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Kokole D, Ferreira-Borges C, Galea G, Tran A, Rehm J, Neufeld M. Public awareness of the alcohol-cancer link in the EU and UK: a scoping review. Eur J Public Health 2023; 33:1128-1147. [PMID: 37802887 PMCID: PMC10710347 DOI: 10.1093/eurpub/ckad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Alcohol increases cancer risk, but less is known about public awareness of this link. This scoping review summarizes recent findings on the public awareness of alcohol as a cancer risk factor in European Union and UK. METHODS Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for papers containing data on awareness of alcohol as cancer risk factor in EU or UK published between January 2017 and December 2022, and complemented with grey literature searches. RESULTS In total, 45 studies were included covering 18 EU countries (Austria, Belgium, Cyprus, Czechia, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Poland, Romania, Slovakia, Slovenia, Spain, Sweden) and UK, presenting data collected between 2009 and 2022. Studies covered general population (17 studied a nationally representative sample), women, health professionals, patients and young people. Awareness of alcohol causing cancer in general was higher and studied more often than awareness of alcohol's impact on specific cancers. Among the EU general population, awareness of the link between alcohol and breast cancer ranged between 10% and 20%, head and neck cancer 15-25%, colorectal and oesophagus cancer 15-45% and liver cancer 40%. Awareness was higher among young people and specialized health professions and lower among women (the latter specifically for the breast cancer). CONCLUSIONS While awareness rates varied depending on the exact question wording, many studies showed low awareness of the alcohol-cancer link, especially for specific types such as breast and colon cancer. Public should be better informed about alcohol consumption-related cancer risk.
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Affiliation(s)
- Daša Kokole
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - Gauden Galea
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
| | - Alexander Tran
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Maria Neufeld
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
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Booth L, McCausland T, Keric D, Kennington K, Stevens-Cutler J, Scott L, Pettigrew S. Evaluating an alcohol harm-reduction campaign advising drinkers of the alcohol-cancer link. Addict Behav 2023; 145:107760. [PMID: 37269794 DOI: 10.1016/j.addbeh.2023.107760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Public awareness of the alcohol-cancer link is low. Provision of this information could reduce alcohol consumption and related harms. The Spread campaign is a multi-media education campaign implemented in Western Australia to inform people about the carcinogenic properties of alcohol and associated harms. The aims of the present study were to (i) examine attitudinal and behavioural outcomes of the Spread campaign and (ii) identify demographic and drinking status factors associated with enactment of harm-reduction behaviours resulting from exposure. METHOD A cross sectional survey of Western Australian drinkers (consumed alcohol at least a few times in the previous 12 months, n = 760) examined campaign recognition, campaign perceptions, and behaviours resulting from campaign exposure. Chi-square analyses and a generalised linear model were used to identify demographic and alcohol-related factors associated with behavioural outcomes. RESULTS Around two-thirds of respondents recognised the campaign (65%), and of these, 22% reported successfully reducing how often or how much they drank due to seeing the campaign. Three quarters (73%) of all respondents considered the campaign message about the alcohol-cancer link to be believable. Respondents drinking at levels above the Australian guideline were less likely to have positive perceptions of the campaign than those complying with the guideline, but were more likely to report enacting the assessed harm-reduction behaviours as a result of campaign exposure. DISCUSSION AND CONCLUSION The results suggest that provision of information about the alcohol-cancer link has the potential to motivate reduced alcohol consumption. Implementing such campaigns could constitute an effective alcohol harm-reduction strategy.
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Affiliation(s)
- Leon Booth
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW 2042, Australia.
| | - Tahnee McCausland
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Danica Keric
- Cancer Council Western Australia, Level 1/420 Bagot Road, Subiaco, WA 6008, Australia.
| | - Kelly Kennington
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - James Stevens-Cutler
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Lucy Scott
- Mental Health Commission, Western Australian Government, 1/1 Nash St, Perth, WA 6000, Australia.
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, 1 King St, Newtown, NSW 2042, Australia.
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Booth L, McCausland T, Stafford J, Kennington K, Pettigrew S. Trends in and factors associated with parental provision of alcohol to minors in Western Australia, 2013-2019. Drug Alcohol Rev 2023. [PMID: 37053108 DOI: 10.1111/dar.13657] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Some parents provide alcohol to their underage children, despite a range of negative outcomes being associated with this practice. The present study aimed to assess factors associated with and changes in parental provision behaviours from 2013 to 2019 in Western Australia. METHODS Annual cross-sectional online surveys were conducted (total n = 2635). Assessed variables included parents' demographic characteristics, alcohol use, awareness of the relevant Australian alcohol guideline, attitudes to parental provision of alcohol and provision behaviours. A binary logistic generalised linear model was used to identify factors associated with parental provision of alcohol. RESULTS Parental provision of alcohol prevalence decreased from 40% in 2013 to 27% in 2019. The following variables were significantly associated with parental provision: permissive attitudes to provision (β = 2.82); older parental age (β = 1.28); a lack of knowledge of the relevant guideline (β = 0.78); survey year (β = 0.083); and greater alcohol use (β = 1.12). Socioeconomic position was not associated with parental provision. Female parents were more likely to report that an adult in the household provided children with alcohol (β = 1.3) DISCUSSION AND CONCLUSIONS: The findings suggest that (i) although still commonplace, parental provision of alcohol to minors in Western Australia has declined over time; and (ii) the effectiveness of campaigns aiming to reduce this behaviour may be enhanced by targeting households with parents who are older and heavier drinkers and by including content that challenges permissive views on alcohol provision to minors.
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Affiliation(s)
- Leon Booth
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Tahnee McCausland
- Mental Health Commission, Western Australian Government, Perth, Australia
| | | | - Kelly Kennington
- Mental Health Commission, Western Australian Government, Perth, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
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Quatremère G, Guignard R, Cogordan C, Andler R, Gallopel-Morvan K, Nguyen-Thanh V. Effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms and low-risk drinking guidelines, and in lowering alcohol consumption. Addiction 2023; 118:658-668. [PMID: 36478316 DOI: 10.1111/add.16107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022]
Abstract
AIMS To evaluate the effectiveness of a French mass-media campaign in raising knowledge of both long-term alcohol-related harms (LTH) and low-risk drinking guidelines (LRDG), as well as in lowering alcohol consumption. DESIGN An 8-month longitudinal survey from February to October 2019, with three waves of on-line data collection (T0 before the campaign, T1 just after it ended and T2 6 months after it ended). SETTING France. PARTICIPANTS A total of 2538 adult drinkers (aged 18-75 years). MEASUREMENTS The main outcomes' variables were LTH knowledge (cancer, hypertension, brain haemorrhage), LRDG knowledge (two guidelines: 'maximum of two drinks a day' and 'minimum of 2 days without alcohol per week'), intention to reduce alcohol consumption and self-declared consumption with respect to the French LRDG. At T1, exposure to the campaign was measured using self-reported campaign recall. FINDINGS In T1, we observed significant positive interactions between exposure group based on campaign recall and survey waves on knowledge of (i) the 'maximum two drinks a day' guideline [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.08-1.62, P = 0.008], (ii) brain haemorrhage (aOR = 1.80, 95% CI = 1.44-2.25, P < 0.001) and (iii) hypertension (aOR = 1.41, 95% CI = 1.09-1.81, P = 0.008) risks. Campaign exposure was also associated with a significant decrease in at-risk drinking in women (aOR = 0.67, 95% CI = 0.50-0.88, P = 0.004). No significant interaction was observed at T1 for the knowledge of the 'minimum of 2 days without alcohol a week' guideline, or of cancer risk. At T2, no significant interaction was observed for the main outcomes' variables. CONCLUSIONS There appears to be an association between exposure to a 2019 French mass-media campaign to raise knowledge of long-term alcohol-related harms and low-risk drinking guidelines and reduce alcohol consumption and (i) improved knowledge of the 'maximum two drinks per day guideline', (ii) knowledge of the risks of hypertension and brain haemorrhage and (iii) a reduction in the proportion of people exceeding low-risk drinking guidelines (in the general population only). These associations were only observed over the short term and, in some cases, only for certain segments of the population.
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Affiliation(s)
- Guillemette Quatremère
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
| | - Romain Guignard
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
| | - Chloé Cogordan
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France.,ORS Paca, Southeastern Health Regional Observatory, Marseille, France
| | - Raphaël Andler
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
| | | | - Viêt Nguyen-Thanh
- Prevention and Health Promotion Department, Santé publique France, Saint-Maurice, France
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Marko S, Thomas SL, Robinson K, Daube M. Gamblers' perceptions of responsibility for gambling harm: a critical qualitative inquiry. BMC Public Health 2022; 22:725. [PMID: 35413823 PMCID: PMC9004097 DOI: 10.1186/s12889-022-13109-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/29/2022] [Indexed: 12/31/2022] Open
Abstract
Background Gambling has traditionally been conceptualised as an issue of addiction and personal responsibility. While there are now clear public health models that recognise that gambling harm is caused by a range of socio-cultural, environmental, commercial and political determinants, government and industry messages about gambling are still largely personal responsibility focused. Given the well-recognised issues associated with personal responsibility paradigms, this study sought to understand how gamblers themselves conceptualised responsibility for gambling harm. Methods A qualitatively led online panel survey was conducted with 363 adult gamblers in New South Wales and Victoria, Australia. Participants were asked to respond to what they thought were the causes of gambling harm, and what could be done to prevent harm. A reflexive thematic analysis was conducted. Results Six common tropes were constructed from gamblers’ responses: (1) Gambling in moderation; (2) Personal responsibility for rational behaviour; (3) Character flaws; (4) Personal responsibility to seek help; (5) More education is needed; and (6) Governments are responsible for action – but motivation and efficacy are questioned. Gamblers primarily understood gambling harm as being a matter of personal responsibility, and government responsibility was generally seen as limited to providing information to facilitate informed gambling choices. Conclusions This study demonstrates that gamblers’ perceptions of gambling harm are similar to the personal responsibility framings and tropes present in industry and government messaging strategies. Refocusing public communication strategies away from ‘responsible gambling’ messaging, and towards evidence-based approaches, will be an important part of addressing the harms associated with gambling.
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Affiliation(s)
- Sarah Marko
- Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Samantha L Thomas
- Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Australia
| | - Kim Robinson
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Australia
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Booth L, Jongenelis MI, Drane C, Brennan E, Wakefield M, Chikritzhs T, Hasking P, Pettigrew S. Understanding and Overcoming Barriers to Drink Counting. Subst Use Misuse 2022; 57:2063-2073. [PMID: 36252568 DOI: 10.1080/10826084.2022.2129998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Drink counting has been found to be an effective protective behavioral strategy (PBS) to reduce alcohol consumption. However, little is known about attitudes to this strategy and barriers and facilitators to its use. The aim of this study was to explicate these factors and draw comparisons with less efficacious PBSs. Method: In Stage 1, 1,703 Australian drinkers were surveyed about their perceptions of five PBSs ("Count the number of drinks you have," "Drink slowly rather than gulping or sculling," "Refuse an alcoholic drink you are offered because you don't really want it," "Avoid trying to 'keep up' or 'outdrink' others," and "Decide not to exceed a certain number of drinks"). Respondents reported perceived believability, relevance, ease of use, effectiveness, barriers, and facilitators. In Stage 2, 10 focus groups were conducted with drinkers to identify potential methods of effectively promoting drink counting. Results: Overall, drink counting was rated less favorably than the less-efficacious PBSs, indicating a need to inform drinkers of the importance and feasibility of this strategy to encourage its use. The main identified barriers were a lack of awareness of the long-term harms associated with alcohol use, social factors (e.g., peer pressure), and difficulty counting when intoxicated. Participants suggested improving drinkers' understanding of alcohol-related harms and developing mechanisms to assist with counting. Conclusion: To encourage drink counting, information campaigns are needed to educate the community about the long-term risks of alcohol use. Evidenced-based mechanisms to facilitate drink counting may be welcomed by drinkers.
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Affiliation(s)
- Leon Booth
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia.,School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine Drane
- School of Population Health, Curtin University, Bentley, Western Australia, Australia.,National Centre for Student Equity in Higher Education, Curtin University, Bentley, Western Australia, Australia
| | - Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Penelope Hasking
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia.,National Drug Research Institute, Curtin University, Bentley, Western Australia, Australia
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