Most Americans Unaware Alcohol Can
Cause Cancer

Pam Harrison

February 17, 2022

The majority of Americans are not aware that alcohol consumption causes a variety of cancers, and especially do not consider wine and beer to have a link with cancer, suggest the results from a national survey.

"Alcohol is a leading modifiable risk factor for cancer yet most Americans are unaware that alcohol increases cancer risk," write lead author Andrew Seidenberg, PhD, MPH, National Cancer Institute, Rockville, Maryland, and colleagues.

"Increasing awareness of the alcohol–cancer link, such as through multimedia campaigns and patient–provider communication, may be an important new strategy for health advocates working to implement preventive alcohol policies," they add.

The findings were published in the February issue of the American Journal of Preventive Medicine.

"This is the first study to examine the relationship between alcohol control policy support and awareness of the alcohol–cancer link among a national US sample," the authors write.

The results show that there is some public support for the idea of adding written warnings about the alcohol–cancer risk to alcoholic beverages, which is something that  a number of cancer organizations have been petitioning for, as previously reported by Medscape Medical News.

A petition filed by, the American Society of Clinical Oncology, the American Institute for Cancer Research, and Breast Cancer Prevention Partners, all in collaboration with several public health organizations, proposes labeling that would read: "WARNING: According to the Surgeon General, consumption of alcoholic beverages can cause cancer, including breast and colon cancers."

Such labeling has "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 groups said in the petition.  

Public Support

The findings come from an analysis of the 2020 Health Information National Trends Survey 5 Cycle 4. A total of 3865 adults participated in the survey, approximately half of whom were nondrinkers.

As well as investigating how aware people were of the alcohol–cancer link, the investigators looked at how prevalent public support might be for the following three communication-focused alcohol policies:

  • Banning outdoor alcohol-related advertising

  • Requiring health warnings on alcohol beverage containers

  • Requiring recommended drinking guidelines on alcoholic beverage containers

"Awareness of the alcohol–cancer link was measured separately for wine, beer, and liquor by asking: In your opinion, how much does drinking the following types of alcohol affect the risk of getting cancer?" the authors explain.

"Awareness of the alcohol–cancer link was low," the investigators comment; only about one third (31.8%) of participants were aware that alcohol increases the risk of cancer. The figures were even lower for individual beverage type, at 20.3% for wine, 24.9% for beer and 31.2% for liquor. Furthermore, approximately half of participants responded with "don’t know" to the three awareness items, investigators noted.

On the other hand, more than half of the Americans surveyed supported adding both health warning labels (65.1%) and information on recommended drinking guidelines (63.9%) to alcoholic beverage containers. Support was lower (34.4% of respondents) for banning outdoor alcohol advertising.

Among Americans who were aware that alcohol increased cancer risk, support was also higher for all three policies.

For example, about 75% of respondents who were aware that alcohol increases cancer risk supported adding health warnings and drinking guidelines to beverage containers. This compared with about half of Americans who felt that alcohol consumption had either no effect on or decreased cancer risk.

Even among those who were aware of the alcohol–cancer link, public support for outdoor advertising was not high (37.8%) but it was even lower (23.6%) among respondents who felt alcohol had no effect on or decreased the risk of cancer.

"Policy support was highest among nondrinkers, followed by drinkers and was lowest among heavier drinkers," the authors report.

For example, almost 43% of nondrinkers supported restrictions on outdoor alcohol advertising. This compared with only about 28.6% of drinkers and 22% of heavier drinkers. More respondents supported adding health warning labels on alcoholic beverages — 70% of nondrinkers, 65% of drinkers, and 57% of heavier drinkers, investigators observe.

The study had no specific funding. The authors have disclosed no relevant financial relationships.

Am J Prev Med. Published February 2022 issue. Full text

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