Challenges in Achieving US Population Awareness of Alcohol as a Carcinogen: Identifying Predictors of Continued Lack of Awareness after Educational Video Exposure

BACKGROUND: Alcohol use increases the risk of seven cancers, including breast and colorectal cancers. Awareness of this is low in the US population (34%), which impedes risk reduction efforts, support for alcohol regulation policies, and physician and family communication about this topic. Efforts to improve awareness of the cancer risks of alcohol will require multiple approaches, including the use of educational messages tailored to audience needs. There is a lack of evidence about how existing messaging influences awareness and characteristics associated with awareness that could guide future messaging. METHODS: We recruited a nationally representative sample of N = 827 US adults aged ≥21 who reported alcohol use in the past month and were unaware that alcohol increases cancer risk. Participants viewed a publicly available educational video on this topic and subsequently reported cancer risk awareness. RESULTS: After video exposure, 70% of participants reported awareness. Post-video awareness was lower among heavier drinkers, those with a cancer history, those with no family cancer history, and those who tend to avoid health information, perceive low cancer controllability, or feel cancer information overload. Those who reported inaccurate beliefs at baseline (responding "no" to the question of whether cancer can result from too much alcohol) reported lower awareness than those who initially reported that they "didn't know" whether alcohol increased cancer risk. CONCLUSIONS: These findings provide groundwork to guide the development of adaptations to available alcohol and cancer risk messaging. IMPACT: Educational messages tailored to audience needs can help inform all sectors of the US public about the cancer harms of alcohol. See related In the Spotlight, p. 367.