Addictions
Governments ease alcohol access as evidence of its harms mount
By Alexandra Keeler
From cancer to heart disease to brain damage, the evidence of alcohol’s harms is mounting. So why are governments making it easier to drink?
In May, shortly after Parliament resumed, Quebec Senator Patrick Brazeau introduced Bill S-202, a private member’s bill to require nearly all alcoholic beverages to carry health warning labels.
“As a former alcohol consumer, I was once in the 75 per cent of Canadians who are not aware that there is a causal link between alcohol consumption and seven cancers,” Brazeau told the House of Commons on June 3.
“I personally battled colon cancer several years ago, so much so that when I received treatment, I felt I was being killed inside.”
Brazeau is something of an outlier in government. Public health experts say Canadian governments are not doing enough to address alcohol’s known health risks — and that the alcohol industry is a big part of the problem.
“We’ve known about the carcinogenic effects of alcohol since the 80s,” said Peter Butt, a University of Saskatchewan researcher and co-chair of Canada’s latest drinking guidelines. “But there are no warning labels, so the consumer is given false confidence.
“Some of this falls at the doorstep of the government, because they regulate the labeling.”
Alcohol harms
Today, the World Health Organization warns that alcohol harms nearly every system in the body.
The International Agency for Research on Cancer classifies alcohol as a cause of six cancers.
Chronic alcohol use raises the risks of liver and heart disease, brain damage, mental health issues, injuries and fetal alcohol spectrum disorders.
In Canada, the federal government oversees labeling and public health messaging rules, while the provinces control liquor sales and drinking ages.
In January 2023, Health Canada released updated national alcohol guidelines in response to the growing evidence of alcohol-related harms. This new guidance marked a major departure from its 2011 recommendations, which had suggested women not exceed 10 drinks per week and men not exceed 15.
The new guidelines have a sober message: no amount of alcohol is risk-free, and risk rises significantly with more than two drinks a week.
“We didn’t say you shouldn’t drink more than two standard drinks a week. We said you should reduce the amount that you drink,” said Butt, who co-chaired the team that updated the guidelines.
“The consumer had a right to know.”
Mixed messages
Aside from tightening its guidelines, Canadian governments have done little to better protect the public.
Public health experts say one major flashpoint has been warning labels. In general, drinks with greater than 0.5 per cent alcohol content are exempt from standard food and beverage labeling requirements.
“Even bottled water or non-alcoholic beer has to have the nutrition facts because it doesn’t have enough alcohol in it to get the exemption,” said Adam Sherk, a research scientist at the Canadian Centre for Substance Use and Addiction who also advised on Canada’s updated alcohol guidelines.
The Canadian Cancer Society has been advocating for labels on alcohol products since 2017. The Canadian Institute for Substance Use Research has done the same since 2023. But Health Canada has not initiated any regulatory process to mandate warning labels for alcohol products.
Some research indicates such labels could reduce sales.
A 2020 study by the Yukon government and the Canadian Institute for Substance Use Research tested how warning labels affect consumer behaviour. It found labels did increase awareness and reduce sales.
Yukon pulled its label requirements after the alcohol industry threatened to sue the government.
Convenient
Labelling is just one of many measures governments could take to reduce alcohol-related harm.
In addition to labels, the Canadian Alcohol Policy Evaluation project recommends minimum unit pricing, marketing and advertising controls, and public education campaigns. No province or territory has fully implemented all of these measures.
“[T]he Canadian federal government has not adopted or only partially adopted many evidence based alcohol policies,” the project’s report reads.
Meanwhile, some provinces are moving in the opposite direction.
Nova Scotia is considering expanding retail options. In April, Quebec rejected a recommendation to lower its blood alcohol limit for drivers, despite repeated coroner warnings.
Ontario has gone the furthest.
The province plans to invest $175 million over five years to grow its alcohol sector. It has begun permitting alcohol sales in convenience stores for the first time — with up to 8,500 new retailers expected to carry alcohol by 2026. It has also scrapped previous limits on pack sizes and discount pricing.
In April 2024, the province’s chief medical officer, Dr. Kieran Moore, recommended raising the legal drinking age from 19 to 21. Premier Doug Ford rejected the idea, arguing that if 18-year-olds can enlist in the military, they should be allowed to drink.
“We believe in treating people like adults,” he told media at the time.
In late June, the province also approved alcohol consumption on so-called “pedal pubs” — large, multi-person bicycles equipped with a U-shaped bar, often used for tours or bachelor parties.
“There’s never been such a large increase in availability all at once,” said Sherk, calling Ontario’s expansion “unprecedented.”
False profits
Tim Stockwell, a University of Victoria professor and former director of the Canadian Institute for Substance Use Research, says corporate influence helps explain why governments are failing to address alcohol’s health risks.
“Evidence for harms from alcohol has been with us for decades and has only strengthened,” said Stockwell. “Commercial vested interests have always dominated the policy sphere.”
Federal lobbying records show Beer Canada has routinely targeted Health Canada and more than two dozen federal agencies to influence policy on labeling, taxation and public health messaging. This includes closed-door meetings with MPs and senior officials from the Department of Finance and Agriculture Canada.
Beer Canada did not respond to multiple requests for comment by press time. Spirits Canada and Molson Coors Beverage Company also did not respond to multiple requests for comment.
Butt, of the University of Saskatchewan, says the money governments generate from alcohol sales creates a conflict with their public health mandate.
Federal and provincial governments generate revenue from alcohol through a range of mechanisms, including excise taxes, provincial markups, sales taxes and licensing fees. In some provinces, governments also earn profits from government-run liquor stores.
“[Governments] look at it from a lost revenue perspective, rather than from a public health perspective,” said Butt.
Ian Culbert, of Public Health Canada, puts it more bluntly. “Governments have a substance sales issue, as opposed to a substance use issue,” he said. “But it’s short-term gain for long-term pain.”
“Public Health wants to reduce consumption, because all consumption contributes to harm,” said Stockwell, of the Canadian Institute for Substance Use Research. “Commerce wants to … expand the consumption.”
A familiar playbook
Every expert interviewed for this story said the alcohol industry is following the tobacco industry’s playbook.
“They’re using the same sort of rear-guard action policies: denial, heavy government lobbying, government revenue,” said Butt.
“I don’t trust either the industry nor the government to do the right thing based upon past action. I think it’s important that consumers are educated.”
Adam Sherk agrees. “If I was [the industry], I would also be scared about consumers knowing this link [to cancer] better,” he said.
“The strategy is to obfuscate the link — point to studies that might be older or found no link, or put a lot of things in the water so it seems less clear than it is.”
But alcohol, experts say, is harder to regulate than tobacco. “Nobody liked to be in an airplane with smokers eating dinner next to smokers, so it was really easy to demonize smoking,” said Culbert.
“Alcohol is so ingrained in everything: we drink when we’re happy, we drink when we’re sad, we drink when we’re bored — we drink.”
Still, the normalization does not make the risks any less real. “There’s a mortality rate attached to this,” said Butt.
“And that’s the thing that is tragic — this is a modifiable risk factor.”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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From the Brownstone Institute
Cigarettes kill nearly half a million Americans each year. Everyone knows it, including the Food and Drug Administration. Yet while the most lethal nicotine product remains on sale in every gas station, the FDA continues to block or delay far safer alternatives.
Nicotine pouches—small, smokeless packets tucked under the lip—deliver nicotine without burning tobacco. They eliminate the tar, carbon monoxide, and carcinogens that make cigarettes so deadly. The logic of harm reduction couldn’t be clearer: if smokers can get nicotine without smoke, millions of lives could be saved.
Sweden has already proven the point. Through widespread use of snus and nicotine pouches, the country has cut daily smoking to about 5 percent, the lowest rate in Europe. Lung-cancer deaths are less than half the continental average. This “Swedish Experience” shows that when adults are given safer options, they switch voluntarily—no prohibition required.
In the United States, however, the FDA’s tobacco division has turned this logic on its head. Since Congress gave it sweeping authority in 2009, the agency has demanded that every new product undergo a Premarket Tobacco Product Application, or PMTA, proving it is “appropriate for the protection of public health.” That sounds reasonable until you see how the process works.
Manufacturers must spend millions on speculative modeling about how their products might affect every segment of society—smokers, nonsmokers, youth, and future generations—before they can even reach the market. Unsurprisingly, almost all PMTAs have been denied or shelved. Reduced-risk products sit in limbo while Marlboros and Newports remain untouched.
Only this January did the agency relent slightly, authorizing 20 ZYN nicotine-pouch products made by Swedish Match, now owned by Philip Morris. The FDA admitted the obvious: “The data show that these specific products are appropriate for the protection of public health.” The toxic-chemical levels were far lower than in cigarettes, and adult smokers were more likely to switch than teens were to start.
The decision should have been a turning point. Instead, it exposed the double standard. Other pouch makers—especially smaller firms from Sweden and the US, such as NOAT—remain locked out of the legal market even when their products meet the same technical standards.
The FDA’s inaction has created a black market dominated by unregulated imports, many from China. According to my own research, roughly 85 percent of pouches now sold in convenience stores are technically illegal.
The agency claims that this heavy-handed approach protects kids. But youth pouch use in the US remains very low—about 1.5 percent of high-school students according to the latest National Youth Tobacco Survey—while nearly 30 million American adults still smoke. Denying safer products to millions of addicted adults because a tiny fraction of teens might experiment is the opposite of public-health logic.
There’s a better path. The FDA should base its decisions on science, not fear. If a product dramatically reduces exposure to harmful chemicals, meets strict packaging and marketing standards, and enforces Tobacco 21 age verification, it should be allowed on the market. Population-level effects can be monitored afterward through real-world data on switching and youth use. That’s how drug and vaccine regulation already works.
Sweden’s evidence shows the results of a pragmatic approach: a near-smoke-free society achieved through consumer choice, not coercion. The FDA’s own approval of ZYN proves that such products can meet its legal standard for protecting public health. The next step is consistency—apply the same rules to everyone.
Combustion, not nicotine, is the killer. Until the FDA acts on that simple truth, it will keep protecting the cigarette industry it was supposed to regulate.
Author
By Adam Zivo
Both are shaped by radical LGBTQ activism and questionable evidence.
Over the past decade, North America embraced two disastrous public health movements: pediatric gender medicine and “harm reduction” for drug use. Though seemingly unrelated, these movements are actually ideological siblings. Both were profoundly shaped by extremist LGBTQ activism, and both have produced grievous harms by prioritizing ideology over high-quality scientific evidence.
While harm reductionists are known today for championing interventions that supposedly minimize the negative effects of drug consumption, their movement has always been connected to radical “queer” activism. This alliance began during the 1980s AIDS crisis, when some LGBTQ activists, hoping to reduce HIV infections, partnered with addicts and drug-reform advocates to run underground needle exchanges.
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In the early 2000s, after the North American AIDS epidemic was brought under control, many HIV organizations maintained their relevance (and funding) by pivoting to addiction issues. Despite having no background in addiction medicine, their experience with drug users in the context of infectious diseases helped them position themselves as domain experts.
These organizations tended to conceptualize addiction as an incurable infection—akin to AIDS or Hepatitis C—and as a permanent disability. They were heavily staffed by progressives who, influenced by radical theory, saw addicts as a persecuted minority group. According to them, drug use itself was not the real problem—only society’s “moralizing” norms.
These factors drove many HIV organizations to lobby aggressively for harm reduction at the expense of recovery-oriented care. Their efforts proved highly successful in Canada, where I am based, as HIV researchers were a driving force behind the implementation of supervised consumption sites and “safer supply” (free, government-supplied recreational drugs for addicts).
From the 2010s onward, the association between harm reductionism and queer radicalism only strengthened, thanks to the popularization of “intersectional” social justice activism that emphasized overlapping forms of societal oppression. Progressive advocates demanded that “marginalized” groups, including drug addicts and the LGBTQ community, show enthusiastic solidarity with one another.
These two activist camps sometimes worked on the same issues. For example, the gay community is struggling with a silent epidemic of “chemsex” (a dangerous combination of drugs and anonymous sex), which harm reductionists and queer theorists collaboratively whitewash as a “life-affirming cultural practice” that fosters “belonging.”
For the most part, though, the alliance has been characterized by shared tones and tactics—and bad epistemology. Both groups deploy politicized, low-quality research produced by ideologically driven activist-researchers. The “evidence-base” for pediatric gender medicine, for example, consists of a large number of methodologically weak studies. These often use small, non-representative samples to justify specious claims about positive outcomes. Similarly, harm reduction researchers regularly conduct semi-structured interviews with small groups of drug users. Ignoring obvious limitations, they treat this testimony as objective evidence that pro-drug policies work or are desirable.
Gender clinicians and harm reductionists are also averse to politically inconvenient data. Gender clinicians have failed to track long-term patient outcomes for medically transitioned children. In some cases, they have shunned detransitioners and excluded them from their research. Harm reductionists have conspicuously ignored the input of former addicts, who generally oppose laissez-faire drug policies, and of non-addict community members who live near harm-reduction sites.
Both fields have inflated the benefits of their interventions while concealing grievous harms. Many vulnerable children, whose gender dysphoria otherwise might have resolved naturally, were chemically castrated and given unnecessary surgeries. In parallel, supervised consumption sites and “safer supply” entrenched addiction, normalized public drug use, flooded communities with opioids, and worsened public disorder—all without saving lives.
In both domains, some experts warned about poor research practices and unmeasured harms but were silenced by activists and ideologically captured institutions. In 2015, one of Canada’s leading sexologists, Kenneth Zucker, was fired from the gender clinic he had led for decades because he opposed automatically affirming young trans-identifying patients. Analogously, dozens of Canadian health-care professionals have told me that they feared publicly criticizing aspects of the harm-reduction movement. They thought doing so could invite activist harassment while jeopardizing their jobs and grants.
By bullying critics into silence, radical activists manufactured false consensus around their projects. The harm reductionists insist, against the evidence, that safer supply saves lives. Their idea of “evidence-based policymaking” amounts to giving addicts whatever they ask for. “The science is settled!” shout the supporters of pediatric gender medicine, though several systematic reviews proved it was not.
Both movements have faced a backlash in recent years. Jurisdictions throughout the world are, thankfully, curtailing irreversible medical procedures for gender-confused youth and shifting toward a psychotherapy-based “wait and see” approach. Drug decriminalization and safer supply are mostly dead in North America and have been increasingly disavowed by once-supportive political leaders.
Harm reductionists and queer activists are trying to salvage their broken experiments, occasionally by drawing explicit parallels between their twin movements. A 2025 paper published in the International Journal of Drug Policy, for example, asserts that “efforts to control, repress, and punish drug use and queer and trans existence are rising as right-wing extremism becomes increasingly mainstream.” As such, there is an urgent need to “cultivate shared solidarity and action . . . whether by attending protests, contacting elected officials, or vocally defending these groups in hostile spaces.”
How should critics respond? They should agree with their opponents that these two radical movements are linked—and emphasize that this is, in fact, a bad thing. Large swathes of the public understand that chemically and surgically altering vulnerable children is harmful, and that addicts shouldn’t be allowed to commandeer public spaces. Helping more people grasp why these phenomena arose concurrently could help consolidate public support for reform and facilitate a return to more restrained policies.
Adam Zivo is director of the Canadian Centre for Responsible Drug Policy.
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