Americans who average 14 alcoholic drinks a week, or two a day, face an estimated 1 in 25 lifetime risk of dying from an alcohol-caused disease or injury, according to the Alcohol Intake and Health Study in the Journal of Studies on Alcohol and Drugs. Drinking up to seven drinks a week was linked to only small increases in risk for most conditions.

The study first appeared online in June and drew renewed attention on Oct. 25 when a summary circulated on ScienceDaily. What gives it weight is its origin. The federal government originally commissioned the work to inform the Dietary Guidelines for Americans, 2025-2030, which now advise Americans to limit alcohol without naming a number.

The finding speaks directly to a common habit — earlier federal guidance treated up to two drinks a day for men and one for women as moderate. The new estimate suggests that two a day carries meaningful risk for both sexes.

Behind the One in 25 Estimate

Researchers from the U.S. and Canada, led by Kevin Shield of the University of Toronto, reviewed more than 7,200 publications on alcohol-related illness and injury. NBC News reported the team ultimately drew on 56 systematic reviews. They applied those risk estimates to large U.S. health and mortality datasets, then used statistical models to project lifetime risk across drinking levels.

The figures are population averages, not personal predictions. Shield noted that individual risk depends on genetics, lifestyle, drinking patterns, and other factors.

What counts as a drink matters. According to the National Institute on Alcohol Abuse and Alcoholism, a U.S. standard drink holds about 14 grams of pure alcohol. That equals 12 ounces of regular beer at about 5% alcohol, 5 ounces of wine at about 12% or 1.5 ounces of 80-proof spirits. A 16-ounce craft beer at higher strength can equal two drinks or more.

Risk Climbs Past Seven Drinks a Week

According to NBC News' reporting on the study, men drinking more than 6.5 drinks a week and women drinking more than seven crossed a 1 in 1,000 lifetime risk of alcohol-related death. Above 8.5 drinks a week, risk topped 1 in 100 for both sexes. At 14 drinks, it reached about 1 in 25.

"Even low levels of alcohol use come with health risks," Shield said in the study release. The team found no significant protective effect at any level. Light drinking was associated with lower risk of ischemic heart disease and stroke, but those possible benefits were outweighed by risks from cancers of the mouth, esophagus and breast, liver disease and injuries, even at seven drinks a week.

Co-author Jürgen Rehm of the University of Toronto told NBC News, "One in 25 is a very high risk."

The authors say the data support a threshold of no more than one drink a day for both men and women.

The cancer list is long. According to NBC Boston's report on the study, even a daily drink was linked to a higher risk of dying from oral, throat, esophageal, colon and liver cancers, breast cancer in women, liver cirrhosis and injuries. The possible heart benefit at low intake disappeared when people occasionally binge drank. Rehm noted that people with a strong family history of heart disease or of cancer may weigh those trade-offs differently.

A Federal Report Left Out of the Guidelines

In an accompanying editorial, Robert M. Vincent, a former associate administrator at the Substance Abuse and Mental Health Services Administration, wrote that the report was invited to inform federal alcohol guidance but that "its findings were sidelined," according to a journal release distributed by AlphaGalileo. An HHS spokesperson told NBC News that the guidelines reflect the full scientific record rather than any single report.

That disagreement concerns how evidence was weighed — not whether alcohol carries risk. Both the old and new federal guidance point toward drinking less.

Evidence Limits and Practical Steps

This is a modeling study built on observational research, so it estimates risk rather than proving that a set number of drinks will cause death in any individual. The authors note open questions, including alcohol's possible role in pancreatic cancer. The study was publicly commissioned, and its authors are academic researchers.

Who faces the greatest risk? People who drink heavily on single occasions, people with a family history of alcohol-related cancers or liver disease, and those who take medications that interact with alcohol.

Practical steps are straightforward. Count drinks by standard size, not by glass. Co-author Christopher Kahler of Brown University advised drinkers to "aim never to exceed three drinks on any day." Talk with a doctor about your personal risk, especially if you have liver disease, a cancer history, or take medications.

Small changes add up. Alternating alcoholic drinks with water, choosing smaller pours or lower-strength options, and setting alcohol-free days each week all reduce weekly totals. People who drink every day should not stop abruptly without medical advice if they experience shaking, sweating, or anxiety when cutting back, since withdrawal can be dangerous.

Warning signs that call for professional help include needing more alcohol to feel its effects, failed attempts to cut back, or drinking that interferes with work or family. SAMHSA's National Helpline at 1-800-662-4357 offers free, confidential referrals 24 hours a day.

The bottom line: a study built to inform national guidance estimates that two drinks a day carries a 1 in 25 lifetime risk of alcohol-related death. It does not predict any one person's fate, but it gives drinkers a clearer number to weigh.

What Readers Want to Know

What does the 1 in 25 figure mean? Among people averaging 14 drinks a week over a lifetime, about 1 in 25 would be expected to die from an alcohol-caused condition or injury.

Is moderate drinking good for the heart? The study found possible heart benefits at low levels were outweighed by cancer, liver, and injury risks.

What counts as one drink? About 14 grams of alcohol: 12 ounces of 5% beer, 5 ounces of 12% wine, or 1.5 ounces of 80-proof spirits.

What do current U.S. guidelines say? The 2025-2030 guidelines advise limiting alcohol but do not set a daily number.

Does this apply to me personally? Not exactly. The figures are population estimates, and personal risk depends on genetics, health, and drinking patterns.

Where can I get help cutting back? Talk to a doctor or call SAMHSA's National Helpline at 1-800-662-4357.