As the Lunar New Year approaches, a season synonymous with joyous celebrations, feasting and social gatherings, the consumption of alcohol is often at the center of events. From toasts with family to business celebrations, alcohol plays a prominent cultural role in Taiwan. Kaoliang, Taiwan’s famous alcoholic beverage, exemplifies the cultural significance of alcohol. Known for its robust flavor and high alcohol content — typically 58 percent — Kaoliang is a staple at social gatherings, symbolizing tradition and indulgence. However, it is crucial to reflect on the health, societal and economic impacts of drinking, especially in light of recent developments and emerging evidence.
Alcohol, a known carcinogen, has been linked to increased risks of several cancers, including liver, esophageal and breast cancer. A US Surgeon General report this month underscores that even moderate alcohol consumption — one drink per day — elevates cancer risk. Alarmingly, Taiwan’s genetic predisposition to alcohol intolerance exacerbates these risks. About 50 percent of the Taiwanese population experiences facial flushing due to alcohol, a sign of impaired metabolism that significantly heightens the likelihood of alcohol-related cancers.
The health impacts extend beyond cancer. Alcohol is a leading contributor to liver disease, including cirrhosis, and accelerates fatty liver disease. In Taiwan, fatty liver disease affects a significant portion of the population, with alcohol consumption being a key aggravating factor. These conditions collectively increase the risk of liver cancer, which remains one of Taiwan’s most prevalent and deadly cancers. Persistent alcohol-induced inflammation compounds the problem, leading to long-term health consequences.
Furthermore, alcohol consumption has a tangible economic impact on Taiwan. Research indicates that alcohol-related diseases cost the National Health Insurance system approximately NT$5.3 billion (US$161.7 million) annually. Beyond healthcare expenses, alcohol is a significant factor in drunk-driving incidents, leading to preventable deaths, injuries and substantial insurance payouts by private companies. The societal costs of alcohol-related harm cannot be overstated, as they encompass loss of productivity, family disruptions and long-term disability.
Internationally, the narrative surrounding moderate drinking as “healthy” is being debunked. Studies by the US National Academies of Sciences reveal that earlier claims of alcohol’s cardiovascular benefits were based on flawed methodologies, including “abstainer bias” and inadequate controls for socioeconomic factors. The concept of a “J-curve” relationship, suggesting that moderate drinking reduces all-cause mortality, has been increasingly challenged. Methodological flaws in these studies indicate that moderate drinkers often have other lifestyle factors — such as higher income, better access to healthcare and healthier diets — that confound the results.
More recent analyses have shown that even modest drinking can reduce life expectancy. Some research estimates that one drink per day might shorten life expectancy by five minutes per drink, compounding over time. The evidence against moderate drinking has prompted countries like Canada to revise their guidelines, recommending no more than two drinks per week for low-risk alcohol consumption.
Amid these concerns, the Ministry of Finance’s decision to raise duty-free alcohol limits — from 1 liter to 1.5 liters — raises questions about the potential impact on public health. While aligning Taiwan’s policies with international norms might benefit importers and travelers, it risks sending a mixed message about the importance of drinking reduction. Kaoliang’s cultural prominence and high alcohol content further complicate efforts to curb alcohol consumption. As a symbol of tradition and celebration, it underscores the challenge of balancing cultural preservation with public health priorities.
To counteract these challenges, Taiwan must adopt a comprehensive approach to minimize alcohol-related harms. Public awareness campaigns should focus on educating the population about the dangers of alcohol consumption, particularly the heightened risks for those with alcohol intolerance. Recent findings provide an opportunity to dispel myths about “healthy” drinking and emphasize the direct links between alcohol and cancer. Tailored messaging could highlight the specific risks posed by Kaoliang, encouraging moderation and exploring cultural alternatives to drinking-centered celebrations.
Regulatory measures are another critical avenue. Increasing taxes on alcoholic beverages could serve as a deterrent and a means of generating revenue for healthcare initiatives. Simultaneously, restrictions on alcohol advertising — particularly targeting younger demographics — could help reduce the social normalization of drinking. Clear and visible warning labels on alcohol products, modeled after tobacco regulations, could further educate consumers about the risks.
Healthcare providers must also be equipped to address alcohol-related harms. Screening for alcohol use and offering culturally sensitive counseling should become standard practice. Physicians could play a pivotal role in early intervention, helping people reduce consumption before it leads to severe health issues. Moreover, integrating alcohol education into primary care visits could normalize discussions about drinking and its risks.
Community-level support is equally essential. Programs designed to assist people in reducing or quitting alcohol could provide vital resources, including counseling services, peer support networks and access to non-alcoholic alternatives. Collaborations between government agencies, non-profits and community groups could amplify these efforts, fostering a culture of health and wellness.
As Taiwan celebrates its rich cultural traditions, it is time to reconsider the role of alcohol. Public health efforts should encourage alternatives to drinking during festivities, such as non-alcoholic beverages or activities that emphasize family bonding and wellness. Kaoliang, while a cherished symbol of tradition, could coexist with a broader movement toward healthier celebrations. Highlighting its cultural significance without overemphasizing consumption could help shift societal norms.
The upcoming holidays offer an opportunity for reflection and action. Let us ensure that the celebrations of today do not compromise the health and well-being of tomorrow. By addressing alcohol’s risks head-on and fostering a culture that prioritizes health, Taiwan can lead by example in promoting a balanced approach to tradition and public health.
Y. Tony Yang is an endowed professor and associate dean at George Washington University.
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