How Should We Talk about Alcohol and Risk?
A recent study led by Theresa Hydes (University of Southampton, UK) recently published in BMC Public Health, aimed to directly compare the carcinogenic risk of alcohol consumption with that of smoking cigarettes. The study sub-titled ‘how many cigarettes are there in a bottle of wine?’ found the overall absolute increase in cancer risk for one bottle of wine per week equals that of five (for men) or ten cigarettes (for women) per week.
The analysis, and the mixed manner in which it was received, offers an insight into an ongoing conversation about the population-level health risks of alcohol consumption, and how best to communicate them. A range of criticisms have been levelled at the study.
The rationale given by Hydes and colleagues for comparing cigarettes and alcohol head-to-head was that “the number of cancers attributed to alcohol is poorly understood by the public”.
It is true that despite the strong associations between alcohol consumption and a range of cancers including colorectal cancer, hepatocellular carcinoma, oesophageal cancer, and breast cancer, public perceptions of alcohol are that it is less harmful than other drugs, and it is not viewed primarily as a carcinogen. For example, in a 2015 survey of 2100 adults in England, only 13% of respondents identified cancer as a potential health outcome of alcohol consumption, stated the Lancet Editorial as per The Lancet.
The historical lack of clarity in public health messaging about alcohol consumption is further exemplified by a study recently published in The Lancet, which debunks the widely held misconception that moderate alcohol consumption confers beneficial health effects.
The clarity and accuracy of public health messaging on alcohol lags behind that for tobacco and other drugs. The analysis by Hydes and colleagues offers a novel way of communicating the risks of alcohol consumption to the public. By comparing alcohol use with smoking, they leverage the hard-won successes of anti-tobacco campaigners in creating a deep public awareness of the links between cigarettes and cancer.