South Africans know that when Dezemba hits, the mood shifts. The music gets louder, year-end parties multiply, and for many, a drink becomes an almost automatic part of celebration. We laugh about the babalaas, stack up cooler boxes and treat alcohol as if it is inseparable from joy.
But it’s time we faced the truth: alcohol is one of the most harmful substances we consume, and its impact on health and society is devastating. According to the World Health Organization (WHO), alcohol contributes to 2.6 million deaths globally each year. South Africa ranks among the top five countries in the world for alcohol consumption, with an estimated 62,300 premature deaths annually linked to drinking. The National Treasury reported that in 2022, South Africans consumed 4.5 billion litres of liquor.
In 2023, the WHO boldly affirmed in a Lancet study that “no safe amount of alcohol consumption for cancers and health can be established”. In other words, there is no level of drinking that does not harm health.
If we still think that alcohol is “not that bad”, or if we have forgotten about its dangers, maybe it’s time for us to revisit what its devastating impacts are on our bodies and minds.
The toll of alcohol on our bodies
Alcohol harms nearly every major organ in our system, yet we often reduce its dangers to jokes about hangovers or vague worries about “the liver”. In reality, alcohol contributes to liver cirrhosis, a condition in which healthy liver tissue is replaced by scar tissue until the organ can no longer function. Its consumption elevates the risk of cardiovascular disease, weakens the immune system, worsens injuries and fuels chronic illness.
Among these risks, cancer deserves particular attention. Alcohol has been classified by the International Agency for Research on Cancer as a Group 1 Carcinogen since 1987, meaning there is conclusive evidence that it causes cancer in humans.
The evidence is overwhelming. Drinking increases the risk of cancers of the mouth, throat, oesophagus, liver and breast. Even light drinkers face elevated risks: mouth and throat cancers are nearly twice as likely with them, while heavy drinkers face up to five times the risk.
As Fanfarillo et al. explained in a 2024 study that looked at alcohol being a modifiable risk factor for breast and ovarian cancer: “When ethanol is metabolised, it is converted primarily to acetaldehyde by the enzyme alcohol dehydrogenase (ADH), a potent carcinogen that can form DNA adducts, leading to mutations.”
In simple terms this means that when your body breaks down alcohol, it turns it into a chemical called acetaldehyde. This chemical is highly toxic and can damage DNA, which increases the risk of cancer.
What alcohol does to our mind and mood
Alcohol starts affecting the brain from the very first drink. It slows down the messages the brain is trying to send to the body, which is why one’s reaction time gets worse, judgment slips, and things like walking, talking and even seeing clearly become harder. When someone drinks a lot (more than two drinks) in one sitting, alcohol decreases inhibitions and eventually can shut down the part of the brain that stores memories; this is why blackouts happen. The person is awake, but the brain isn’t recording.
Over time, regular drinking causes real, physical damage. It kills brain cells, increases the risk of stroke, and speeds up memory loss and cognitive decline, things we normally only expect with older age.
Alcohol also has a big impact on mental health. Even though a drink may feel calming at first, it eventually deepens sadness, heightens anxiety, and makes moods more unpredictable. Additionally, it disrupts sleep patterns, increases irritability and negatively affects emotional control – and all of this can last long after we have drunk alcohol.
Sadly, two-thirds of South Africans know someone or have personally experienced the negative consequences of alcohol. South Africans have had enough, and 76% say that alcohol companies should take responsibility for the harm caused by alcohol, and not just rake in the profits!
Avoiding alcohol is the best gift to give yourself
Many fear that avoiding alcohol means sacrificing fun, connection, or joy, especially during festive times, a myth projected in order to sell more alcohol. But research tells a different story. A 2022 UK study found that university students who chose not to drink reported high wellbeing, strong friendships and solid social support. A 2023 Swedish study showed that adolescents who abstained from alcohol tended to have better mental health and more content relationships with their parents.
Meanwhile, findings from China indicate that adults with stronger physical health, better mobility, less pain and improved general functioning were more likely to be non-drinkers. Across age groups and countries, the pattern is clear: people who avoid alcohol often thrive personally, socially and physically.
Avoiding or quitting alcohol is not about deprivation, it is about reclaiming clarity, energy, presence and saving money. It means engaging more deeply with loved ones and experiencing celebrations with genuine joy rather than chemically induced and detrimental highs. Poet Mary Karr captured this transformation powerfully: “When I got sober, I thought giving up was saying goodbye to all the fun and all the sparkle, and it turned out to be just the opposite. That’s when the sparkle started for me.”
In the end, sobriety doesn’t dim the world, it lets us see both it and ourselves in full colour. DM
Darshen Naidoo is a Researcher and Associate Lecturer at South African Medical Research Council/Wits Centre for Health Economics and Decision Science – PRICELESS SA, Wits School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
Susan Goldstein is a Public Health Specialist, Managing Director and Associate Professor at South African Medical Research Council/Wits Centre for Health Economics and Decision Science – PRICELESS SA, Wits School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.