Public health officials are urging Americans to exercise caution if they choose to participate in “drinking games” during the first Republican primary debate this Thursday in Cleveland, Ohio.

“You simply can’t drink every time one of these guys says something silly,” said Surgeon General Vivek Murthy during a Wednesday morning press conference. “We’ve got three candidates who are prone to gaffes — Jeb Bush, John Kasich and Scott Walker — and then a half-dozen obscure goofballs vying with Donald Trump for a little media attention. It’s just a formula for disaster.”

Murthy suggested that people play a safer variation of the traditional debate drinking game by only consuming alcohol when one of the candidates says something reasonable.

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Coastal cities and liberal college towns were among the hardest hit. “The last time these guys competed in the marketplace of ideas, it looked like a war-zone in here,” said Jack Murphy, an ER physician at the Ann Arbor Regional Medical Center in Ann Arbor, Mich.