Cancer warning labels on alcohol? It's not that simple.

The country's top doctor wants a new warning added to alcohol that would alert drinkers about links to cancer, but don't expect cigarette-style warning labels any time soon.

U.S. Surgeon General Dr. Vivek Murthy said Friday that there is a direct link between alcohol consumption and increased risk for cancer, including cancers of the breast, esophagus, liver and several others. For some cancers, that risk starts at just one drink a day or even fewer, he said.

He wants new warning labels that acknowledge the link ? and for new assessments of alcohol consumption guidelines to factor in cancer risk too.

But even advocacy groups supportive of the move acknowledged Friday that it would face serious hurdles before ever making it to store shelves, the Hackensack Meridian Health John Theurer Cancer Center said in a statement. The decision to update the label will ultimately be made by Congress, Reuters reports.

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A warning label for cancer won't be coming tomorrow, but the surgeon general's move could add momentum to what advocates in a 2020 petition to the government said would "have the potential to save lives by ensuring that consumers have a more accurate understanding of the link between alcohol and cancer, which will empower them to better protect their health."

The idea of a warning label was met with skepticism from trade groups representing alcoholic beverage manufacturers. The federal government should consider the entire body of scientific research – all harms and potential benefits – regarding alcohol before changing an existing warning label that does not mention cancer risks, Dr. Amanda Berger, senior vice president of science and research of the Distilled Spirits Council, said in a statement sent to USA TODAY.

While many lifestyle choices carry potential risks, she said the council doesn’t recommend anyone drink alcohol to gain any health benefits and urges adults who choose to drink alcohol to consult their doctor.

What do warning labels do?

Murthy said adding a warning about cancer will help close a huge gap in public awareness about the risks, which his advisory says has not improved in recent decades despite new research. In a 2019 survey cited in the advisory, just 45% of Americans said they were aware alcohol was a risk factor for cancer, compared to 91% for radiation exposure, 89% for tobacco use, 81% for asbestos exposure and 53% for obesity.

"While scientific evidence for this connection has been growing over the past four decades, less than half of Americans recognize it as a risk factor for cancer," his office said.

The public has for years been getting mixed messages about the pros and cons of drinking alcohol, and warning labels would remind people of the strong scientific evidence connecting increased alcohol intake with elevated risk of some cancers, said Jiyoung Ahn, a cancer molecular epidemiologist at NYU Langone Health in Manhattan.

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“There’s plenty of evidence of alcohol as a potential cancer risk, but the public has not been fully aware,” Ahn told USA TODAY. “So I think it’s the right decision to announce this."

Murthy says in the advisory that warning labels that display imagery rather than just plain text, in addition to rotating messages, are more effective at influencing people's awareness and behavior.

Current required warning labels on alcohol sold in the U.S. say: "GOVERNMENT WARNING: (1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects. (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery, and may cause health problems.”

The label hasn't been updated since 1988 when it was introduced.

Dr. Laura Catena, a winemaker and doctor based in San Francisco, said in a written statement she welcomes any kind of alert or communication from the surgeon general about the dangers of heavy alcohol drinking and cancer risks.

However, she says more research is needed to assess the overall health outcomes of moderate drinking before creating a warning label.

Other scientists say the data is clear.

Any amount of alcohol is associated with an increased risk of certain cancers and Americans should be making informed decisions about consumption, said Jennifer Hay, behavioral scientist at Memorial Sloan Kettering Cancer Center in New York City.

“It’s not prohibition or making alcohol illegal,” she said. “It’s all about making sure that people are aware around the actual data of alcohol and cancer.”

How likely are new warning labels?

Existing health labels, which appear in small print on alcohol containers, were made mandatory by the Alcoholic Beverage Labeling Act of 1988. Any change or addition to the labels would also have to go through Congress, said Timothy Rebbeck, professor of cancer prevention at Harvard T.H. Chan School of Public Health.

And such a change is likely to face opposition from the alcohol manufacturing industry; some companies' shares tumbled by as much as 3% after Murthy's announcement Friday, according to Reuters.

The surgeon general can also make a recommendation for companies to voluntarily label their products.

With the Biden administration on its way out of office and a Republican-controlled Congress on the horizon, it's also unclear how the new administration will act on the surgeon general’s call to require labels.

Whether labels are in alcohol’s future or not, Rebbeck said it’s only the beginning. When the first surgeon general’s report on smoking came out in 1964, he said it took decades for public health officials to come up with a plan to end smoking that included strategies such as limiting advertisements, banning cigarettes in public places, taxation and economic incentives.

“It took time for people’s mindset to change and it’s going to be the same for alcohol,” he said.

Do other countries have warnings on alcohol?

According to the surgeon general's advisory, 47 countries require warnings on alcohol about health risks, including the U.S.

In South Korea, alcohol manufacturers are required to choose one of three messages to include on a warning level, two of which mention cancer.

Ireland became the first country in the European Union to include such a warning, which goes into effect for all alcohol beginning in 2026. Labels there will read: "There is a direct link between alcohol and fatal cancers." It will also include a warning about liver disease and drinking while pregnant.

Alcohol and cancer risk is an issue that’s been developing “for a long time” in other countries, said Hay.

“This is a really important and positive movement for the U.S. to acknowledge,” she said. “The scientific literature is solid and we should address the barriers to get cancer warnings on labels on alcohol.”

(This story has been updated to add new information.)

Contributing: Claire Thornton, USA TODAY; Reuters

This article originally appeared on USA TODAY: US surgeon general wants cancer warnings on alcohol. Will it happen?