Does Believing Alcohol Causes Cancer Moderate the Relationship Between Consumer Awareness of the Alcohol-Cancer Link and Support for Alcohol Policies? Findings From a Canadian Cross-Sectional Study.

INTRODUCTION: Extending research observing an association between awareness that alcohol causes cancer and support for alcohol policies, this study examined if believing or accepting alcohol causes cancer moderates the relationship between awareness of alcohol as a carcinogen and policy support. METHODS: Adult alcohol consumers (n = 5180) in Canada completed an online survey in March-April 2023. Four separate logistic regression models were conducted with policy support affecting alcohol availability, pricing, marketing and labelling as outcomes to assess if believing alcohol causes seven types of cancer moderates the relationship between awareness of the alcohol-cancer link and support for alcohol policies. An interaction between awareness and belief was included as a predictor, adjusting for covariates. RESULTS: Overall, 29.3% were aware alcohol causes seven types of cancer and, of those aware, 83.6% believed this link. Those both aware of and believing that alcohol causes cancer had higher odds of supporting policies restricting alcohol availability (OR 1.76, 95% CI 1.13, 2.74) and marketing (OR 1.75, 95% CI 1.16, 2.64) than those not aware and did not believe. Consumers who were both aware of and believed the alcohol-cancer link had higher odds of supporting labelling policies (OR 1.59, 95% CI 1.05, 2.40), although this was not significant after adjusting for multiple comparisons. DISCUSSION AND CONCLUSIONS: This study highlights that believing alcohol is a carcinogen moderates the relationship between awareness of the alcohol-cancer link and support for policies restricting alcohol availability and marketing. Future longitudinal studies are needed to test interventions for effectively raising awareness and strengthening belief and acceptance of alcohol-related cancer risks.