New study links alcohol harm knowledge to stronger support for tougher alcohol policies in Europe

08.03.2026 - A new European study suggests that public understanding of alcohol’s health risks, especially its link to cancer, may play an important role in building support for stronger alcohol policy. The study, titled Support for alcohol policies and its association with knowledge of alcohol-related health consequences: findings from 5 EU countries, was published in 2026 in the European Journal of Public Health. It was written by Dasa Kokole, Maria Neufeld, Aleksandra Olsen, Carina Ferreira-Borges, Catherine Paradis, Jürgen Rehm and Daniela Correia, and published by Oxford University Press on behalf of the European Public Health Association.

The researchers analysed responses from 3,620 adults in Bulgaria, Ireland, Spain, Slovakia and Latvia, gathered through an online survey conducted in October and November 2024. The aim was to examine whether knowledge of alcohol-related harms was associated with support for different types of alcohol control policies. The study used adjusted linear regression models and grouped 15 policy items into four categories: supportive and educational interventions, marketing and youth protection policies, point-of-sale and display regulation policies, and pricing and physical availability control policies.

Support for alcohol policies was broadly similar across the five countries. The highest support was found for drink-driving measures, while the lowest support was found for increasing alcohol prices and reducing the number of alcohol outlets. More broadly, supportive and educational measures received the strongest backing, while pricing and availability controls were the least popular. That matters because those less popular measures are also among the most system-level tools available to governments trying to reduce alcohol harm.

The central finding of the study was that knowledge that alcohol can cause cancer was associated with higher support for some of the more restrictive policy types. After adjusting for sociodemographic characteristics and alcohol consumption patterns, cancer knowledge was positively associated with support for point-of-sale and display regulation policies (β = 0.18, 95% CI: 0.11 to 0.25) and pricing and physical availability control policies (β = 0.12, 95% CI: 0.05 to 0.19). In plain language, people who knew alcohol can cause cancer were more likely to support measures such as restrictions related to how alcohol is sold, displayed and made available.

The study also found movement in the opposite direction when respondents held a more favourable health belief about alcohol. Belief that wine benefits heart health was associated with lower support for marketing and youth protection policies (β = −0.09, 95% CI: −0.16 to −0.02) and for pricing and physical availability controls (β = −0.11, 95% CI: −0.18 to −0.04). The authors note that such beliefs may reflect the continued presence of mixed messages in media and sometimes even in health-related communication, which can weaken support for effective public health measures.

One of the more important points in the paper is that cancer awareness did not mainly boost support for policies that already enjoy broad approval. Instead, it was associated with stronger support for the measures that usually face the most resistance, especially those related to pricing, physical availability and point-of-sale restrictions. According to the authors, this suggests that awareness of alcohol’s cancer risk can shift attitudes toward population-level interventions that change the alcohol environment, not just individual behaviour. In other words, cancer knowledge may help move opinion where policy change is usually hardest.

The pattern remained broadly consistent across the five countries, although the strength of the association varied. The study found that the difference in support linked to cancer knowledge was more pronounced in Slovakia, Latvia and Bulgaria for point-of-sale and display regulation, while the same tendency appeared in Spain but was not statistically significant, and was absent in Ireland. Even so, the overall direction of the relationship remained the same across the countries studied, suggesting that national context may affect the strength of the link, but not its basic nature.

The authors argue that the findings have practical implications for public health. Communication about alcohol and cancer, including through awareness campaigns and warning labels, should not be treated as secondary or symbolic. In their view, such communication can help build the public backing needed for policies that are effective but often politically difficult. The paper also points out that marketing restrictions and youth protection measures already have a relatively high level of support and may offer governments a more feasible starting point while broader awareness is built around alcohol’s cancer risk.

At the same time, the researchers are careful not to overclaim. This was a cross-sectional study, which means it shows associations, not proof of causation. The results cannot establish with certainty that increased knowledge causes stronger policy support. The sample also cannot be treated as fully representative of the five countries, although it was designed to include diverse population groups and allow cross-country comparison. Still, the study adds to a growing body of evidence suggesting that informing the public about alcohol’s health consequences, especially cancer risk, may be a key ingredient in making stronger alcohol policy more politically acceptable.

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Source: Kokole D, Neufeld M, Olsen A, Ferreira-Borges C, Paradis C, Rehm J, Correia D. Support for alcohol policies and its association with knowledge of alcohol-related health consequences: findings from 5 EU countries. European Journal of Public Health (2026), doi: 10.1093/eurpub/ckag008