Myth or fact

Moderate drinkers live longer than people who don't drink

Short answerNot the way you think

By GyroscopeUpdated November 15, 20266 sources

Not the way you think. The old studies compared drinkers with “non-drinkers” who often included people who had quit because they were sick. A 2023 review found 86 of 107 studies did this, and after correcting for it, light drinkers didn’t live longer than people who never drank. A 2024 review still found a benefit.

Where did the idea come from?

It comes from a curve that showed up in study after study for decades. People who drank a little seemed to die at a lower rate than people who didn’t drink at all, and heavy drinkers at a much higher rate. The shape got called the J curve, and it made “a drink a day is good for you” sound like settled science.

What was wrong with the comparison?

The trouble is in who counts as a non-drinker. People often stop drinking because they’re already sick, or because a medicine or a doctor tells them to. If those people go into the “non-drinker” group, that group looks sicker, and light drinkers look healthy by comparison.

It’s like checking whether a gym membership helps you live longer by comparing members with non-members, when the non-members include people who cancelled because they got too sick to go.

What did the 2023 review find?

Researchers led by Jinhui Zhao pulled together 107 studies from 1980 to 2021 that followed drinkers over time, with 4.8 million people and 425,564 deaths. Then they checked how each study defined its non-drinkers. In 86 of the 107, former drinkers or occasional drinkers had been put in that group. Only 21 were free of both problems.

When they corrected for it and compared drinkers with people who had never drunk, the benefit disappeared. Occasional drinkers, under 1.3 g a day, and low-volume drinkers, 1.3 to 24 g a day, had no significantly lower risk of dying. For women, the risk was significantly higher from 25 g a day, about 1.8 US drinks. For men it was significantly higher from 45 g a day, about 3.2 US drinks.

They also looked at the studies least likely to have the problem, ones that enrolled people aged 50 or younger and followed them for at least 10 years, before many had a reason to quit. In those, occasional drinkers and medium-volume drinkers had a significantly higher risk of dying than never-drinkers, and the risks for heavier drinking were higher than in the full set.

The best case for it

The strongest case on the other side comes from the National Academies. Congress asked it to review the evidence for the new US guidelines, and in December 2024 it concluded, with moderate certainty, that moderate drinkers (up to two drinks a day for men and one for women) had lower deaths from all causes than people who never drank. It also found, with moderate certainty, that moderate drinking went with a higher risk of breast cancer.

That’s a serious group. Two careful reviews looked at overlapping research and came out in different places. We side with the 2023 review, because it measured the counting problem directly and showed how much the answer moved when it was fixed. Genetic studies, which aren’t affected by people quitting when they get sick, also point the other way. In 371,463 UK adults, genes that nudge people to drink more went with more high blood pressure and heart disease, at all amounts.

What do we know for sure?

• Heavier drinking raises the risk of dying. In the 2023 review it was significantly higher from about 1.8 US drinks a day for women and 3.2 for men.
• Alcohol causes cancer. The National Cancer Institute counts nearly 25,000 US cancer deaths from alcohol in 2019, and even light drinking raises the risk of some cancers. Cancer, your heart and the long run has the numbers.
• The US advice changed. In January 2026, the 2025-2030 Dietary Guidelines dropped their daily limit and now say “Consume less alcohol for better overall health.”

More than half of Americans now agree. In Gallup’s August 2025 poll, a record 53% said drinking in moderation is bad for your health.

A drink a day is good for you takes on the broader version of this myth, and why one drink a day looked healthy tells the whole story of the J-curve and the genetic studies that tested it.