Alcohol is one of the leading causes of death and disability worldwide. A causal relationship has been established between alcohol and over 60 health conditions, such as female breast cancer, bowel cancer and high blood pressure.1 Despite the growing evidence on the contribution of alcohol to the global burden of disease and mortality, research in other countries demonstrates poor public knowledge of the association between alcohol and a range of alcohol-related health conditions, including cancer.2,3 The aim of this research was to establish public knowledge of six alcohol-related health conditions in Ireland, namely liver disease, pancreatitis, stomach ulcers, high blood pressure, female breast cancer, and bowel cancer.

Methods

Data were generated from Wave 2 of the Healthy Ireland Survey, a nationally representative cross-sectional survey of adults aged 15 years or older in Ireland. A total of 7,498 respondents took part in Wave 2, with interviews completed between September 2015 and May 2016. More details on the sample and methodology can be found in the Healthy Ireland Wave 2 technical report.4

Respondents’ knowledge of the link between the six alcohol-related conditions was measured by presenting the respondents with a showcard with the following question: ‘Looking at this showcard, can you please tell me which of the following you are at increased risk of developing by drinking more than the recommended number of standard drinks in a week?’ The options presented on the showcard were: liver disease; pancreatitis; stomach ulcers; high blood pressure; female breast cancer; skin cancer; bowel cancer; all of these. The risk of developing skin cancer is not increased by consuming alcohol. The risk of all other conditions on the list is increased by drinking more than the recommended standard drinks in a week.

Findings

Respondents’ awareness of the six alcohol-related health conditions broken down by gender is displayed in Figure 1. With the exception of liver disease (90.5%), knowledge of the link between alcohol and all other alcohol-related conditions was poor, ranging from 21.2% for breast cancer to just over 50% for high blood pressure. Some 14.1% of respondents identified alcohol consumption as a risk for developing skin cancer, despite no such evidence existing to support this link. Some 10.1% also incorrectly identified that ‘all of these’ conditions were related to excessive alcohol consumption. With the exception of high blood pressure, females’ awareness of alcohol-related conditions was slightly better than that of males. However, a higher proportion of females also incorrectly reported an association between alcohol consumption and skin cancer and ‘all of these’ conditions.

The age breakdown of responses is presented in Figure 2. For most of the alcohol-related health conditions, with the exception of bowel cancer, awareness was highest among those aged 30–64. Overall, the age differences were relatively small. In particular, however, the low awareness of alcohol-related conditions among the youngest age bracket is of concern given that they are the group which has been shown to report the highest rates of hazardous and harmful drinking patterns.5 

Conclusions

With the exception of liver disease, public awareness that alcohol can increase the risk of developing a variety of health conditions is low. Awareness varied greatly across specific conditions, with approximately one-half of the public being aware that increased alcohol consumption is linked to high blood pressure, compared with less than one-quarter being aware of the link between alcohol consumption and female breast cancer.

The poor public awareness of alcohol-related conditions and in particular of alcohol-related cancers is of concern. In Ireland, between 2001 and 2010, some 4,585 (4.7%) male and 4,593 (4.2%) female invasive cancer diagnoses were attributable to alcohol, while 2,823(6.7%) of male cancer deaths and 1,700 (4.6%) of female cancer deaths were attributable to alcohol.6 Despite these figures, it is clear that the general public are not aware of the potential risks associated with increased alcohol consumption. The findings from this study provide support for the timely implementation of health warning labels on alcohol products as set out in the Public Health (Alcohol) Act 2018.

1    Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD, et al. (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 392(10152): 1015–35. https://www.drugsandalcohol.ie/29555/

2    Buykx P, Gilligan C, Ward B, Kippen R and Chapman K (2015) Public support for alcohol policies associated with knowledge of cancer risk. Int J Drug Policy, 26(4): 371–79.

3    Buykx P, Li J, Gavens L, Hooper L, Lovatt M, de Matos EG, et al. (2016) Public awareness of the link between alcohol and cancer in England in 2015: a population-based survey. BMC Public Health, 16(1): 1194. https://www.drugsandalcohol.ie/26464/

4    Ipsos MRBI (2016) Healthy Ireland Survey 2016: Technical Report. Dublin: Stationery Office.