Improving Knowledge that Alcohol Can Cause Cancer is Associated with Consumer Support for Alcohol Policies

Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies.

Alcohol consumption is a leading risk factor for burden of disease, contributing to an estimated 3 million deaths (5% of all deaths) and 133 million disability-adjusted life years (DALYs) (5% of all DALYs) globally in 2016. The ethanol in alcoholic beverages has been classified as a Group 1 carcinogen (the highest category of risk) since 1988, and recent evidence indicated that alcohol consumption can cause at least seven types of cancers. In 2016, alcohol use accounted for approximately 4% of cancer deaths and cancers were the predominant source of total alcohol-attributable deaths in higher-income countries, particularly among those over age 50. The relationship between alcohol consumption and increased risk of certain cancers has now been extended beyond heavy alcohol consumption to include low and moderate levels of consumption, and to all types of alcohol including wine, beer, and spirits.

Knowledge that alcohol is a risk factor for cancer was associated with greater support for alcohol policies controlling price, marketing, and availability. These findings are in line with previous research examining associations between awareness of the alcohol–cancer link and policy support. This study extended previous research by also examining the extent to which policy support is associated with increases in individual-level knowledge that alcohol can cause cancer among a prospective cohort of Canadian drinkers after an alcohol labelling intervention. Participants who became aware that alcohol can cause cancer between waves 1 and 2, before and after a one-month alcohol labelling intervention with a cancer warning label, were almost two times more likely to support alcohol pricing policies relative to individuals with no change in knowledge (i.e., individuals that were not aware that alcohol can cause cancer in wave 2 or that were already aware that alcohol can cause cancer in wave 1). Previous cross-sectional studies in Denmark and England have observed that TV and social media campaigns highlighting the link between alcohol and cancer were associated with higher levels of public awareness and support for alcohol policies. Together, these findings suggest that consumer awareness of the health risks of alcohol can be increased and that increasing awareness may have an impact on public support for strengthening alcohol pricing policies, which if implemented, may increase health and wellness within society.

In the context of a short alcohol labelling intervention, support for alcohol policies affecting alcohol price, availability, and marketing was associated with knowledge that alcohol can cause cancer. Increases in individual-level knowledge that alcohol is a risk factor for cancer was also associated with greater support for alcohol pricing policies. Improving knowledge of alcohol consumption health risks, specifically cancer risk, using alcohol warning labels may be an effective strategy for increasing public support for effective alcohol control policies that are currently not well supported, and which, in return, may improve population health.

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