Awareness of Alcohol as a Carcinogen and Support for Alcohol Control Policies

Seidenberg, Andrew B.; Wiseman, Kara P.; Eck, Raimee; Blake, Kelly D.; Platter, Heather; Klein, William M. P.

doi:10.1016/j.amepre.2021.07.005

Cited by 22 publications

(8 citation statements)

References 24 publications

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“…However, this awareness has yet to extend to knowledge about the link between alcohol use and other cancer types. Additionally, recent work suggests that awareness of the carcinogenic nature of alcohol is associated with support for alcohol control policies [ 38 – 41 ], which are known to reduce per capita alcohol consumption and population-level alcohol related harms [ 42 ]. Thus, increasing awareness of the carcinogenic effects of alcohol may increase public support for traditionally unpopular alcohol control policies such as taxation and make their enactment more likely.…”

Section: Discussionmentioning

confidence: 99%

Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women

Swahn,

Martinez,

Balenger

et al. 2024

BMC Public Health

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Background Alcohol use is an established yet modifiable risk factor for breast cancer. However, recent research indicates that the vast majority of U.S. women are unaware that alcohol use is a risk factor for breast cancer. There is limited information about the sociodemographic characteristics and alcohol use correlates of awareness of the alcohol use and breast cancer link, and this is critically important for health promotion and intervention efforts. In this study, we assessed prevalence of the awareness of alcohol use as a risk factor for breast cancer among U.S. women and examined sociodemographic and alcohol use correlates of awareness of this link. Methods We conducted a 20-minute online cross-sectional survey, called the ABLE (Alcohol and Breast Cancer Link Awareness) survey, among U.S. women aged 18 years and older (N = 5,027) in the fall of 2021. Survey questions assessed awareness that alcohol use increases breast cancer risk (yes, no, don’t know/unsure); past-year alcohol use and harmful drinking via the Alcohol Use Disorders Identification Test (AUDIT); and family, health, and sociodemographic characteristics. We conducted multivariate multinomial regression analysis to identify correlates of awareness that alcohol use increases breast cancer risk. Results Overall, 24.4% reported that alcohol use increased breast cancer risk, 40.2% reported they were unsure, and 35.4% reported that there was no link between alcohol use and breast cancer. In adjusted analysis, awareness of alcohol use as a breast cancer risk factor, compared to not being aware or unsure, was associated with being younger (18–25 years old), having a college degree, and having alcohol use disorder symptoms. Black women were less likely than white women to report awareness of the alcohol use and breast cancer link. Conclusions Overall, only a quarter of U.S. women were aware that alcohol use increases breast cancer risk, although 40% expressed uncertainty. Differences in awareness by age, level of education, race and ethnicity and level of alcohol use offer opportunities for tailored prevention interventions, while the overall low level of awareness calls for widespread efforts to increase awareness of the breast cancer risk from alcohol use among U.S. women.

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Section: Discussionmentioning

confidence: 99%

Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women

Swahn,

Martinez,

Balenger

et al. 2024

BMC Public Health

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show abstract

“…Finally, studies with larger samples would allow testing of potential associations between demographics and knowledge levels. Greater efforts are needed to determine how to increase awareness of the link between alcohol and cancer to help address the burden of alcohol-attributable cancers and increase support for policies aimed at reducing the harms of alcohol [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…The 2019 American Institute for Cancer Research Cancer Risk Awareness Survey found that only 45% of US adults (18 years or older) were aware that alcohol is a cancer risk factor [7]. In addition to increasing the probability of healthy behavior related to alcohol, awareness 2 of 12 of the association between alcohol and cancer is associated with support for alcohol control policies [8,9].…”

Section: Introductionmentioning

confidence: 99%

Awareness of Alcohol and Cancer Risk and the California Proposition 65 Warning Sign Updates: A Natural Experiment

Budenz

Moser

Eck

et al. 2022

IJERPH

Self Cite

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In 1986, California enacted Proposition 65 (P65), requiring businesses to display warning signs informing consumers that specific chemicals and alcohol exposure increase the risk of cancer and reproductive harm. In 2018, the P65 alcohol warning signs were updated to include an informational P65 website link, and the update was associated with media coverage and increased enforcement of warning requirements. This study examines knowledge of the association between alcohol use and cancer risk in California compared to the rest of the US before and after the 2018 P65 update. We analyzed state-level data on alcohol and cancer knowledge from the Health Information National Trends Survey from 2017 (n = 3285), 2019 (n = 5438), and 2020 (n = 3865). We performed multinomial logistic regressions to examine knowledge levels by survey year and location (California vs. all other states) and reported the predicted marginals of knowledge by survey year and location. The adjusted prevalence of respondents who reported an association between alcohol and cancer risk was higher in California (41.6%) than the remaining states (34.1%) (p = 0.04). However, knowledge levels decreased significantly over survey years, and there was no evidence for an effect of the P65 update on knowledge in California compared to other states based on the testing of an interaction between state and year (p = 0.32). The 1986 warning signs may have had an enduring effect on awareness, though the update, so far, has not. Further efforts are needed to determine how to increase alcohol and cancer knowledge to address the burden of alcohol-attributable cancers.

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confidence: 99%

“…Indeed, recent studies have demonstrated that cancer warning labels can improve knowledge about the alcohol-cancer link, increase risk perceptions, and decrease the selection of alcoholic versus non-alcoholic drinks (Clarke et al, 2021;Jones et al, 2022;Morgenstern et al, 2021). Furthermore, awareness of the alcohol-cancer link predicts stronger support for cancer warning labels (Seidenberg et al, 2022).However, research also suggests that the effectiveness of cancer warning labels may depend on the label design. For example, Wigg and Stafford (2016) found that compared with control (no warnings), exposure to pictorial warnings featuring diseased organs led to greater intentions to reduce and quit alcohol consumption.…”

mentioning

confidence: 99%

Designing Cancer Warning Labels for Alcoholic Beverages: Examining the Impact of Visual Elements

2023

Health Educ Behav

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Alcohol is a known carcinogen. However, public awareness of cancer risk associated with alcohol use is low. A promising approach to raising awareness is to include cancer warning labels on alcohol-containing products, but there is limited knowledge of the design and effect of such warnings. The present study investigated the impact of visual elements on the effectiveness of cancer warning labels. In a randomized online experiment, alcohol consumers ( N = 1,190) were randomly assigned to one of three conditions: exposure to (a) text-only warning labels, (b) pictorial warning labels showing graphic health effects (e.g., diseased organs), and (c) pictorial warning labels showing lived experience (e.g., cancer patients in a medical setting). The results showed that whereas the three warning types did not differ significantly in behavioral intentions, pictorial warnings featuring health effects led to greater disgust and anger than text-only warnings and pictorial warnings featuring lived experience. Moreover, anger predicted lower intentions to reduce alcohol use and was a significant mediator of the effects of warning type on behavioral intentions. The findings highlight the role of emotions in responses to health warning labels with different visual elements and suggest that text-only warnings and pictorial warnings with lived experience may be useful in preventing boomerang effects.

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Awareness of Alcohol as a Carcinogen and Support for Alcohol Control Policies

Cited by 22 publications

References 24 publications

Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women

Demographic disparities in the limited awareness of alcohol use as a breast cancer risk factor: empirical findings from a cross-sectional study of U.S. women

Awareness of Alcohol and Cancer Risk and the California Proposition 65 Warning Sign Updates: A Natural Experiment

Designing Cancer Warning Labels for Alcoholic Beverages: Examining the Impact of Visual Elements

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