1
|
Schwartz D, Torres-Ulloa I, Corvalán C. Effectiveness of alcohol warning labels for at-risk groups and the general public: A policy-informing randomized experiment in Chile. Prev Med 2024; 187:108087. [PMID: 39097006 DOI: 10.1016/j.ypmed.2024.108087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVE The World Health Organization recommends using health-risk warnings on alcoholic beverages. This study examines the impact of separate or combined warning labels for at-risk groups and the general population on alcohol purchase decisions. METHODS In 2022, 7758 adults who consumed alcohol or were pregnant/lactating women (54.0 % female, mean age = 40.6 years) were presented with an online store's beverage section and randomly assigned to one of six warning labels in a between-subjects experimental design: no-warning, pregnant/lactating, drinking-driving, general cancer risk, combined warnings, and assorted warnings across bottles. The main outcome, the intention to purchase an alcoholic vs. non-alcoholic beverage, was examined with adjusted risk differences using logistic regressions. RESULTS Participants exposed to the general cancer risk warning decreased their alcoholic choices by 10.4 percentage points (pp.) (95 % CI [-0.139, -0.069], p < 0.001, OR = 0.561), while those in the pregnancy/lactation warning condition did it by 3.8 pp. (95 % CI [-0.071, -0.005], p = 0.025, OR = 0.806). The driving-drinking warning had no significant effect. Participants exposed to the combined warnings label, or the assorted warnings reduced alcohol purchase decisions by 6.1 pp. (95 % CI [-0.095, -0.028], p < 0.001, OR = 0.708) and 4.3 pp. (95 % CI [-0.076, -0.010], p = 0.011, OR = 0.782), respectively. Cancer warning outperformed other labels and was effective for subgroups such as pregnant/lactating women, young adults, and low-income individuals. CONCLUSIONS General cancer risk warnings are more effective at reducing alcohol purchase decisions compared to warning labels for specific groups or labels using multiple warnings. In addition to warning labels, other policies should be considered for addressing well-known alcohol-related risks (e.g., drinking and driving).
Collapse
Affiliation(s)
- Daniel Schwartz
- Department of Industrial Engineering, University of Chile and Instituto Sistema Complejos de Ingeniería, Av. Beauchef, 851 Santiago, Chile.
| | - Ignacio Torres-Ulloa
- Department of Economics, University of Southern California, Kaprielian Hall, 3620 S Vermont Ave, Los Angeles, CA, United States.
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Av. El Líbano 5524, Macul, Santiago, Chile.
| |
Collapse
|
2
|
Lacoste-Badie S, Yu JJ, Droulers O. Do health warning labels on alcohol packaging attract visual attention? A systematic review. Public Health 2024; 236:184-192. [PMID: 39299085 DOI: 10.1016/j.puhe.2024.07.030] [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: 02/07/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVES To synthesize eye-tracking-based evidence on consumers' visual attention devoted to alcohol warning labels (AWLs) on alcohol packaging. STUDY DESIGN A systematic review was conducted and reported in accordance with the PRISMA guidelines. METHODS Two rounds of a literature search were conducted to identify relevant peer-reviewed articles and unpublished grey literature. While the first round (July 3 to August 21, 2023) was based on three electronic databases (PubMed, Web of Science, and PsycINFO), the second round (May 20 to 28, 2024) followed a multiple-step protocol that systematically searched the grey literature. Five criteria were applied to screen eligible articles. Using established quality control tools, the identified articles were assessed for overall quality and then for quality specific to the eye-tracking method. RESULTS Six published peer-reviewed articles were thus included in the current review along with one unpublished research paper from a doctoral thesis. This review paper summarizes earlier findings in terms of bottom-up (i.e., AWL design-related) factors such as size, color, surrounding border, and pictorial elements, and top-down (i.e., goal-driven) factors such as motivation to change drinking behavior and self-affirmation. The review found that people tend to pay very little attention to AWLs displayed on alcohol packaging, although there is mixed evidence as to the effectiveness of specific factors. CONCLUSIONS Further investigations using eye-tracking are needed to collect additional evidence on attention devoted to AWLs. Meanwhile, we put forward implications for policymakers and future avenues for research based on our review of the existing literature.
Collapse
Affiliation(s)
| | - J J Yu
- Univ. Angers, GRANEM, F-49000 Angers, France.
| | - O Droulers
- Univ. Rennes, CNRS NeuroLab CREM (UMR 6211), F-35000 Rennes, France.
| |
Collapse
|
3
|
Davies E, Lewin J, Field M. Am I a responsible drinker? The impact of message frame and drinker prototypes on perceptions of alcohol product information labels. Psychol Health 2024; 39:1005-1022. [PMID: 36190181 DOI: 10.1080/08870446.2022.2129055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/01/2022] [Accepted: 09/21/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Current alcohol product labelling tends to include ambiguous messages such as 'drink responsibly'. Consumers who identify as responsible drinkers may not pay heed to health warning messages, believing that they are not the intended target. AIMS We aimed to determine how responses to responsible drinking labels would differ from responses to positively and negatively framed health messages. We also explored if prototype perceptions would moderate the message impact. METHODS A between groups, three arm (ambiguous, positive or negative messages) experiment recruited 465 participants. Outcomes were drinking intentions and label acceptability (novelty, believability, personal relevance, and potential to change behaviour). Measures of heavy and responsible drinker prototype perceptions were included for exploratory moderation analyses. RESULTS Positive and negative messages were rated significantly more likely to change behaviour than ambiguous messages. There was also a moderation effect: participants with stronger favourability and similarity to the responsible drinker prototype intended to drink more alcohol in the future after exposure to negatively framed labels, but not after exposure to ambiguous or positively framed labels. DISCUSSION Drink responsibly' messages are unlikely to lead to behaviour change. Incorporating theoretical moderators may have value in developing our understanding of the impact of alcohol product labelling.
Collapse
Affiliation(s)
- Emma Davies
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Joel Lewin
- The Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| |
Collapse
|
4
|
Kerr WC, Lui CK, Ye Y, Li L, Greenfield T, Karriker-Jaffe KJ, Martinez P. Long-term trends in beverage-specific drinking in the National Alcohol Surveys: Differences by sex, age, and race and ethnicity. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1322-1335. [PMID: 38658368 PMCID: PMC11236498 DOI: 10.1111/acer.15335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Despite substantial declines in underage drinking and binge drinking, alcohol consumption has increased in the past 30 years. This study examined how beverage-specific drinking patterns varied by sex, age, and race and ethnicity from 1979 to 2020. METHODS Secondary data analysis was conducted on pooled data from the National Alcohol Survey series from 1979 to 2020 of a sample of U.S. adults ages 18 years or older. Total and beverage-specific volume were calculated from graduated frequency questions on reported beverage type, which included beer, wine, and spirits. Sex-stratified analyses focused on descriptive trends of each alcohol measure over time and by age and race and ethnicity. Time-varying effect models were also conducted to identify subgroups at higher risk for increased consumption over time. RESULTS Women's drinking increased, with alcohol volume rising substantially from 2000 to 2020; the largest increase was among women 30 and older. Men's alcohol volume also rose over this period but remained below the levels of 1979 and 1984, with older adults increasing their consumption those 18-29 decreased their drinking. Beverage-specific trends showed some similarities by gender: in 2020, wine volume was at its highest level for both women and men, while spirits volume also was at its highest level for men and in women was tied with the 1979 peak in spirits consumption. Increases were also found among Black men and women and Latina women from 2000 to 2020. CONCLUSIONS Given the increases in alcohol volume, particularly among women and older age groups, alcohol policy, interventions, and education should consider ways to reduce harms associated with alcohol use among these groups. Continued monitoring of beverage-specific drinking patterns is needed to track policy-relevant changes.
Collapse
Affiliation(s)
- William C. Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Camillia K. Lui
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, CA
| | | | | | | |
Collapse
|
5
|
Reile R, Rehm J. Does higher alcohol consumption affect attitudes towards alcohol control measures in Estonia? PUBLIC HEALTH IN PRACTICE 2024; 7:100455. [PMID: 38405229 PMCID: PMC10885783 DOI: 10.1016/j.puhip.2023.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/24/2023] [Accepted: 11/15/2023] [Indexed: 02/27/2024] Open
Abstract
Objectives To analyze whether higher alcohol consumption is associated with negative attitudes towards stricter alcohol control policy measures in Estonia. Study design Cross-sectional analysis of nationally representative data from 2022 (n = 2059). Methods Attitudes towards seven alcohol control measures and their association with high-risk alcohol consumption (>140 g absolute alcohol for men and >70 g for women per week) were analyzed using used descriptive statistics and binary logistic regression using nationally representative data on Estonian 15-74-year-old population. Results In general, high-risk consumption associated with lower acceptance for alcohol control policies. Although men had higher prevalence of opposing alcohol control measure for every item considered, both men and women with high-risk alcohol consumption were significantly more likely to be against alcohol control measures in general even after accounting for the variation by demographic characteristics. Conclusions As public opinion is detrimental to the successful implementation of alcohol policies, these findings emphasize the need to communicate alcohol-related harms to the public in order to increase awareness and support for alcohol control policies.
Collapse
Affiliation(s)
- Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Jürgen Rehm
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & WHO CC, 81-95 Roc Boronat St., 08005, Barcelona, Spain
| |
Collapse
|
6
|
Swahn MH, Martinez P, Balenger A, Luningham J, Seth G, Awan S, Aneja R. 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. BMC Public Health 2024; 24:1076. [PMID: 38637773 PMCID: PMC11025251 DOI: 10.1186/s12889-024-18565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Monica H Swahn
- Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA, USA.
| | | | | | - Justin Luningham
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Gaurav Seth
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sofia Awan
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ritu Aneja
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
7
|
Winter SF, Walsh D, Catsman-Berrevoets C, Feigin V, Destrebecq F, Dickson SL, Leonardi M, Hoemberg V, Tassorelli C, Ferretti MT, Dé A, Chadha AS, Lynch C, Bakhtadze S, Saylor D, Hwang S, Rostasy K, Kluger BM, Wright C, Zee PC, Dodick DW, Jaarsma J, Owolabi MO, Zaletel J, Albreht T, Dhamija RK, Helme A, Laurson-Doube J, Amos A, Baingana FK, Baker GA, Sofia F, Galvin O, Hawrot T. National plans and awareness campaigns as priorities for achieving global brain health. Lancet Glob Health 2024; 12:e697-e706. [PMID: 38485433 PMCID: PMC10951964 DOI: 10.1016/s2214-109x(23)00598-3] [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] [Received: 07/11/2023] [Revised: 11/26/2023] [Accepted: 12/12/2023] [Indexed: 03/19/2024]
Abstract
Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including representatives of the OneNeurology Partnership (a consortium uniting global neurology organisations), take stock and advocate for urgent acceleration of IGAP implementation. Drawing on lessons from relevant global health contexts, this Health Policy identifies two priority IGAP targets to expedite national delivery of the entire 10-year plan: namely, to update national policies and plans, and to create awareness campaigns and advocacy programmes for neurological conditions and brain health. To ensure rapid attainment of the identified priority targets, six strategic drivers are proposed: universal community awareness, integrated neurology approaches, intersectoral governance, regionally coordinated IGAP domestication, lived experience-informed policy making, and neurological mainstreaming (advocating to embed brain health into broader policy agendas). Contextualised with globally emerging IGAP-directed efforts and key considerations for intersectoral policy design, this novel framework provides actionable recommendations for policy makers and IGAP implementation partners. Timely, synergistic pursuit of the six drivers might aid WHO member states in cultivating public awareness and policy structures required for successful intersectoral roll-out of IGAP by 2031, paving the way towards brain health for all.
Collapse
Affiliation(s)
- Sebastian F Winter
- OneNeurology Partnership, Brussels, Belgium; International Bureau for Epilepsy, Washington, DC, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Donna Walsh
- OneNeurology Partnership, Brussels, Belgium; International Bureau for Epilepsy, Washington, DC, USA
| | - Coriene Catsman-Berrevoets
- OneNeurology Partnership, Brussels, Belgium; European Paediatric Neurology Society, Paris, France; Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - Valery Feigin
- OneNeurology Partnership, Brussels, Belgium; World Stroke Organization, Geneva, Switzerland; National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Frédéric Destrebecq
- OneNeurology Partnership, Brussels, Belgium; European Brain Council, Brussels, Belgium
| | - Suzanne L Dickson
- OneNeurology Partnership, Brussels, Belgium; European Brain Council, Brussels, Belgium; Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Matilde Leonardi
- OneNeurology Partnership, Brussels, Belgium; World Federation for Neurorehabilitation, North Shields, UK; Fondazione IRCCS Istituto Neurologico CarloBesta, Milan, Italy
| | - Volker Hoemberg
- OneNeurology Partnership, Brussels, Belgium; World Federation for Neurorehabilitation, North Shields, UK
| | - Cristina Tassorelli
- OneNeurology Partnership, Brussels, Belgium; International Headache Society, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Maria Teresa Ferretti
- OneNeurology Partnership, Brussels, Belgium; Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden; Women's Brain Project, Bottighofen, Switzerland
| | - Anna Dé
- OneNeurology Partnership, Brussels, Belgium; Women's Brain Project, Bottighofen, Switzerland
| | | | - Chris Lynch
- OneNeurology Partnership, Brussels, Belgium; Alzheimer's Disease International, London, UK
| | - Sophia Bakhtadze
- OneNeurology Partnership, Brussels, Belgium; European Paediatric Neurology Society, Paris, France; Department of Paediatric Neurology, Tbilisi State Medical University, Tbilisi, Georgia
| | - Deanna Saylor
- OneNeurology Partnership, Brussels, Belgium; World Neurology Foundation, New York, NY, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Soonmyung Hwang
- OneNeurology Partnership, Brussels, Belgium; World Neurology Foundation, New York, NY, USA
| | - Kevin Rostasy
- OneNeurology Partnership, Brussels, Belgium; European Paediatric Neurology Society, Paris, France; Department of Paediatric Neurology, Children's Hospital Datteln, University of Witten/Herdecke, Witten, Germany
| | - Benzi M Kluger
- OneNeurology Partnership, Brussels, Belgium; International Neuropalliative Care Society, Roseville, MN, USA; Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Claire Wright
- OneNeurology Partnership, Brussels, Belgium; Meningitis Research Foundation, Bristol, UK; Confederation of Meningitis Organisations, Bristol, UK
| | - Phyllis C Zee
- OneNeurology Partnership, Brussels, Belgium; World Sleep Society, Rochester, MN, USA; Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David W Dodick
- OneNeurology Partnership, Brussels, Belgium; International Headache Society Global Patient Advocacy Coalition, London, UK; Mayo Clinic College of Medicine, Phoenix, AZ, USA; Atria Academy of Science and Medicine, New York, NY, USA; American Migraine Foundation, New York, NY, USA; American Brain Foundation, Minneapolis, MN, USA
| | - Joke Jaarsma
- OneNeurology Partnership, Brussels, Belgium; European Federation of Neurological Associations, Brussels, Belgium
| | - Mayowa O Owolabi
- OneNeurology Partnership, Brussels, Belgium; World Federation for Neurorehabilitation, North Shields, UK; Center for Genomic and Precision Medicine, and Neurology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria; African Stroke Organization, Ibadan, Nigeria; Lebanese American University of Beirut, Beirut, Lebanon; Blossom Specialist Medical Center, Ibadan, Nigeria
| | - Jelka Zaletel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Tit Albreht
- National Institute of Public Health, Ljubljana, Slovenia
| | - Rajinder K Dhamija
- OneNeurology Partnership, Brussels, Belgium; World Federation for Neurorehabilitation, North Shields, UK; International Neuropalliative Care Society, Roseville, MN, USA; Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Anne Helme
- Multiple Sclerosis International Federation, London, UK
| | | | - Action Amos
- International Bureau for Epilepsy, Washington, DC, USA; International Bureau for Epilepsy African Region, Blantyre, Malawi
| | - Florence K Baingana
- Regional Advisor, Mental Health and Substance Abuse, World Health Organization African Region, Brazzaville, Congo
| | - Gus A Baker
- OneNeurology Partnership, Brussels, Belgium; International Bureau for Epilepsy, Washington, DC, USA
| | - Francesca Sofia
- OneNeurology Partnership, Brussels, Belgium; International Bureau for Epilepsy, Washington, DC, USA
| | - Orla Galvin
- OneNeurology Partnership, Brussels, Belgium; European Federation of Neurological Associations, Brussels, Belgium
| | - Tadeusz Hawrot
- OneNeurology Partnership, Brussels, Belgium; European Federation of Neurological Associations, Brussels, Belgium
| |
Collapse
|
8
|
Booth L, Miller M, Pettigrew S. The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review. Drug Alcohol Rev 2024; 43:141-155. [PMID: 37934620 DOI: 10.1111/dar.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/09/2023]
Abstract
ISSUES Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. APPROACH A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. KEY FINDINGS The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. IMPLICATIONS AND CONCLUSION Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.
Collapse
Affiliation(s)
- Leon Booth
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| | - Mia Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Simone Pettigrew
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Rehm J, Ferreira-Borges C, Kokole D, Neufeld M, Olsen A, Rovira P, Segura Garcia L, Tran A, Colom J. Assessing the impact of providing digital product information on the health risks of alcoholic beverages to the consumer at point of sale: A pilot study. Drug Alcohol Rev 2023; 42:1332-1337. [PMID: 37132168 DOI: 10.1111/dar.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION There is an ongoing policy debate in the European Union regarding the best method of providing information to consumers on the health risks of alcohol use. One of the proposed channels is via the provision of QR codes. This study tested the usage rate of QR codes placed on point-of-sale signs in a supermarket in Barcelona, Catalonia over a 1-week period. METHODS Nine banners with beverage-specific health warnings in large text were prominently displayed in the alcohol section of a supermarket. Each banner provided a QR code of relatively large image size that linked to a government website providing further information on alcohol-related harms. A comparison was made between the number of visits to the website and the number of customers in the supermarket (number of unique sales receipts) in a single week. RESULTS Only 6 out of 7079 customers scanned the QR code during the week, corresponding to a usage rate of 0.085%, less than 1 per 1000. The usage rate was 2.6 per 1000 among those who purchased alcohol. DISCUSSION AND CONCLUSIONS Despite the availability of prominently displayed QR codes, the overwhelming majority of customers did not make use of the QR codes to obtain further information on alcohol-related harms. This corroborates the results from other studies investigating customers' use of QR codes to obtain additional product information. Based on the current evidence, providing online access to information through QR codes will likely not reach a significant portion of consumers.
Collapse
Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Daša Kokole
- WHO European Office for Prevention and Control of Noncommunicable Diseases, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Aleksandra Olsen
- WHO European Office for Prevention and Control of Noncommunicable Diseases, WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Lidia Segura Garcia
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Joan Colom
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| |
Collapse
|
11
|
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.
Collapse
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.
| |
Collapse
|
12
|
Manthey J, Kokole D, Riedel-Heller S, Rowlands G, Schäfer I, Schomerus G, Soellner R, Kilian C. Improving alcohol health literacy and reducing alcohol consumption: recommendations for Germany. Addict Sci Clin Pract 2023; 18:28. [PMID: 37161561 PMCID: PMC10169338 DOI: 10.1186/s13722-023-00383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although the detrimental health effects of alcohol are well established, consumption levels are high in many high-income countries such as Germany. Improving alcohol health literacy presents an integrated approach to alcohol prevention and an important complement to alcohol policy. Our aim was to identify and prioritize measures to enhance alcohol health literacy and hence to reduce alcohol consumption, using Germany as an example. METHODS A series of recommendations for improving alcohol health literacy were derived from a review of the literature and subsequently rated by five experts. Recommendations were rated according to their likely impact on enhancing (a) alcohol health literacy and (b) reducing alcohol consumption. Inter-rater agreement was assessed using a two-way intra-class correlation coefficient (ICC). RESULTS Eleven recommendations were established for three areas of action: (1) education and information, (2) health care system, and (3) alcohol control policy. Education and information measures were rated high to increase alcohol health literacy but low to their impact on alcohol consumption, while this pattern was reversed for alcohol control policies. The ratings showed good agreement (ICC: 0.85-0.88). CONCLUSIONS Improving alcohol health literacy and reducing alcohol consumption should be considered complementary and become part of a comprehensive alcohol strategy to curb the health, social, and economic burden of alcohol.
Collapse
Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands
| | - Steffi Riedel-Heller
- Public Health Sciences Institute, Campus for Ageing & Vitality, Westgate Rd, Newcastle Upon Tyne, NE4 6BE, UK
| | - Gill Rowlands
- Institute of Social Medicine, Medical Faculty, Occupational Health and Public Health (ISAP), University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Ingo Schäfer
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - Renate Soellner
- Institute for Psychology, University of Hildesheim, Universitätsplatz 1, 34414, Hildesheim, Germany
| | - Carolin Kilian
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research (IMHPR), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| |
Collapse
|
13
|
Greene NK, Rising CJ, Seidenberg AB, Eck R, Trivedi N, Oh AY. Exploring correlates of support for restricting breast cancer awareness marketing on alcohol containers among women. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104016. [PMID: 36990013 PMCID: PMC10593197 DOI: 10.1016/j.drugpo.2023.104016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Although alcohol consumption increases breast cancer risk, some alcohol products include breast cancer awareness marketing (i.e., pink ribbons) on alcohol containers, which poses a contradiction. Some researchers and advocacy groups have called for restrictions on use of the pink ribbon and other breast cancer awareness marketing on alcohol products. This exploratory study aimed to describe individual and behavioral correlates (age, knowledge, attitudes, purchase intention) of reported support for potential policy restrictions of pink ribbon labeling on alcohol containers. METHODS The study sample was drawn from the Prolific crowd-sourced research platform in September 2020. Eligible participants included U.S. women aged 21+ years. The primary outcome was policy position for restrictions on pink ribbon labeling on alcohol containers, coded as support, neutral, or oppose. The association between pink ribbon labeling attitudes and support or opposition (vs neutral) was examined using multinomial logistic regression. Covariates were 1) knowledge of the alcohol-cancer link; 2) likelihood of buying an alcohol product with pink ribbon labeling; and 3) age. Models were used to calculate adjusted predicted probabilities for support, oppose, and neutral. RESULTS The analytic sample included 511 women. Overall, 46% of women opposed, 34% were neutral, and 20% supported restricting pink ribbon labeling on alcohol containers. Controlling for all covariates, women who reported that wine increases cancer risk had the highest probability of opposing restrictions on pink ribbon labeling (56.4% [95%CI: 48.1%-64.8%]). Women who reported wine had no effect on cancer risk had the highest probability of being neutral about restrictions on pink ribbon labeling (45.5% [95% CI: 35.7%-55.3%]). Across levels of knowledge about the alcohol-cancer risk association, as favorable attitudes toward pink ribbon labeling increased, the probability of policy opposition increased and the probability of being policy neutral decreased. CONCLUSION Findings from this study suggest women's favorable attitudes toward pink ribbon labeling on alcohol containers are a stronger predictor of support or opposition for restrictions on pink ribbon labeling than knowledge of the alcohol-cancer link. Future research could examine whether pink ribbon labeling may interact with potential or current health warnings on alcohol containers.
Collapse
Affiliation(s)
- Naomi K Greene
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA.
| | - Camella J Rising
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, USA
| | - Andrew B Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; Truth Initiative Schroeder Institute, Washington, DC, USA
| | - Raimee Eck
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA
| | - Neha Trivedi
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; NORC at the University of Chicago, Public Health Department, 4350 East-West Hwy, Suite 800, Bethesda, MD 20814, USA
| | - April Y Oh
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA
| |
Collapse
|
14
|
Morris J, Boness CL, Witkiewitz K. Should we promote alcohol problems as a continuum? Implications for policy and practice. DRUGS (ABINGDON, ENGLAND) 2023; 31:271-281. [PMID: 38682086 PMCID: PMC11052541 DOI: 10.1080/09687637.2023.2187681] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/01/2023] [Indexed: 04/03/2023]
Abstract
The highly heterogeneous nature of alcohol use and problems has presented significant challenges to those attempting to understand, treat or prevent what is commonly termed alcohol use disorder (AUD). However, any attempts to capture this complex phenomenon, including the various current criterion of AUD, come with a number of limitations. One particular limitation has been how alcohol problems are represented or understood in ways which do not capture the broad spectrum of alcohol use and harms and the many potential routes to prevention, treatment, and recovery. One possible response to this has been proposed as more explicitly framing or conceptualizing a continuum model of alcohol use and harms. In this commentary, we attempt to identify the key implications of a continuum model for policy and practice, examining the historical and current context of alcohol problem classifications and models. We argue a continuum model of alcohol use and problems holds a number of advantages for advancing public health goals, but also some potential limitations, both of which require further examination.
Collapse
Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - C L Boness
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
| | - K Witkiewitz
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
| |
Collapse
|
15
|
Doyle A, O'Dwyer C, Mongan D, Millar SR, Galvin B. Factors associated with public awareness of the relationship between alcohol use and breast cancer risk. BMC Public Health 2023; 23:577. [PMID: 36978036 PMCID: PMC10044731 DOI: 10.1186/s12889-023-15455-8] [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: 12/02/2022] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Public awareness of the carcinogenic effects of alcohol is low, particularly the association between alcohol use and the risk of developing breast cancer. Breast cancer is the third most common cancer in Ireland and alcohol use remains high. This study examined factors related to awareness of the association between alcohol use and breast cancer risk. METHODS Using data from Wave 2 of the national Healthy Ireland Survey, a representative sample of 7,498 Irish adults aged 15 + years, descriptive and logistic regression analyses were conducted to investigate relationships between demographic characteristics, type of drinker and awareness of breast cancer risk. RESULTS A low level of awareness of the risk of alcohol use (drinking more than the recommended low-risk limit) associated with breast cancer was found, with just 21% of respondents correctly identifying the relationship. Multivariable regression analyses found that factors most strongly associated with awareness were sex (female), middle age (45-54 years) and higher educational levels. CONCLUSION As breast cancer is a prevalent disease among women in Ireland, it is essential that the public, in particular women who drink, are made aware of this association. Public health messages that highlight the health risks associated with alcohol use, and which target individuals with lower educational levels, are warranted.
Collapse
Affiliation(s)
- Anne Doyle
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland.
| | - Claire O'Dwyer
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| | - Deirdre Mongan
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| | - Seán R Millar
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Cork, Ireland
| | - Brian Galvin
- Health Research Board, Grattan House 67-72 Lower Mount Street, Dublin, Ireland
| |
Collapse
|
16
|
Zomerdijk N, Jongenelis MI, Collins B, Turner J, Short CE, Smith A, Huntley K. Factors associated with changes in healthy lifestyle behaviors among hematological cancer patients during the COVID-19 pandemic. Front Psychol 2023; 14:1081397. [PMID: 36968693 PMCID: PMC10033534 DOI: 10.3389/fpsyg.2023.1081397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundThere is a paucity of research examining the effects of the COVID-19 pandemic on the healthy lifestyle behaviors of hematological cancer patients. We examined changes in healthy lifestyle behaviors since the pandemic and identified factors associated with these changes among members of this high-risk population.MethodsHematological cancer patients (n = 394) completed a self-report online survey from July to August 2020. The survey assessed pandemic-related changes in exercise, alcohol consumption, and consumption of fruit, vegetables, and wholegrains. Information relating to several demographic, clinical, and psychological factors was also collected. Factors associated with changes in healthy lifestyle behaviors were analyzed using logistic regression.ResultsJust 14% of patients surveyed reported exercising more during the pandemic (39% exercised less). Only a quarter (24%) improved their diet, while nearly half (45%) reported eating less fruit, vegetables, and wholegrains. Just over a quarter (28%) consumed less alcohol (17% consumed more alcohol). Fear of contracting COVID-19 and psychological distress were significantly associated with reduced exercise. Younger age was significantly associated with both increased alcohol consumption and increased exercise. Being a woman was significantly associated with unfavorable changes in diet and being married was significantly associated with decreased alcohol consumption.ConclusionA substantial proportion of hematological cancer patients reported unfavorable changes in healthy lifestyle behaviors during the pandemic. Results highlight the importance of supporting healthy lifestyle practices among this particularly vulnerable group to ensure health is optimized while undergoing treatment and when in remission, particularly during crisis times like the COVID-19 pandemic.
Collapse
Affiliation(s)
- Nienke Zomerdijk
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Victorian Comprehensive Cancer Centre Alliance, Parkville, VIC, Australia
- *Correspondence: Nienke Zomerdijk,
| | - Michelle I. Jongenelis
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, VIC, Australia
| | - Ben Collins
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
- Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Camille E. Short
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, VIC, Australia
- School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | | |
Collapse
|
17
|
Seidenberg AB, Wiseman KP, Klein WMP. Do Beliefs about Alcohol and Cancer Risk Vary by Alcoholic Beverage Type and Heart Disease Risk Beliefs? Cancer Epidemiol Biomarkers Prev 2023; 32:46-53. [PMID: 36453075 PMCID: PMC9839574 DOI: 10.1158/1055-9965.epi-22-0420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/18/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Alcohol is a leading risk factor for cancer, yet awareness of the alcohol-cancer link is low. Awareness may be influenced by perceptions of potential health benefits of alcohol consumption or certain alcoholic beverage types. The purpose of this study was to estimate awareness of the alcohol-cancer link by beverage type and to examine the relationship between this awareness and concomitant beliefs about alcohol and heart disease risk. METHODS We analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4, a nationally representative survey of U.S. adults. RESULTS Awareness of the alcohol-cancer link was highest for liquor (31.2%), followed by beer (24.9%) and wine (20.3%). More U.S. adults believed wine (10.3%) decreased cancer risk, compared with beer (2.2%) and liquor (1.7%). Most U.S. adults (>50%) reported not knowing how these beverages affected cancer risk. U.S. adults believing alcoholic beverages increased heart disease risk had higher adjusted predicted probabilities of being aware of the alcohol-cancer link (wine: 58.6%; beer: 52.4%; liquor: 59.4%) compared with those unsure (wine: 6.0%; beer: 8.6%; liquor: 13.2%), or believing alcoholic beverages reduced (wine: 16.2%; beer: 21.6%; liquor: 23.8%) or had no effect on heart disease risk (wine: 10.2%; beer: 12.0%; liquor: 16.9%). CONCLUSIONS Awareness of the alcohol-cancer link was low, varied by beverage type, and was higher among those recognizing that alcohol use increased heart disease risk. IMPACT These findings underscore the need to educate U.S. adults about the alcohol-cancer link, including raising awareness that drinking all alcoholic beverage types increases cancer risk. See related commentary by Hay et al., p. 9.
Collapse
Affiliation(s)
- Andrew B. Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kara P. Wiseman
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - William M. P. Klein
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
18
|
Glasgow TE, Miller CA, McGuire KP, Freudenberger DC, Fuemmeler BF. Support for cancer prevention public health policies: results from a nationally representative sample of residents in the United States. Transl Behav Med 2022; 12:1124-1132. [PMID: 35972325 PMCID: PMC9802572 DOI: 10.1093/tbm/ibac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Assessing public support of health policies designed to reduce cancer risk is important for policy implementation. This study aimed to identify support for cancer prevention policies and factors associated with support. Data were obtained from the Health Information National Trends Survey. Support for three types of cancer prevention policies were evaluated: tobacco, alcohol, and junk food regulations. Linear and logistic regression analyses were employed to assess the relationship between support for the different types of policies and sociodemographic, lifestyle behaviors, and cancer beliefs. Certain policies, such as providing warning labels on cigarettes (69.9% support) and requiring specific health warnings on alcohol containers (65.1% support), were popular. Banning outdoor advertising of alcohol was not popular (34.4% support). There were individual differences associated with policy support. For example, respondents who were 75 years or older (B = 0.61, p < .001) or female (B = 0.14, p < .008) were more likely to support tobacco polices compared to their counterparts (i.e., younger or male). Respondents who identified as politically conservative (B = -0.20, p < .004) or those who endorsed high cancer fatalistic beliefs (e.g., there's not much you can do to lower your chances of getting cancer, B = -0.07, p < .012) were less likely to support alcohol policies compared to those who were liberal or had lower cancer fatalistic beliefs. Generally, support was high for most policy questions. However, support varied by different individual factors. The findings also highlight that there may be opportunities to increase understanding and awareness about cancer prevention policies, especially among some segments of the population.
Collapse
Affiliation(s)
- Trevin E Glasgow
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| |
Collapse
|
19
|
Muacevic A, Adler JR, Hussaini T, Omar M, Cox B, Marquez-Azalgara V, Yoshida EM. Liver Transplant Recipients Speak Out on Public Awareness and Education Surrounding Alcohol-Related Health Effects: A Survey Study. Cureus 2022; 14:e31760. [PMID: 36569722 PMCID: PMC9771763 DOI: 10.7759/cureus.31760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Compared to other recreational substances in Canada, alcohol consumption incurs the highest healthcare costs. Liver transplant recipients are unique stakeholders as members of the general public with lived experiences of liver disease. We sought to explore their perspectives on the current state of public education on alcohol-related health effects. METHODS The most recent 400 liver transplant recipients at Vancouver General Hospital, Canada, were invited to participate in an anonymous online survey on alcohol-related health effects by mail, email, and phone. RESULTS Of 372 contacted patients, 212 (57%) completed the survey. Most patients were between 60-79 years, 63% were male, and 69% were Caucasian. The most common liver conditions leading to transplant were viral hepatitis (33%), alcohol-related liver disease (16%), autoimmune liver disease (14%), and non-alcoholic fatty liver disease (15%). Most patients knew that alcohol leads to liver failure (85%), but fewer knew about alcohol leading to cancer (54%), heart disease (50%), and damage to other organs (58%). Most common sources of information included public media (61%), family and friends (52%), and physicians (49%), with narrative comments about learning of alcohol-related health effects after liver diagnosis. Most patients believed that public health education at a middle/high school level would have long-term efficacy (72%) compared to health warning labels (33%) and safety messaging in commercials (39%). Current public education was felt to be adequate by only 20% of patients and 73% of patients supported health warning labels. CONCLUSIONS Liver transplant patients reported a high, but not universal, awareness of alcohol-related health effects. A majority thought that current public health efforts were inadequate; it is critical to implement public health interventions to ensure consumers are able to make an informed decision on alcohol consumption.
Collapse
|
20
|
Budenz A, Moser RP, Eck R, Agurs-Collins T, McNeel TS, Klein WMP, Berrigan D. Awareness of Alcohol and Cancer Risk and the California Proposition 65 Warning Sign Updates: A Natural Experiment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11862. [PMID: 36231178 PMCID: PMC9564772 DOI: 10.3390/ijerph191911862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
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.
Collapse
Affiliation(s)
- Alexandra Budenz
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - Richard P. Moser
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - Raimee Eck
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - Tanya Agurs-Collins
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - Timothy S. McNeel
- Information Management Services, Inc., 3901 Calverton Blvd #200, Calverton, MD 20705, USA
| | - William M. P. Klein
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - David Berrigan
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| |
Collapse
|
21
|
The impact of having a relative or a friend with cancer on person's modifiable cancer-related risk factors. Ir J Med Sci 2022:10.1007/s11845-022-03073-z. [PMID: 35739359 DOI: 10.1007/s11845-022-03073-z] [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: 02/23/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND It is known that targeting cancer-related modifiable risk factors is the best way to fight cancer. Behavioral and lifestyle changes can significantly reduce the burden of cancer. AIMS We aim to assess the impact of having a relative/friend with cancer on the number of cancer-related modifiable risk factors a participant might have. METHODS A survey-based cross-sectional study was conducted at King Hussein Cancer Center from June 2020 until July 2020. The survey was distributed via social media platforms, where we targeted adults who have never been diagnosed with cancer. We asked about modifiable cancer-related risk factors and compared between participants with and without relatives or friends with cancer. RESULTS A total of 1486 participants were considered for analysis, with a mean age of 30.62 (SD 11.19) years. Participants who had a relative with cancer had a mean of 0.31 (p = 0.007; 95% CI: 0.08-0.54) fewer risk factors, with smoking and extra sun exposure were significantly lower among participants with a cancer relative. No significant difference in modifiable risk factors was found between participants with a friend who have cancer and those who do not (p = 0.193). CONCLUSION People who have relatives with cancer had less modifiable risk factors, which might reflect on their willingness to modify their cancer-related risk factors.
Collapse
|
22
|
Chi FW, Parthasarathy S, Palzes VA, Kline-Simon AH, Metz VE, Weisner C, Satre DD, Campbell CI, Elson J, Ross TB, Lu Y, Sterling SA. Alcohol brief intervention, specialty treatment and drinking outcomes at 12 months: Results from a systematic alcohol screening and brief intervention initiative in adult primary care. Drug Alcohol Depend 2022; 235:109458. [PMID: 35453082 PMCID: PMC10122418 DOI: 10.1016/j.drugalcdep.2022.109458] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Alcohol screening, brief intervention and referral to treatment (SBIRT) in adult primary care is an evidence-based, public health strategy to address unhealthy alcohol use, but evidence of effectiveness of alcohol brief intervention (ABI) in real-world implementation is lacking. METHODS We fit marginal structural models with inverse probability weighting to estimate the causal effects of ABI on 12-month drinking outcomes using longitudinal electronic health records data for 312,056 adults with a positive screening result for unhealthy drinking between 2014 and 2017 in a large healthcare system that implemented systematic primary care-based SBIRT. We examined effects of ABI with and without adjusting for receipt of specialty alcohol use disorder (AUD) treatment, and whether effects varied by patient demographic characteristics and alcohol use patterns. RESULTS Receiving ABI resulted in significantly greater reductions in heavy drinking days (mean difference [95% CI] = -0.26 [-0.45, -0.08]), drinking days per week (-0.04 [-0.07, -0.01]), drinks per drinking day (-0.05 [-0.08, -0.02]) and drinks per week (-0.16 [-0.27, -0.04]). Effects of ABI on 12-month drinking outcomes varied by baseline consumption level, age group and whether patients already had an AUD, with better improvement in those who were drinking at levels exceeding only daily limits, younger, and without an AUD. CONCLUSIONS Systematic ABI in adult primary care has the potential to reduce drinking among people with unhealthy drinking considerably on both an individual and population level. More research is needed to help optimize ABI, in particular tailoring it to diverse sub-populations, and studying its long-term public health impact.
Collapse
Affiliation(s)
- Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
| | - Sujaya Parthasarathy
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Vanessa A Palzes
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Andrea H Kline-Simon
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Verena E Metz
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA; Department of Psychiatry, Weill Institute of Neurosciences, University of California, 401 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Cynthia I Campbell
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Joseph Elson
- The Permanente Medical Group, 1600 Owens Street, San Francisco, CA 94158, USA
| | - Thekla B Ross
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Yun Lu
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA
| |
Collapse
|
23
|
Frank JW. Controlling the obesity pandemic: Geoffrey Rose revisited. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:736-742. [PMID: 35451744 PMCID: PMC9481849 DOI: 10.17269/s41997-022-00636-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/28/2022] [Indexed: 11/28/2022]
Abstract
The ongoing obesity pandemic threatens the health of hundreds of millions globally. However, to date, no country has had much success in limiting its growth, let alone reversing it. This commentary demonstrates the relevance to the obesity pandemic of the public health conceptual framework of epidemiologist Geoffrey Rose, first published as "Sick Individuals and Sick Populations" in 1985. That framework provides a useful way to analyze the pandemic's prevention and control options, based on the notions of primordial, primary, secondary and tertiary prevention-the full spectrum of "more upstream and more downstream" approaches, each with its pros and cons. Based on an analysis of key studies to date, this commentary argues strongly that only the primordial prevention approach is likely to be successful against the obesity pandemic-but its onerous requirements for society-wide behavioural and cultural change may make that public health struggle a long one.
Collapse
Affiliation(s)
- John W. Frank
- Usher Institute, University of Edinburgh, Edinburgh, Scotland ,Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
| |
Collapse
|
24
|
Yu J, Dong D, Sumerlin TS, Goggins WB, Feng Q, Kim JH. Selling World Health Organization's Alcohol “Best Buys” and Other Recommended Interventions in an Urban Chinese Population: Public Acceptability of Alcohol Harms Reduction Strategies in Hong Kong. Front Public Health 2022; 10:855416. [PMID: 35530734 PMCID: PMC9068987 DOI: 10.3389/fpubh.2022.855416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background To counter the harms caused by alcohol use, the World Health Organization (WHO) outlined a series of evidence-based recommendations, including the highly cost-effective “Best Buys” recommendations. While many Western countries have been actively introducing alcohol harms reduction strategies, it is unclear whether these cost-effective policies would be publicly acceptable in Asian regions with traditionally low alcohol consumption. This study examines the public acceptability of WHO-recommended alcohol harms reduction strategies in an Asian city with few extant alcohol regulations. Methods A cross-sectional telephone survey of Hong Kong Chinese residents aged 18–74 (n = 4,000) was conducted from January to August 2018. Respondents were asked about their perceptions of various WHO-recommended strategies and consequences of their implementation. After reducing the strategies into several policy categories by principal component analysis, multivariable linear regression was performed to identify factors associated with endorsement of the various policies. Results Among the “Best Buys”, introduction of moderate beer/wine taxes (68.7%) and shortened alcohol retail hours (51.9%) were the most supported while bans on event sponsorships (19.5%) and public drinking events (17.7%) were the least popular. Strategies targeting young drinkers were particularly highly supported. Males, younger adults, Non-abstainers, and those who believed in drinking's social benefits were less likely to endorse stringent control measures (p < 0.05). Adults with higher household income were less supportive, partially due to concerns about infringements on local economy, lifestyles, and economic freedom. Women and older people were generally more supportive, partially because they perceived these policies would lower alcohol-related harms. Conclusion In order to reduce barriers to implementing WHO-recommended strategies in the region, it is imperative to increase awareness of alcohol-related harms and to strengthen beliefs in the effectiveness of these countermeasures, especially among men, young adults, and drinkers.
Collapse
Affiliation(s)
- Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Timothy S. Sumerlin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - William B. Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Qi Feng
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jean H. Kim
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- *Correspondence: Jean H. Kim
| |
Collapse
|
25
|
Seidenberg AB, Wiseman KP, Eck RH, Blake KD, Platter HN, Klein WMP. Awareness of Alcohol as a Carcinogen and Support for Alcohol Control Policies. Am J Prev Med 2022; 62:174-182. [PMID: 34654593 DOI: 10.1016/j.amepre.2021.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/21/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Alcohol use increases cancer risk, yet awareness of this association is low. Alcohol control policies have the potential to reduce alcohol-caused cancer morbidity and mortality. Research outside the U.S. has found awareness of the alcohol-cancer link to be associated with support for alcohol control policies. The purpose of this study is to estimate the prevalence of support for 3 communication-focused alcohol policies and examine how awareness of the alcohol-cancer link and drinking status are associated with policy support among U.S. residents. METHODS Investigators analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4. Analyses were performed in 2021. The proportion of Americans who supported banning outdoor alcohol advertising and adding warning labels and drinking guidelines to alcohol containers was estimated. Weighted multivariable logistic regression was used to examine how awareness of the alcohol-cancer link and drinking status were associated with policy support. RESULTS Most Americans supported adding warning labels (65.1%) and drinking guidelines (63.9%), whereas only 34.4% supported banning outdoor alcohol advertising. Americans reporting that alcohol had no effect/decreased cancer risk had lower odds of support for advertising ban (OR=0.56), warning labels (OR=0.43), and guidelines (OR=0.46) than Americans aware of the alcohol-cancer link. Moreover, heavier drinkers had lower odds of support for advertising ban (OR=0.41), warning labels (OR=0.59), and guidelines (OR=0.60) than nondrinkers. CONCLUSIONS Awareness of the alcohol-cancer link was associated with policy support. Increasing public awareness of the alcohol-cancer link may increase support for alcohol control policies.
Collapse
Affiliation(s)
- Andrew B Seidenberg
- Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland.
| | - Kara P Wiseman
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Raimee H Eck
- Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Kelly D Blake
- Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Heather N Platter
- Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| | - William M P Klein
- Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland
| |
Collapse
|
26
|
Staub C, Siegrist M. How health warning labels on wine and vodka bottles influence perceived risk, rejection, and acceptance. BMC Public Health 2022; 22:157. [PMID: 35073894 PMCID: PMC8785573 DOI: 10.1186/s12889-022-12564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background Wine consumption has a particular place in the culture of many European countries, and beliefs that wine offers health benefits are widespread. High consumption of wine and other alcoholic beverages among many Europeans correlates with alcohol-related accidents and disease burdens. Health warning labels (HWLs) on alcohol containers have been increasingly recommended to deter consumers from drinking. However, findings on the impact of HWLs on consumers’ behavior have been mixed. Moreover, many European consumers have been found to reject the use of warning labels as a policy intervention, especially for wine, perhaps due to its cultural and economic importance. Methods An online study with a between-subjects design was conducted in Switzerland (N = 506) to assess whether HWLs can influence the perceived risk associated with drinking wine and vodka, a beverage insignificant to Swiss culture. Participants were presented an image of either a wine or vodka bottle with or without an HWL presenting a liver cancer warning statement. They were then asked to indicate their perceived risk of regularly consuming the depicted beverage. Acceptance and rejection of HWLs were also assessed. Results The perceived risk of vodka consumption exceeded the corresponding risk for wine but was unaffected by an HWL. Perceived health benefits were the main, negative predictor of perceived consumption risk. Participants mainly rejected HWLs due to their perceived effectiveness, perceived positive health effects, social norms, and individualistic values. Conclusions Perceived risk is an important determinant of drinking behavior, and our results suggest that HWLs may be unable to alter risk perceptions. Furthermore, a strong belief in the health benefits of alcohol consumption, particularly wine consumption, reduce risk perceptions and may be unaffected by HWLs.
Collapse
|
27
|
Kiviniemi MT, Orom H, Hay JL, Waters EA. Limitations in American adults' awareness of and beliefs about alcohol as a risk factor for cancer. Prev Med Rep 2021; 23:101433. [PMID: 34189021 PMCID: PMC8220226 DOI: 10.1016/j.pmedr.2021.101433] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022] Open
Abstract
Alcohol is a carcinogen. Recommendations to reduce alcohol use to lower cancer risk are increasingly common. However, neither the beliefs of US adults about alcohol consumption and cancer risk, nor factors influencing those beliefs, are well understood. We used data from the 2019 Health Information National Trends Survey (analysis N = 4,470) to examine beliefs about whether drinking too much alcohol increases cancer risk. We compared those beliefs to beliefs for three other health problems, and examined whether believing alcohol is a cancer risk factor was related to demographics, risk perceptions, other beliefs about the nature of cancer, and alcohol consumption behavior. Only 33% of US adults reported believing that alcohol is a cancer risk factor; 27% stated that it was not, and the highest proportion (40%) reported they did not know. Misbeliefs and lack of knowledge about alcohol and health outcomes were higher for cancer than other outcomes. Higher age, education, seeking health information, risk perceptions, and pessimistic beliefs about cancer predicted both lack of knowledge and misbeliefs about alcohol use and cancer. However, misbeliefs and lack of knowledge were not limited to those who reported alcohol consumption. Demographic and psychosocial factors are associated with problematic beliefs about alcohol's role as a risk factor for cancer. Because perceived risk for health problems is a driver of behavior change, cancer prevention and control efforts to reduce alcohol consumption must attend to and address both the misperceptions about and lack of knowledge of alcohol's role in increasing risk for cancer.
Collapse
Affiliation(s)
- Marc T. Kiviniemi
- Department of Health, Behavior, and Society University of Kentucky, Lexington, KY, USA
| | - Heather Orom
- Department of Community Health & Health Behavior University at Buffalo, SUNY Buffalo, NY, USA
| | - Jennifer L. Hay
- Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Institute, New York, NY, USA
| | - Erika A. Waters
- Department of Surger, Washington University at Saint Louis School of Medicine, St. Louis, MO, USA
| |
Collapse
|
28
|
Kokole D, Anderson P, Jané-Llopis E. Nature and Potential Impact of Alcohol Health Warning Labels: A Scoping Review. Nutrients 2021; 13:3065. [PMID: 34578942 PMCID: PMC8469468 DOI: 10.3390/nu13093065] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/16/2023] Open
Abstract
Alcohol is toxic to human health. In addition to providing nutritional information, labels on alcohol products can be used to communicate warnings on alcohol-related harms to consumers. This scoping review examined novel or enhanced health warning labels to assess the current state of the research and the key studied characteristics of labels, along with their impact on the studied outcomes. Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched between January 2010 and April 2021, and 27 papers were included in the review. The results found that most studies were undertaken in English-speaking populations, with the majority conducted online or in the laboratory setting as opposed to the real world. Seventy percent of the papers included at least one cancer-related message, in most instances referring either to cancer in general or to bowel cancer. Evidence from the only real-world long-term labelling intervention demonstrated that alcohol health warning labels designed to be visible and contain novel and specific information have the potential to be part of an effective labelling strategy. Alcohol health warning labels should be seen as tools to raise awareness on alcohol-related risks, being part of wider alcohol policy approaches.
Collapse
Affiliation(s)
- Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, The Netherlands; (P.A.); (E.J.-L.)
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, The Netherlands; (P.A.); (E.J.-L.)
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, The Netherlands; (P.A.); (E.J.-L.)
- ESADE Business School, University Ramon Llull, Avenida de Pedralbes, 60-62, 08034 Barcelona, Spain
- Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON M5S 2S1, Canada
| |
Collapse
|
29
|
Stockwell T, Giesbrecht N, Vallance K, Wettlaufer A. Government Options to Reduce the Impact of Alcohol on Human Health: Obstacles to Effective Policy Implementation. Nutrients 2021; 13:2846. [PMID: 34445006 PMCID: PMC8399748 DOI: 10.3390/nu13082846] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022] Open
Abstract
Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.
Collapse
Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Toronto, ON M5V 2B4, Canada; (N.G.); (A.W.)
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Toronto, ON M5V 2B4, Canada; (N.G.); (A.W.)
| |
Collapse
|
30
|
Dudás L, Szántó R. Nudging in the time of coronavirus? Comparing public support for soft and hard preventive measures, highlighting the role of risk perception and experience. PLoS One 2021; 16:e0256241. [PMID: 34388215 PMCID: PMC8362989 DOI: 10.1371/journal.pone.0256241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/03/2021] [Indexed: 11/18/2022] Open
Abstract
The importance of researching public support for preventive policies have been amplified by the COVID-19 pandemic. Using a representative sample of the Hungarian population, we investigated the support for commonly used preventive measures (social distancing, hand hygiene and wearing masks) comparing two different policy tools (nudges and regulations). Because of the high risk and unfamiliarity of the pandemic, the respondents' risk perception and experience with the disease was also assessed. All preventive measures were generally supported and, contrary to the findings of previous nudge research, there was no clear pattern whether regulations or nudges are preferred. People with higher level of risk perception supported both types of policies more but slightly favoured the regulations. Those who had contact with the disease (either themselves or a close friend or family member contracting COVID-19) reported a higher level of risk perception. When the person themselves was afflicted, this higher levels of risk perception did not translate to a higher level of support, moreover, it even decreased support for the regulations according to regression analysis. In case of a loved one contracting the disease, there was an increased support for both types of measures, but that is explained by the higher risk perception.
Collapse
Affiliation(s)
- Levente Dudás
- Department of Decision Sciences, Corvinus University of Budapest, Budapest, Hungary
| | - Richárd Szántó
- Department of Decision Sciences, Corvinus University of Budapest, Budapest, Hungary
| |
Collapse
|
31
|
Critchlow N, Moodie C, Jones D. Health information and warnings on alcohol packaging in Ireland: it is time to progress the Public Health (Alcohol) Act 2018. Ir J Med Sci 2021; 191:1461-1463. [PMID: 34319546 PMCID: PMC8316105 DOI: 10.1007/s11845-021-02719-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Nathan Critchlow
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland. .,UK-Ireland Alcohol Research Network (ACORN), University of Stirling, Stirling, Scotland.
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | - Daniel Jones
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
| |
Collapse
|
32
|
O'Brien P, Stockwell T, Vallance K, Room R. WHO should not support alcohol industry co-regulation of public health labelling. Addiction 2021; 116:1619-1621. [PMID: 33751660 DOI: 10.1111/add.15462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Paula O'Brien
- Melbourne Law School, University of Melbourne, Carlton, VIC, Australia
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.,Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| |
Collapse
|
33
|
Polish High School Students' Knowledge about Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094765. [PMID: 33947049 PMCID: PMC8124587 DOI: 10.3390/ijerph18094765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/25/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022]
Abstract
Background: Cancer, as the second most common cause of death after cardiovascular diseases, is a global health problem. There is still an increasing number of cancer incidences and deaths. Methods: The study was conducted as a part of the health promotion educational project concerning oncological education to develop the knowledge of cancer risk factors among high school students in Poland. A special questionnaire was filled out by students before the educational lesson on cancer conducted by medical students and young doctors. Results: The study was carried out on 227 high school students (aged 17–18 years). Most students (67.5%) indicated that genetic predisposition is the most important cancer risk factor. Only about a quarter of students pointed to the relationship between lifestyle and cancer. Moreover, 41% of students admitted to smoking cigarettes. Most of them (80.6%) claimed that they can modify their own cancer risk. Almost all responders believed that early detected cancer is curable. Conclusions: High school students do not know about cancer risk factors and they do not relate cancer with lifestyle. Some students indicated bad lifestyle habits such as tobacco smoking. It is necessary to emphasize cancer prevention in early education, especially focusing on modification of lifestyle.
Collapse
|
34
|
Hobin E, Weerasinghe A, Vallance K, Hammond D, McGavock J, Greenfield TK, Schoueri-Mychasiw N, Paradis C, Stockwell T. Testing Alcohol Labels as a Tool to Communicate Cancer Risk to Drinkers: A Real-World Quasi-Experimental Study. J Stud Alcohol Drugs 2020. [PMID: 32359056 PMCID: PMC7201213 DOI: 10.15288/jsad.2020.81.249] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: This study tested the initial and continued effects of cancer warning labels on drinkers’ recall and knowledge that alcohol can cause cancer. Method: A quasi-experiment was conducted to examine changes in the intervention versus comparison site for three outcomes: unprompted and prompted recall of the cancer warning, and knowledge that alcohol can cause cancer. The intervention site applied cancer warning labels to alcohol containers in its liquor store for 1 month, and the two liquor stores in the comparison site did not apply cancer labels. In total, 2,049 unique cohort participants (1,056 male) were recruited at liquor stores in the intervention and comparison sites to participate in surveys 4 months before labels were applied and 2 and 6 months after the cancer label was halted because of alcohol industry interference. Generalized estimating equations tested differences in outcomes between sites over time adjusting for socio-demographics and other covariates. Results: Two months after the cancer label, unprompted (+24.2% vs. +0.6%; adjusted odds ratio [AOR] = 32.7, 95% CI [5.4, 197.7]) and prompted (+35.7% vs. +4.1%; AOR = 6.2, 95% CI [3.6, 10.9]) recall increased to a greater extent in the intervention versus comparison site. There was a 10% greater increase in knowledge (+12.1% vs. +11.6%; AOR = 1.1, 95% CI [0.7, 1.5]) 2 months after the cancer label in the intervention versus comparison site. Similar results were found 6 months after the cancer label for all three outcomes. Conclusions: In a real-world setting, cancer warning labels get noticed and increase knowledge that alcohol can cause cancer. Additional cancer label intervention studies are required that are not compromised by industry interference.
Collapse
Affiliation(s)
- Erin Hobin
- Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| |
Collapse
|
35
|
Vallance K, Vincent A, Schoueri-Mychasiw N, Stockwell T, Hammond D, Greenfield TK, McGavock J, Hobin E. News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland. J Stud Alcohol Drugs 2020. [PMID: 32359058 PMCID: PMC7201216 DOI: 10.15288/jsad.2020.81.273] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated. METHOD We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis. RESULTS Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43). CONCLUSIONS News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.
Collapse
Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | | | - Nour Schoueri-Mychasiw
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, United States
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
36
|
Vallance K, Stockwell T, Zhao J, Shokar S, Schoueri-Mychasiw N, Hammond D, Greenfield TK, McGavock J, Weerasinghe A, Hobin E. Baseline Assessment of Alcohol-Related Knowledge of and Support for Alcohol Warning Labels Among Alcohol Consumers in Northern Canada and Associations With Key Sociodemographic Characteristics. J Stud Alcohol Drugs 2020. [PMID: 32359055 PMCID: PMC7201212 DOI: 10.15288/jsad.2020.81.238] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Evidence-informed alcohol warning labels (AWLs) are a promising, well-targeted strategy to increase consumer awareness of health risks. We assessed consumers' baseline knowledge of alcohol-related cancer risk, standard drinks, and low-risk drinking guidelines as well as levels of support for AWLs. We further assessed associations with sociodemographic factors. METHOD Forming part of a larger study testing new evidence-informed AWLs in a northern Canadian territory compared with a neighboring territory, baseline surveys were completed among liquor store patrons systematically selected in both sites. Chi-square and multivariable logistic regression analyses were performed to assess outcomes. RESULTS In total, 836 liquor store patrons (47.8% female) completed baseline surveys across both sites. Overall, there was low knowledge of alcohol-related cancer risk (24.5%), limited ability to calculate a standard drink (29.5%), and low knowledge of daily (49.5%) and weekly (48.2%) low-risk drinking guideline limits. There was moderate support for AWLs with a health warning (55.9%) and standard drink information (51.4%), and lower support for low-risk drinking guideline labels (38.7%). No sociodemographic characteristics were associated with cancer knowledge. Identifying as female and having adequate health literacy were associated with support for all three AWLs; high alcohol use was associated with not supporting standard drink (adjusted odds ratio = 0.60, 95% CI [0.40, 0.88]) and low-risk drinking guideline (adjusted odds ratio = 0.57, 95% CI [0.38, 0.87]) labels. CONCLUSIONS Few consumers in this study had key alcohol-related health knowledge; however, there was moderate support for AWLs as a tool to raise awareness. Implementation of information-based interventions such as evidence-informed AWLs with health messages including alcohol-related cancer risk, standard drink information, and national drinking guidelines is warranted.
Collapse
Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Jinhui Zhao
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Simran Shokar
- Canadian Agency for Drugs and Technologies in Health, Toronto, Ontario, Canada
| | - Nour Schoueri-Mychasiw
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, United States
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ashini Weerasinghe
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
37
|
Blokhin IO, Khorkova O, Saveanu RV, Wahlestedt C. Molecular mechanisms of psychiatric diseases. Neurobiol Dis 2020; 146:105136. [PMID: 33080337 DOI: 10.1016/j.nbd.2020.105136] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/24/2020] [Accepted: 10/09/2020] [Indexed: 12/16/2022] Open
Abstract
For most psychiatric diseases, pathogenetic concepts as well as paradigms underlying neuropsychopharmacologic approaches currently revolve around neurotransmitters such as dopamine, serotonin, and norepinephrine. However, despite the fact that several generations of neurotransmitter-based psychotropics including atypical antipsychotics, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors are available, the effectiveness of these medications is limited, and relapse rates in psychiatric diseases are relatively high, indicating potential involvement of other pathogenetic pathways. Indeed, recent high-throughput studies in genetics and molecular biology have shown that pathogenesis of major psychiatric illnesses involves hundreds of genes and numerous pathways via such fundamental processes as DNA methylation, transcription, and splicing. Current review summarizes these and other molecular mechanisms of such psychiatric illnesses as schizophrenia, major depressive disorder, and alcohol use disorder and suggests a conceptual framework for future studies.
Collapse
Affiliation(s)
- Ilya O Blokhin
- Center for Therapeutic Innovation, University of Miami, Miami, FL, United States of America; Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, United States of America; Jackson Memorial Hospital, Miami, FL, United States of America
| | - Olga Khorkova
- OPKO Health Inc., Miami, FL, United States of America
| | - Radu V Saveanu
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, United States of America
| | - Claes Wahlestedt
- Center for Therapeutic Innovation, University of Miami, Miami, FL, United States of America; Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, United States of America.
| |
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW To provide an overview of the risk relationships between alcohol use and cancer and of the alcohol-attributable cancer burden; to highlight areas of controversy in the alcohol-cancer relationship; to examine the reasons why these risk relationships have not received greater public attention. RECENT FINDINGS In 2016, alcohol caused an estimated 376,200 cancer deaths, 10.0 million cancer years of life lost (YLLs), 236,600 cancer years lived with disability (YLDs), and 10.3 million cancer disability-adjusted years of life (DALYs), representing 4.2%, 4.2%, 4.6%, and 4.2% of all deaths, YLLs, YLDs, and DALYs lost due to cancer, respectively, proportionally highest in high- and upper-middle-income countries. Alcohol use is a major contributor to cancer and is linked to the most prevalent types of cancer. No threshold for the effects of alcohol on cancer has yet been identified, and thus, abstinence is best for cancer prevention. Greater public awareness of the relationship between alcohol use and cancer is advisable.
Collapse
Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Room T420, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.
- Institute of Medical Science (IMS), University of Toronto, Room 2374, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, ON, M5T 3M7, Canada.
- WHO Collaboration Centre, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada.
- Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex, France
| | - Carina Ferreira-Borges
- World Health Organization, WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office), 9 Leontyevsky Pereulok, Moscow, Russian Federation, 125009
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Room T420, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, ON, M5T 3M7, Canada
- WHO Collaboration Centre, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada
| |
Collapse
|
39
|
Hobin E, Shokar S, Vallance K, Hammond D, McGavock J, Greenfield TK, Schoueri-Mychasiw N, Paradis C, Stockwell T. Communicating risks to drinkers: testing alcohol labels with a cancer warning and national drinking guidelines in Canada. Canadian Journal of Public Health 2020; 111:716-725. [PMID: 32458295 DOI: 10.17269/s41997-020-00320-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 04/02/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To test whether alcohol labels with a cancer warning and national drinking guidelines are an effective tool for supporting more informed and safer alcohol consumption among drinkers. METHODS Using a quasi-experimental design, pre-post surveys were conducted with 1647 cohort participants systematically selected in liquor stores in two matched sites in Canada in 2017-2018. Enhanced labels designed according to best practices for effective product labels were applied to alcohol containers in the liquor store in the intervention site for one month, and usual practice continued in the comparison site. Generalized estimating equations tested the differences between sites over time in label salience and processing, and self-reported impact of the labels on drinking behaviours. RESULTS After the intervention, recall of the cancer warning label increased to a greater extent in the intervention versus comparison site (adjusted odds ratio (AOR) = 32.2, 95% CI = 5.4, 191.1), but not the national drinking guideline label (AOR = 2.7, 95% CI = 0.2, 31.8). There were significant label effects in the intervention versus comparison site for reading (AOR = 1.8, 95% CI = 1.3, 2.5), thinking about (AOR = 2.0, 95% CI = 1.4, 2.9), and talking with others about (AOR = 2.1, 95% CI = 1.3, 3.6) the labels, as well as self-reported impact to cut down on drinking (AOR = 2.5, 95% CI = 1.3, 4.7) and to drink less (AOR = 2.4, 95% CI = 1.3, 4.3). CONCLUSIONS Alcohol labels with a cancer warning and national drinking guidelines do a better job conveying risk information and promoting safer consumption than existing practices. Industry has a legal duty to adequately inform consumers about their products and should be mandated to include key information on alcohol containers.
Collapse
Affiliation(s)
- Erin Hobin
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Simran Shokar
- Public Health Ontario, 480 University Ave, Suite 300, Toronto, ON, M5G 1V2, Canada
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| |
Collapse
|
40
|
Ahmed SB, Amer S, Hussein A, D. Kampani D, Al Hasham N, M. Assker M, Shawa N, Saleh D, Alfarouk KO. Assessing the Knowledge of Environmental Risk Factors for Cancer among the UAE Population: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17092984. [PMID: 32344867 PMCID: PMC7246594 DOI: 10.3390/ijerph17092984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/20/2020] [Accepted: 04/22/2020] [Indexed: 01/22/2023]
Abstract
The incidence of cancer is increasing worldwide as well as in the United Arab Emirates (UAE). Currently, researchers are advocating not only for prevention programs but also for early detection. In this study, we aimed to assess the general awareness of cancer among the UAE population, with a focus on environmental risk factors. A descriptive cross-sectional design was employed, and a structured questionnaire was used to collect data from 385 participants. A total of 91.2% of the study population identified cancer as the leading cause of death, while 64.6% of the subjects were able to identify the key causes of cancer. A total of 87.3% and 70.5% of the participants were able to define tobacco and alcohol, respectively, as cancer-causing agents. Most of the study population failed to identify cancer-related infectious agents and incense smoke as carcinogens. Respondents in the medical professions had the highest knowledge score when compared with respondents with a non-medical profession and unemployed participants (p < 0.0005). To fill the gaps in cancer-related knowledge, participants were asked about their preferred method for cancer education, and 83.9% of the participants favored the media as a source of information. Conclusively, our findings indicated a gap in cancer knowledge among UAE residents, which highlights the importance of educational campaigns by health authorities; a follow-up study evaluating the success of educational campaigns is also warranted.
Collapse
Affiliation(s)
- Samrein B.M. Ahmed
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, UAE;
- Correspondence:
| | - Sara Amer
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Amal Hussein
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Drishti D. Kampani
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Nour Al Hasham
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Mohamed M. Assker
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | - Nour Shawa
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, UAE;
| | - Dima Saleh
- College of medicine, University of Sharjah, Sharjah 27272, UAE; (S.A.); (A.H.); (D.D.K.); (N.A.H.); (M.M.A.); (D.S.)
| | | |
Collapse
|
41
|
Hobin E, Weerasinghe A, Vallance K, Hammond D, McGavock J, Greenfield TK, Schoueri-Mychasiw N, Paradis C, Stockwell T. Testing Alcohol Labels as a Tool to Communicate Cancer Risk to Drinkers: A Real-World Quasi-Experimental Study. J Stud Alcohol Drugs 2020; 81:249-261. [PMID: 32359056 PMCID: PMC7201213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/04/2020] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE This study tested the initial and continued effects of cancer warning labels on drinkers' recall and knowledge that alcohol can cause cancer. METHOD A quasi-experiment was conducted to examine changes in the intervention versus comparison site for three outcomes: unprompted and prompted recall of the cancer warning, and knowledge that alcohol can cause cancer. The intervention site applied cancer warning labels to alcohol containers in its liquor store for 1 month, and the two liquor stores in the comparison site did not apply cancer labels. In total, 2,049 unique cohort participants (1,056 male) were recruited at liquor stores in the intervention and comparison sites to participate in surveys 4 months before labels were applied and 2 and 6 months after the cancer label was halted because of alcohol industry interference. Generalized estimating equations tested differences in outcomes between sites over time adjusting for socio-demographics and other covariates. RESULTS Two months after the cancer label, unprompted (+24.2% vs. +0.6%; adjusted odds ratio [AOR] = 32.7, 95% CI [5.4, 197.7]) and prompted (+35.7% vs. +4.1%; AOR = 6.2, 95% CI [3.6, 10.9]) recall increased to a greater extent in the intervention versus comparison site. There was a 10% greater increase in knowledge (+12.1% vs. +11.6%; AOR = 1.1, 95% CI [0.7, 1.5]) 2 months after the cancer label in the intervention versus comparison site. Similar results were found 6 months after the cancer label for all three outcomes. CONCLUSIONS In a real-world setting, cancer warning labels get noticed and increase knowledge that alcohol can cause cancer. Additional cancer label intervention studies are required that are not compromised by industry interference.
Collapse
Affiliation(s)
- Erin Hobin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| |
Collapse
|
42
|
Vallance K, Vincent A, Schoueri-mychasiw N, Stockwell T, Hammond D, Greenfield TK, McGavock J, Hobin E. News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland. J Stud Alcohol Drugs 2020; 81:273-283. [PMID: 32359058 PMCID: PMC7201216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/11/2020] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated. METHOD We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis. RESULTS Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43). CONCLUSIONS News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.
Collapse
Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | | | - Nour Schoueri-mychasiw
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Thomas K. Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, United States
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
43
|
The state of cancer prevention in Aotearoa New Zealand: Slow progress requires political leadership and investment for health and equity. J Cancer Policy 2020. [DOI: 10.1016/j.jcpo.2019.100212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
44
|
Sinclair JMA, Dutey-Magni PF, Anderson AS, Baird J, Barker ME, Cutress RI, Kaner EFS, McCann M, Priest CK, Copson ER. A Context-Specific Digital Alcohol Brief Intervention in Symptomatic Breast Clinics (Abreast of Health): Development and Usability Study. JMIR Res Protoc 2020; 9:e14580. [PMID: 32012091 PMCID: PMC7007589 DOI: 10.2196/14580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/25/2019] [Accepted: 09/07/2019] [Indexed: 12/28/2022] Open
Abstract
Background Potentially modifiable risk factors account for approximately 23% of breast cancer cases. In the United Kingdom, alcohol consumption alone is held responsible for 8% to 10% of cases diagnosed every year. Symptomatic breast clinics focus on early detection and treatment, but they also offer scope for delivery of low-cost lifestyle interventions to encourage a cancer prevention culture within the cancer care system. Careful development work is required to effectively translate such interventions to novel settings. Objective The aim of this study was to develop a theory of change and delivery mechanism for a context-specific alcohol and lifestyle brief intervention aimed at women attending screening and symptomatic breast clinics. Methods A formative study combined evidence reviews, analysis of mixed method data, and user experience research to develop an intervention model, following the 6 Steps in Quality Intervention Development (6SQuID) framework. Results A Web app focused on improving awareness, encouraging self-monitoring, and reframing alcohol reduction as a positive choice to improve health was found to be acceptable to women. Accessing this in the clinic waiting area on a tablet computer was shown to be feasible. An important facilitator for change may be the heightened readiness to learn associated with a salient health visit (a teachable moment). Women may have increased motivation to change if they can develop a belief in their capability to monitor and, if necessary, reduce their alcohol consumption. Conclusions Using the 6SQuID framework supported the prototyping and maximized acceptability and feasibility of an alcohol brief intervention for women attending symptomatic breast clinics, regardless of their level of alcohol consumption.
Collapse
Affiliation(s)
- Julia M A Sinclair
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Peter F Dutey-Magni
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute of Health Informatics, University College London, London, United Kingdom
| | - Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Division of Population Health & Genomics, University of Dundee Medical School, Dundee, United Kingdom
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute of Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mary E Barker
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute of Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Ramsey I Cutress
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eileen F S Kaner
- Institute of Health and Society, Newcastle University, Newcastle, United Kingdom
| | - Mark McCann
- Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Caspian K Priest
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ellen R Copson
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| |
Collapse
|
45
|
Weerasinghe A, Schoueri-Mychasiw N, Vallance K, Stockwell T, Hammond D, McGavock J, Greenfield TK, Paradis C, Hobin E. Improving Knowledge that Alcohol Can Cause Cancer is Associated with Consumer Support for Alcohol Policies: Findings from a Real-World Alcohol Labelling Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E398. [PMID: 31936173 PMCID: PMC7014334 DOI: 10.3390/ijerph17020398] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/25/2022]
Abstract
Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol-cancer link and support for alcohol policies, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol polices. Cancer warning labels were applied to alcohol containers at the intervention site, and the comparison site did not apply cancer labels. Pre-post surveys were conducted among liquor store patrons at both sites before and two-and six-months after the intervention was stopped due to alcohol industry interference. Limiting the data to participants that completed surveys both before and two-months after the cancer label stopped, logistic regression was used to examine the association between increases in knowledge and support for policies. Support for pricing and availability policies was low overall; however, increases in individual-level knowledge of the alcohol-cancer link was associated with higher levels of support for pricing policies, specifically, setting a minimum unit price per standard drink of alcohol (OR = 1.86, 95% CI: 1.11-3.12). Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies. International Registered Report Identifier (IRRID): RR2-10.2196/16320.
Collapse
Affiliation(s)
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 2Y2, Canada; (K.V.); (T.S.)
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 2Y2, Canada; (K.V.); (T.S.)
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
| | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, ON K1P 5E7, Canada;
| | - Erin Hobin
- Public Health Ontario, Toronto, ON M5G 1V2, Canada; (A.W.); (N.S.-M.)
| |
Collapse
|
46
|
Winstock AR, Holmes J, Ferris JA, Davies EL. Perceptions of Alcohol Health Warning Labels in a Large International Cross-Sectional Survey of People Who Drink Alcohol. Alcohol Alcohol 2019; 55:315-322. [DOI: 10.1093/alcalc/agz099] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
Aims
This paper aimed to explore perceptions of alcohol health warning labels amongst a large international sample of people who drink alcohol.
Methods
The Global Drug Survey (GDS) is the world’s largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12 months, collected during November–December 2017 (GDS2018).
Results
The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses.
Conclusion
Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol-related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness.
Collapse
Affiliation(s)
- Adam R Winstock
- Institute of Epidemiology and Health Care, University College London, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jason A Ferris
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
| | - Emma L Davies
- Department of Psychology, Oxford Brookes University, Gipsy Lane, Oxford, UK
| |
Collapse
|
47
|
Can a mass media campaign raise awareness of alcohol as a risk factor for cancer and public support for alcohol related policies? Prev Med 2019; 126:105722. [PMID: 31125628 DOI: 10.1016/j.ypmed.2019.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/08/2019] [Accepted: 05/19/2019] [Indexed: 11/23/2022]
Abstract
Alcohol consumption increases the risk of several cancers, but public awareness of alcohol as a risk factor for cancer is low. Research indicates that public opinion about alcohol related policies can be influenced by mass media campaigns and awareness of alcohol as a carcinogen. The objective of this study was to test whether a mass media campaign intended to raise awareness of the relation between alcohol and cancer is associated with higher public awareness of alcohol as a risk factor for cancer, and higher levels of support for alcohol related policies. Cross-sectional surveys of a nationally representative sample of N = 6000 Danish adults were conducted pre- (n = 3000) and post campaign (n = 3000) in 2017-2018. Awareness of alcohol as a cancer risk factor significantly increased between the pre and post campaign survey (approximately 5 percentage points). The proportion of respondents who supported minimum unit pricing, a ban on alcohol advertising, and mandatory nutrition labelling was significantly higher post campaign than pre campaign, while support for limited number of retail outlets and limited sale hours were unchanged. For males, but not females, higher support for an 18 year age limit for purchasing alcohol, age limits for buying alcohol at secondary education school parties, and increased enforcement of age limits was found after the campaign than prior to it. Conclusively, the results show that a mass media campaign was associated with an increase in awareness of alcohol as a risk factor for cancer as well as alcohol policy support at a population level.
Collapse
|
48
|
Thomas F, Thomas C, Hooper L, Rosenberg G, Vohra J, Bauld L. Area deprivation, screen time and consumption of food and drink high in fat salt and sugar (HFSS) in young people: results from a cross-sectional study in the UK. BMJ Open 2019; 9:e027333. [PMID: 31256025 PMCID: PMC6609085 DOI: 10.1136/bmjopen-2018-027333] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To investigate associations between deprivation in young people and consumption of foods high in fat, salt and sugar (HFSS), screen time exposure and health knowledge. DESIGN An online cross-sectional survey with people aged 11-19 years in the UK, where participants reported consumption behaviours across 13 HFSS and two non-HFSS groups; screen time for commercial television and streaming services; and knowledge of health conditions and their links to obesity. SETTING UK PARTICIPANTS: A total of 3348 young people aged 11-19 years across the UK. MAIN OUTCOME MEASURES The study assessed the consumption behaviours, commercial screen time exposure and the health knowledge of 3348 people aged 11-19 years. Multivariate binary regression analysis, controlling for age and gender, was performed. RESULTS Deprivation level was associated with increases in consumption of six of the HFSS products including energy drinks (OR: 2.943, p<0.001) and sugary drinks (OR: 1.938, p<0.001) and a reduction in consumption in the two non-HFSS products included in the study, fruit (OR: 0.668, p=0.004) and vegetables (OR: 0.306, p<0.001). Deprivation was associated with high weekly screen time of both television (OR: 2.477, p<0.001) and streaming (OR: 1.679, p=0.001). Health knowledge was also associated with deprivation. There was lower awareness of the association of obesity and cancer (OR: 0.697, p=0.003), type 2 diabetes (OR: 0.64, p=0.004) and heart disease (OR: 0.519, p<0.001) in the most deprived. CONCLUSIONS Young people from the more deprived areas of the UK were more likely to consume a range of HFSS products, report increased exposure to HFSS advertising and have a poorer awareness of health conditions associated with overweight and obesity. The findings suggest that population-level measures addressing childhood obesity should account for consumption patterns among different groups of children and young people and the factors that may influence these.
Collapse
Affiliation(s)
- Fiona Thomas
- Cancer Policy Research Centre, Cancer Research UK, London, UK
| | | | - Lucie Hooper
- Cancer Policy Research Centre, Cancer Research UK, London, UK
| | | | - Jyotsna Vohra
- Cancer Policy Research Centre, Cancer Research UK, London, UK
| | - Linda Bauld
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
49
|
Wiseman KP, Klein WMP. Evaluating Correlates of Awareness of the Association between Drinking Too Much Alcohol and Cancer Risk in the United States. Cancer Epidemiol Biomarkers Prev 2019; 28:1195-1201. [PMID: 31043419 DOI: 10.1158/1055-9965.epi-18-1010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/15/2018] [Accepted: 04/23/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Awareness that alcohol consumption is associated with cancer is low in the United States, and predictors of awareness are not well understood. METHODS Data from the 2017 Health Information National Trends Survey (HINTS 5 Cycle 1) were used to describe knowledge of the association between drinking too much alcohol and cancer ("Yes," aware of the association; "No"; or "Don't know") among 3,009 adults. Weighted multinomial multivariable logistic regression determined personal characteristics (e.g., demographic characteristics, health-related self-efficacy, cancer beliefs, and information seeking) associated with reporting "Yes" or "Don't know" compared with "No." RESULTS Thirty-eight percent of the U.S. population believed there was an association (38.36%), 36.17% were uncertain, and 25.47% believed there was no association. People believing that everything causes cancer and people who had ever looked up information about cancer had 1.61 and 1.80 higher odds of reporting "Yes" [95% confidence intervals (CI), 1.08-2.42 and 1.27-2.57, respectively]. Compared with people who were completely confident in their ability to take care of their health, people only somewhat confident had 2.32 higher odds of reporting "Don't know" (95% CI, 1.30-4.14). Younger age was negatively associated with reporting "Don't know." CONCLUSIONS Awareness of the association between alcohol and cancer is low in the United States. Personal characteristics associated with awareness differed between reporting "Yes" and "Don't know," and there were few associations between demographic characteristics and awareness. IMPACT A significant knowledge gap exists in the population. Broad reaching public health media campaigns, particularly those that increase information seeking, are needed to increase awareness.
Collapse
Affiliation(s)
- Kara P Wiseman
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
50
|
Schüz J, Espina C, Wild CP. Primary prevention: a need for concerted action. Mol Oncol 2019; 13:567-578. [PMID: 30582778 PMCID: PMC6396360 DOI: 10.1002/1878-0261.12432] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/11/2018] [Indexed: 12/24/2022] Open
Abstract
The burden of cancer is increasing worldwide, and Europe is no exception in this regard. Cancer incidence rate for men in 2018, excluding nonmelanoma skin cancers, averaged over the 40 UN-defined European countries has been estimated as 436/100 000. For women, the estimated incidence rate is 332.6/100 000. Although mortality rates are declining in most European countries, the total number of cancer deaths continues to rise due to an increase in the number of older people in the age range when the cancer typically occurs. The increase in incident cases and cancer deaths increases the pressure on healthcare infrastructure and related costs, thus presenting a challenge to health service sustainability in countries. In the general population, there remains a perception of an ever-increasing cancer risk. Hence, treatment alone is not a solution to address the cancer burden. At the same time, recent estimates of preventable fractions of cancer suggest that about half of all cancer cases could be prevented through rigorous implementation of successful prevention measures, among other actions, by following the cancer prevention recommendations of the European Code against Cancer. Smoking alone explains almost half of all preventable cancers, and the scattered way of implementing tobacco control in Europe with still increasing numbers of lung cancers in women demonstrates the gap between prevention potential and effectively implemented prevention. Cancer prevention clearly needs more resources, stronger support from decision-makers and society, and a solid network to better speak with one voice. The newly established 'Cancer Prevention Europe' (Forman et al., ) offers promising opportunities for the latter.
Collapse
Affiliation(s)
- Joachim Schüz
- International Agency for Research on Cancer (IARC)LyonFrance
| | - Carolina Espina
- International Agency for Research on Cancer (IARC)LyonFrance
| | | |
Collapse
|