how often you consume alcohol in general. Studies show that drinking 1-2 drinks a day is still linked to cancer.

Alcohol is the third leading cause of preventable cancer in the US, after smoking and obesity, according to the US Surgeon General's advisory.

To lower your intake, Metzelaar recommends going without alcohol for at least a few days a week. For example, you might abstain from drinking during the week and then have a glass of wine with friends over the weekend. Some people prefer being "dry by default," only drinking on rare occasions.

With the growth of the sober-curious movement, Susie said it's easier than ever to make alcohol swaps with N/A beers and sparkling water when you're socializing.

"There are just so many things that you can reach for that can still feel like a treat," she said.

• The US Surgeon General issued a report warning alcohol is associated with cancer.
• He cited 4 recent studies to make his case that alcohol should have warning labels like cigarettes.
• Some scientists disagree: Another major report, published in December, found alcohol has benefits.

Dr. Vivek Murthy, the U.S. Surgeon General, said Americans need to know there's a link between alcohol and cancer, citing four recent studies.

Murthy said all alcoholic beverages should have cancer warning labels on them, a measure Congress would have to design and approve.

In a new report, published January 3, Murthy outlined the research that persuaded him — and other medical professionals — that alcohol is a serious and under-appreciated health concern.

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Here's the data that backs up Murthy's advisory, with some caveats:

How alcohol causes cancer

There are four ways alcohol causes cancer, Murthy said, citing a 2021 Nutrients study.

The first two are widely accepted, he wrote. Most physicians agree that when alcohol breaks down in the body it can bind to DNA, damaging cells and fueling tumors. There is also robust evidence that alcohol can drive inflammation, which is linked to cancer.

The study points to newer research that suggests alcohol may influence hormones like estrogen, paving the way to breast cancer, though it's not exactly clear how.

Another emerging idea is that alcohol seems to provide a literal melting pot for other toxins. Tobacco, for example, dissolves in alcohol, which could make it easier for the body to ingest, the study says.

3 studies linking alcohol to cancer

To back up his argument for warning labels, Murthy pointed to a 2015 meta-analysis published in the British Journal of Cancer, which found "a significant relationship" between alcohol consumption and seven cancers.

The team of researchers from Italy, the US, France, Sweden, and Iran examined data from 572 studies, featuring 486,538 cancer cases. They compared the cancer risk of heavy drinkers with occasional drinkers and nondrinkers.

They found heavy drinking was linked to cancers of the mouth, throat, esophagus, colorectum, liver, larynx, and breast.

Murthy also referenced a 2020 study, published in Nature, that specifically looked at alcohol as a risk factor for head and neck cancer.

The research on around 40,000 people in 26 studies found higher-intensity drinking — consuming more drinks per day, and drinking more years in a lifetime — was correlated with higher risk of head and neck cancers.

The third significant study that Murthy highlighted was a 2018 global systematic analysis looking at alcohol-related deaths in 195 countries over the course of 26 years. That report, published in The Lancet, concluded that there is no safe level of alcohol consumption when it comes to cancer.

Each report has caveats. For example, the 2015 meta-analysis used varying measurements of alcohol and the 2018 study did not differentiate between drinking patterns, such as binge-drinking or moderate drinking.

Still, the studies are comprehensive, significant, and have informed many of the physicians who say that alcohol is a serious health concern.

Some scientists disagree

Murthy said he was motivated to publish this report because surveys suggest more than half of Americans do not recognize a link between alcohol and cancer.

The science on alcohol is not cut-and-dry, though.

Some of the healthiest people in the world — in the Mediterranean and so-called Blue Zones — drink wine daily. Researchers believe the social aspect of alcohol may have strong benefits for longevity.

Plus, Murthy's report clashes with a major report by the National Academies of Sciences, Engineering, and Medicine, which was published in December.

The paper, which will be used to inform the new 2025 Dietary Guidelines, found that moderate drinkers have a lower risk of premature death from heart attack and stroke than people who don't drink at all. It also found an increased risk in breast cancer.

The Department of Health and Human Services is due to publish its own analysis of the latest science on alcohol in the coming weeks.