As zero-alcohol products gain popularity, many are loaded with sugar, posing new health concerns.
Last year, the former United States Surgeon General, Dr. Vivek Murthy, issued a new health advisory highlighting the connection between alcohol consumption and cancer risk. According to the advisory, alcohol ranks as the third leading preventable cause of cancer in the country, following tobacco use and obesity. Despite four decades of mounting scientific evidence, fewer than half of Americans are aware of the carcinogenic risks associated with alcohol.
“Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States – greater than the 13,500 alcohol-associated traffic crash fatalities per year in the U.S. – yet the majority of Americans are unaware of this risk,” said Dr. Murthy. He further emphasized the importance of raising awareness through updated health warnings and community education efforts.
The advisory outlined that alcohol consumption is directly linked to at least seven types of cancer, including cancers of the breast, liver, mouth, throat, and esophagus. Notably, breast cancer is significantly impacted by alcohol, with 16.4 percent of cases being attributed to alcohol intake. Additionally, the risk of developing certain cancers can begin to rise even at low levels of consumption — around one or fewer drinks per day.
Beyond its call for updated warning labels on alcoholic beverages, the advisory recommends reevaluating current guidelines regarding safe alcohol limits. Public health professionals and healthcare providers are urged to prioritize education on alcohol-related cancer risks and to promote early screening and treatment interventions.
This announcement arrives as societal attitudes toward drinking are already shifting. The rise of sober-curious movements like Dry January and alcohol-free living has led to increased demand for zero-alcohol (zero-ABV) products. Many consumers now seek alternatives to traditional alcoholic beverages, not just to avoid intoxication but also as part of a broader health-conscious lifestyle. Joshua Carlos, senior vice president of zero-ABV spirits brand Lyre’s North America, told Healthline that the sector is currently “the fastest growing category of beverage, with over 30 percent growth year on year.” Yet, while these zero-ABV drinks may eliminate alcohol’s risks, they are not without health concerns of their own — particularly due to their high sugar content.
These drinks can often contain significant amounts of added sugars to help replicate the flavor and mouthfeel of their alcoholic counterparts. Most non-alcoholic beers contain twice the carbs of regular beer. This trend has sparked concerns among health experts, who warn that substituting alcohol with high-sugar drinks could pose long-term health risks. Excessive sugar intake is linked to obesity, type 2 diabetes, and heart disease, conditions that themselves increase the risk of certain cancers. It seems that in trying to avoid one cancer risk by abstaining from alcohol, consumers may inadvertently expose themselves to another.
Unlike alcoholic beverages, which are subject to strict labeling regulations, zero-ABV drinks often lack detailed nutritional information. This can mislead consumers into thinking that the products are healthy. Public health advocates are now calling for regulatory changes that would require zero-ABV products to disclose their sugar content and other key nutritional data, similar to what is mandated for soft drinks and other non-alcoholic beverages.
The lack of transparency is compounded by aggressive marketing tactics that emphasize wellness and social inclusivity. Brands promoting zero-ABV options frequently position their products as part of a healthy, modern lifestyle. However, without proper labeling, this marketing narrative can obscure potential health downsides. Dr. Thompson added, “We need to shift the conversation from simply avoiding alcohol to making genuinely healthier beverage choices. Otherwise, we risk creating a false sense of security around these products.”
Some companies in the zero-ABV sector have begun to respond to these concerns by reducing sugar content. For example, several brands, like Little Saints, now offer drinks sweetened with natural, low-calorie alternatives like stevia or monk fruit. These innovations aim to maintain the flavor profile of traditional cocktails without the excessive sugar load. While these efforts are commendable, they remain the exception rather than the rule.
Meanwhile, the broader beverage industry faces increasing pressure to balance taste with health. As consumers become more health-conscious, demand for low-sugar or sugar-free options is expected to grow. The global zero-sugar beverages market size was valued at more than $3 billion in 2023 and will surpass $13 billion by 2033. Industry analysts predict that companies that prioritize transparency and healthier formulations will be better positioned to capture this evolving market.
However, achieving a balance between taste and health is no easy task. Sugar plays a critical role in the taste and mouthfeel of beverages, particularly in those designed to mimic alcoholic drinks. Reducing sugar without compromising flavor requires significant investment in research and development, which smaller brands may struggle to afford. Larger companies with greater resources are more likely to lead the way in this area, potentially setting new industry standards in the process.
The growing scrutiny of zero-ABV products comes as public health campaigns against sugar consumption are gaining momentum. Health Secretary Robert F. Kennedy Jr.’s recent updated food pyramid emphasizes minimal sugar intake. And in recent years, several cities across the U.S. have introduced taxes on sugary drinks in an effort to curb consumption. These measures have been credited with reducing sales of sugary beverages and encouraging manufacturers to offer healthier alternatives.
Dr. Murthy’s advisory on alcohol and cancer risk is also a timely reminder of the importance of informed choices. While avoiding alcohol is a positive step for reducing cancer risk, it is only part of the equation.
Related on Ethos:
