"Despite the recognized contribution of alcohol to cancer incidence and mortality, recent evidence suggests that awareness of the link between alcohol and cancer remains low in the US.¹ Beyond public awareness, individuals’ beliefs play a key role in the adoption of healthy behavioral changes.² Although the success of public health policies in reducing alcohol-related cancers is influenced by people’s beliefs about the link between alcohol and cancer risk, few studies have examined these beliefs in the US.³ Furthermore, no study to date has explored individuals’ beliefs about the effect of alcohol on cancer risk in the post–COVID-19 pandemic era, a period marked by sustained increases in alcohol consumption.⁴ To guide the dissemination of alcohol reduction policies, we examined the prevalence and determinants of beliefs about the effect of alcohol on cancer risk in the US.

Methods

This cross-sectional study was based on the 2024 Health Information National Trends Survey data, a nationally representative household survey of the noninstitutionalized US adult population. Sampling weights were used to ensure inferences from respondents were valid for the target population, accounting for nonresponse and noncoverage biases. Because data were deidentified and publicly available, the study was exempt from institutional review board review and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. We included all individuals aged 18 years or older who responded to the questions assessing their beliefs about the effect of alcohol on cancer risk.

The primary outcome was belief about the effect of alcohol on cancer risk, measured with the question “In your opinion, how does drinking alcohol affect the risk of getting cancer?” Possible responses were “decreases risk of cancer,” “has no effect on the risk of cancer,” “increases risk of cancer,” and “don’t know.” Potential predictors included sociodemographic and health-behavioral variables (eMethods in Supplement 1). Weighted descriptive statistics and multinomial logistic regression were performed (SAS Institute, version 9.4) to examine the prevalence and factors associated with beliefs about the effect of alcohol on cancer risk.

Results

Of the 6793 individuals (mean [SD] age, 48.9 [17.3] years) included in this study, 51.6% were male, 48.4% were female, 17.5% were Hispanic, 11.0% were non-Hispanic Black, 60.7% were non-Hispanic White, 51.9% drank alcohol in the past month, and 9.8% had a personal cancer history. Overall, 37.1% of US adults believed that drinking alcohol increases cancer risk, 9.1% believed that alcohol has no effect on cancer risk, 1.0% believed that drinking alcohol decreases cancer risk, and 52.9% did not know whether alcohol has an effect on cancer risk. Prevalence of these beliefs varied according to certain health-behavioral factors (Figure)."