Maryland once had a Republican governor, Theodore Roosevelt McKeldin, who abstained from booze, called it “demon rum” and refused to serve it at the executive mansion in Annapolis, even when British royalty visited in the 1950s. That made him popular with the Temperance League, less so with legislators and reporters.

According to Hirsh Goldberg, who served as his press secretary when he returned to Baltimore and became mayor, McKeldin was a lifelong teetotaler because his father was an alcoholic.

I’ve said this out loud many times: You’re lucky if your family, immediate and extended, manages to plow through life without anyone becoming addicted to alcohol. Consider yourself fortunate if you’ve never had a close friend drink himself to death.

I make those declarations based on 50 years as a journalist and on the heartbreak of two good friends gone too soon, one from liver disease, one from suicide.

So many stories have come my way about people under the influence of alcohol: Drunk drivers and barroom brawlers; violent spouses, abusive parents and traumatized kids; men and women impoverished and even left homeless because of alcoholism. (“Smokehound” was a term I learned years ago for people chronically drunk from cheap liquor or “smoke.” Never heard the word until I arrived in Baltimore, where, according to the Oxford English Dictionary, it likely originated in the 1930s.)

We all tend to personalize things. As I listened through the years to people describe various hardships, booze would often be a factor. Hearing these stories, I would think of family and friends and, for the most part, felt lucky that sorrows related to drink were limited.

But, in all of that, the concern was impairment — the effects of alcohol on judgment and behavior.

Now, says U.S. Surgeon General Vivek Murthy, it should also be about cancer.

In an advisory issued last week, Murthy said alcohol is a leading cause of colorectal and breast cancer, as well as cancer of the mouth, throat and esophagus. A warning about that, he said, should be on the bottled and canned beverages we buy and drink.

Murthy linked alcohol consumption to nearly a million preventable cancer cases over the last decade. About 20,000 people die in the U.S. every year from alcohol-related cancers, according to his advisory.

“Cancer risk increases as you drink more alcohol,” Murthy said.

Before the Surgeon General’s advisory, most Americans were not aware of this link, and many are bound to reject the warning as another example of nanny state alarmism. It comes at a time, post pandemic, when people in large swaths of the country, mainly red states, have turned against government and dangerously down on science — even as their chances of dying prematurely grow higher than peers in blue states. A Washington Post analysis showed harmful consequences for residents of states where public health initiatives are rejected as too expensive or oppressive.

Murthy’s advisory comes as Robert F. Kennedy Jr., an anti-vaxxer and first-rate quack, stands in line to become secretary of health and human services in the next Trump administration.

And the warning arrived at an interesting time in Maryland: Gov. Wes Moore had just expressed support for changing state law to allow grocery stores to sell wine and beer. There was quick backlash, and Moore reportedly backed off. I don’t know if it’s the main reason, but the Surgeon General’s advisory certainly would not have helped the governor make the case for expanding access to booze.

Murthy’s advisory should inform anyone interested in living a long life, and even a cancer-free one.

“I think it was high time somebody said it,” says Dr. Niharika Khanna, a professor in family and community medicine at the University of Maryland School of Medicine.

Evidence of a cancer risk from booze has been growing over the last decade. “It has slowly accumulated to a point where a lot of us believe that many of these cancers directly associate with … alcohol,” Khanna says. “Eventually, I’m pretty sure, we’re going to all come to a place where we agree that alcohol does, indeed, associate with big cancers — colorectal, breast, liver, mouth, esophageal … ”

The American Cancer Society says it’s best not to drink alcohol at all, but those who do should limit themselves to two drinks per day for men and one drink a day for women.

Booze is so ingrained in American culture, it’s hard to imagine a national retreat from it. But, as Khanna notes, that was the case with cigarettes until the Surgeon General’s warning.

“I think the Surgeon General’s office is trying to do what was done for tobacco in 1965, when the Surgeon General was very courageous and said that tobacco associates with cancer,” she says. “And there was a huge pushback from the industry — ‘Not a chance, you’re wrong, there’s no data’ — until, finally, we got to a place where the entire public health community was saying the exact same thing, that tobacco is related to cancer.”

In 1965, an estimated 42% of U.S. adults smoked cigarettes. The national rate is now around 14%, according to the National Cancer Institute, and a Gallup survey last year put it even lower, at 11%.

“The number of people who smoke has gone down [significantly], but it took years to get there,” Khanna says. The same could happen with alcohol, though, these days, the forces against that kind of change are probably even bigger than Big Tobacco.