Massachusetts health officials are broadening their advice about alcohol, emphasizing that regular drinking can carry significant health risks. Guidance released this week by the state Department of Public Health says even moderate consumption can increase the chances of some cancers, high blood pressure and heart disease.

The state defines moderate drinking in the guidance as one glass a day for women or two for men. Sarah Ruiz, deputy director for strategy and community health with the Bureau of Substance Addiction Services, said the recommendations reflect growing evidence that no amount of alcohol is safe.

“The fewer drinks you have each week, the better your health outcomes will be,” said Ruiz. The message places Massachusetts alongside guidance from the Canadian Centre on Substance Use and Addiction, which identifies health risks at lower consumption levels than current United States recommendations.

The U.S. Centers for Disease Control and Prevention also advises that “moderate drinking may have health risks,” but does not identify drink counts associated with low, moderate or high risk. Current federal dietary guidelines say “consume less alcohol for better overall health,” without specifying how many drinks affect health.

The Massachusetts approach has met resistance from Republican leaders on Capitol Hill, who are pushing back against efforts to adopt similar guidance. They argue that the research supporting such recommendations is flawed, while some alcohol researchers say the state could frighten people unnecessarily.

Eric Rimm, an epidemiologist at the Harvard T.H. Chan School of Public Health, called the guidance “a very one-sided warning.” He argued that the state was emphasizing harms without presenting the complete picture.

“They’re only focusing on the negative,” said Rimm. “People who consume at moderate or higher levels do have a slightly higher risk of cancer, but they also live longer.”

Rimm has previously faced criticism for accepting money from organizations connected to alcohol. He pointed to a 2024 report from the National Academies of Science, Engineering and Medicine, which found with “moderate certainty,” that moderate drinkers had a lower risk of death from all causes than people who never drank.

Ruiz said the overall research available supports the state’s guidance. She said the objective is not to scare people, but to explain the benefits of drinking less and potentially reduce problems related to alcohol consumption.

State data illustrate the scale of those problems. In 2023, the most recent year with available highway safety data, 1 in 3 traffic deaths in Massachusetts involved a drunk driver.

In 2025, state health officials reported 1,665 deaths related to alcohol and 90,801 emergency room visits involving an alcohol related problem. Those figures provide part of the rationale for renewing attention to drinking as a public health concern.

Dr. Angela Landerholm, chief of psychiatry at Beth Israel Deaconess Hospital in Plymouth, said the guidance could help prevent movement from lower risk drinking toward an alcohol use disorder. She also said it could encourage people to seek assistance earlier.

“Problematic alcohol use exists on a continuum rather than an abrupt transition from ‘normal’ drinking to alcohol use disorder,” said Landerholm, who treats patients addicted to alcohol. Her comments reflect the guidance’s focus on intervention before drinking problems become more severe.

For the past decade or longer, health leaders in Massachusetts and elsewhere have placed comparatively little focus on the health consequences of drinking. Opioid use was viewed as the more immediate public health emergency, even though incidents attributed to alcohol have been far more numerous.

Last year, Massachusetts recorded 971 opioid overdose deaths and 8,384 emergency room trips following an overdose or related emergency. The source described the comparison with alcohol related incidents as a nearly ninefold difference.

Ruiz said the difference is partly explained by the fact that more people drink alcohol than use opioids. Even so, she said the Department of Public Health considers the figures another reason to update its public messaging.

Public attitudes may already be shifting. In a 2025 Gallup poll, 53% of adults said moderate drinking was bad for their health, while the 54% who reported drinking represented an all time low since Gallup began tracking alcohol use in 1939.

Massachusetts operates a helpline for people seeking assistance with excessive drinking. The state also prohibits retailers and adults from supplying alcohol to minors, while its latest guidance urges residents to recognize that drinking less is associated with better health outcomes.