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Why don’t people know that alcohol causes cancer?

Alcohol is classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen. And we have known it more than 30 years now. The overall awareness of that fact is worryingly low, everywhere. 

Even though many cancer organisations and alcohol policy and harm organisations have done a lot to increase that knowledge, for some reason, it doesn’t seem to work very well. 

A 2011 survey found that only 43% of Danish adult recognised alcohol as a risk factor for cancer when they were directly asked if alcohol increases the risk of cancer. A new study (2020) from the Danish Cancer Society found that unprompted, 22.2% of respondents were aware of the link between alcohol and cancer, whereas prompted 44.8% were aware of this.

In Norway, a representative survey conducted by Sentio for Actis found in 2016 that 7 out of 10 women were not aware of the association between alcohol and cancer. 

According to the Finnish Institute for Health and Welfare report (2018) “Näin Suomi juo” only 37% of survey respondents fully agreed that alcohol use increases the risk of cancer. 

In a Eurobarometer study (2010) only 23% of Swedes agreed completely that there was an association between alcohol and cancer and an additional 33% tended to agree; which was the lowest proportion observed across all EU countries.

Why is this awareness so low? Alcohol use is so common, and people should know all about it by now. But we still learn that some aspects of it are simply not understood. Why is that? Especially when there are so many campaigns, articles, materials that are produced to inform people. In our Alcohol Awareness blog, we have currently 126 entries on alcohol and cancer. Different initiatives, from around the world, to educate people about that link. Aren’t they just getting through to an average consumer?

There are probably several potential reasons for this ignorance. Let me list some of them. 

  1. Too bad to be true. Everything is blamed on alcohol. Alcohol appears to be a factor in almost every problem. And as this drink is consumed so widely, people just don’t believe it all. Curiously, the more there is evidence about alcohol harm, the more some people just ignore it. “Now they claim that my beer will give me cancer as well?” 
  2. Everything is a poison, depending on the dose. That statement was recently made by Australian comedian Shaun Micallef, who did a documentary on alcohol and then gave an interview to Cancer Council’s CEO Professor Sanchia Aranda. He described his position how he used to look at alcohol. Most people consider themselves to be moderate drinkers, and that should be fine, right?! “Sure, alcohol may be causing cancer, but so are probably also strawberries if you eat them too much?” No?
  3. It doesn’t happen to me. We all use that argument with something. And at least when we take this position unconsciously, it is quite understandable. Otherwise, if we would think that all dangers and accidents would happen to us, we wouldn’t leave our home and even there our life would be in danger. These people believe and know the dangers that alcohol causes; they just don’t consider these risks to be affecting them personally. 
  4. We are not reaching most of the people. Yes, there are a lot of campaigns and messages that should have reached people. But most people are not interested in health messages. It’s not getting through. 
  5. It’s not reaching even people who should know. A while ago, I was speaking at a consumer protection seminar about why alcohol shouldn’t be viewed as an ordinary commodity. I also talked about alcohol and cancer link. One of the fellow speakers was a former member of parliament and a member of the European parliament. More than that, she was at one point, even the minister of social affairs in my country. At that seminar, she was courageous enough to admit that she heard for the first time that alcohol is linked to cancer. For people who do work, or are responsible for cancer prevention, other major risk factors, like smoking and obesity, overshadow alcohol.
  6. There is reasonable doubt. This is where the alcohol industry puts its effort. They don’t have to prove that alcohol cures cancer, its enough if they can sow the seed of doubt, just like the tobacco companies did for decades. Unfortunately, the media is playing an important part in this as they give massive platforms for messages that fog the public health-oriented messages. The principles of balanced media, both sides should be heard, grants a room for those who have apparent vested interests.
  7. The risk is acceptable. For many, the risks are known, and they also understand that alcohol increases their chance to get cancer. They don’t make any changes, because that risk is acceptable. For them, various benefits from drinking balance these risks out. This attitude probably changes when people face other health issues, get older, or someone from their family or friends gets cancer. 
  8. Not enough is being done. Even though different organisations are doing their best to inform people, the overall situation is still rather weak, and some countries almost ignore alcohol and cancer link. The State level interventions are non-existent, and this link gets hardly mentioned. It is also overlooked in official low-risk drinking guidelines, which, in most cases, set that limit higher than what the cancer societies recommend. 

This is an indefinite list, and I would welcome your comments and additions. What else should we consider to understand why the awareness is so low and to improve our work in getting the alcohol and cancer link to our societies? 

Lauri Beekmann
Executive director, NordAN