The Real Cost of Alcohol with Expert Guest Mike Marshall / EP 106

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A Conversation with Mike Marshall of the US Alcohol Policy Alliance Reveals Why It's Time for a Public Health Wake-Up Call

The Unseen Impact of Alcohol

Alcohol is ubiquitous in American social life—from baby showers to sports events, from happy hours at work to yoga sessions-turned-Prosecco parties. Yet, behind the celebratory clinking of glasses lies a troubling truth: alcohol is a toxic, addictive carcinogen responsible for more deaths every year than fentanyl overdoses, gun violence, or car crashes—combined. In a candid episode of the Sober and Lit podcast, Mike Marshall, CEO of the US Alcohol Policy Alliance (USAPA), joined Susan Larkin and Ruby Williams to shine a spotlight on the deeply ingrained misconceptions, health risks, and flawed policies around alcohol—and why things need to change now.

The Biggest Misconceptions: Alcohol is Harmless, Right?

According to Mike Marshall, the most pervasive and damaging misconception is the minimization—or outright denial—of alcohol’s harm. Decades of marketing have crafted a cultural narrative that casts alcohol as essential to celebration, socializing, relaxation, and even health. Meanwhile, crucial facts are routinely omitted or ignored, such as alcohol’s status as a carcinogen and its staggering toll on public health.

As Mike Marshall pointed out, “More than half of Americans don’t know that alcohol is a carcinogen,” even as evidence grows of its links to at least seven types of cancer, including breast and liver cancer. This gap in awareness is no accident—it’s the result of an imbalance where the alcohol industry’s voice has drowned out scientific and public health messaging.

The True Scope of Harm: Beyond Addiction

The panelists made it clear: the dangers of alcohol go far beyond addiction. Alcohol is intersectional in its harm, contributing to domestic violence, poverty, cancer, suicide, and impaired judgment leading to accidents. In fact, Mike Marshall shared, “25% of suicides involve alcohol. The judgment is impaired, and whatever emotional or mental health issues are there are exploited by alcohol.”

For older adults, alcohol brings an increased risk of falls, dementia, and isolation-related harm. For women, the risks are magnified—alcohol both aggravates health risks like cancer and increases exposure to violence. Alarmingly, proximity to alcohol outlets and extended late-night sales have been shown to escalate risks for vulnerable populations.

Policy Failures: Outdated Guidelines, Ineffective Warnings

Much of the problem stems from America’s dated approach to alcohol policy. Dietary guidelines still suggest “moderate drinking,” a standard Mike Marshall called out as misleading, noting that labeling one glass of wine—regardless of size—overlooks how consumption and risk vary by person and gender.

The lack of meaningful public health warnings stands in stark contrast to tobacco. “We need warning labels like those Ireland is implementing, and knowledge is power,” Mike Marshall insisted, pointing out that the alcohol industry has consistently resisted labeling that might curb consumption.

Learning from Tobacco: Why Haven’t We Seen a Shift?

Consider the anti-tobacco movement: litigation eventually funded hard-hitting public health campaigns and clear policy changes, cementing public understanding of secondhand smoke dangers and leading to real reductions in smoking rates. With alcohol, such resources and mandates are lacking. Public health efforts like Oregon’s “Rethink the Drink” campaign are rare and often face industry backlash. Warnings about alcohol-related harm are virtually invisible at the point of sale—and, when they exist, they're easy to miss.

Path Forward: Knowledge, Policy, and Grassroots Change

So what can be done? Mike Marshall outlined three critical levers for change:

1. Price: Just as higher cigarette taxes drove smoking down, raising alcohol taxes could deter excess consumption.
2. Access: Restricting hours and density of alcohol sales outlets directly reduces harm in communities—particularly those most at risk.
3. Knowledge: Empowering people with information, through clear labeling, consistent education, and frank conversations, is essential.

Mike Marshall and USAPA also advocate for a new national alcohol strategy—a blueprint for policymakers, communities, and families to reverse the current tide. He urged individuals to support the Alliance’s work, push for policy reform, and start dialogues in their families and communities: “Challenge the assumption that every event needs wine or beer. Is this really necessary?”

Changing the Narrative, One Conversation at a Time

Cultural change begins with awareness and open conversation. As more people hear the facts, the hope is they’ll make informed decisions and advocate for policies that protect all Americans—not just industry profits. “We’re not looking to prohibit alcohol or ruin livelihoods,” Mike Marshall concluded. “We’re trying to improve and elevate the health of every American family.”

For more information, resources, or to get involved, visit [AlcoholPolicy.org](https://alcoholpolicy.org). Together, it’s time to rethink the drink.
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Ruby Williams at Freedom Renegade Coaching https://www.freedomrenegadecoaching.com/

Follow Coach Ruby: @rubywilliamscoaching
Email: [email protected]

Grab your copy of our FREE WineFree Weekend Guide to help you on your alcohol free journey. https://www.freedomrenegadecoaching.com/WineFreeWeekend