Abstract
Background: It is estimated that 30-50% of cancer cases in Aotearoa New Zealand (Aotearoa) are preventable. Yet, cancer causes a substantial loss of health and lives in Aotearoa. Alcohol consumption and what food we eat contribute to this substantially. In 2019 it was estimated that alcohol caused 6% of all cancer deaths, dietary risks caused almost 8% of cancer deaths, and excess body weight caused over 6% of cancer deaths. Urgent action is needed to reduce rates of cancer by reducing our population’s exposure to modifiable risk factors. It has been estimated that this could prevent substantial health loss and up to 4,400 deaths due to cancer in Aotearoa each year. Awareness of modifiable risk factors and population-based prevention efforts to promote healthy environments that support a reduction in exposure to modifiable risk factors are important pathways to achieving this. Internationally, research has assessed the public’s awareness of the causal link between alcohol and cancer and dietary factors and cancer. However, in Aotearoa this information has only been collected sporadically and not since 2015. The current study was designed to address this information gap.
Methods: The current research sought to determine New Zealanders’ awareness of modifiable risk factors for cancer (with a particular focus on alcohol and dietary factors) and support for evidence- based alcohol and food policies to reduce people’s exposure to alcohol and dietary risk factors in their environment. A survey instrument was developed based on previous research. It was included in a self-administered online omnibus survey run by Talbot Mills Research. Data collection was completed in March-April 2023. A sample of 1425 New Zealanders aged 18 years and older were recruited by panel provider DynataTM with boosted sampling for Māori and Pasifika people to provide equal explanatory power for these population groups.
Survey responses were weighted (through post-stratification weights) to ensure that they represented, as closely as possible, the Aotearoa adult population from the 2018 Census. Recall questions were manually coded into categories. Data analysis was conducted using Stata/SE version 18.0. Logistic regression was used to determine if significant differences were evident in responses to the recognition risk factor awareness question and the policy support questions (outcomes), based on specified independent variables.
Findings: It was found that, while there is some awareness of modifiable risk factors for cancer in Aotearoa, more still needs to be done to increase awareness. Increasing awareness of alcohol and food-related risk factors will provide the people of Aotearoa with knowledge that can be used to inform healthier choices (for those who have the means to do so) and will lead to increased support for government policies designed to create healthier environments that support people’s ability to make healthy choices. Government action should start by focusing on policies that currently have the support of the majority of the Aotearoa adult population (e.g. “Banning alcohol sponsorship at sporting, community, and other events that under 18-year-olds go to”, “The alcohol industry should not be involved in developing government policies (local and national) to reduce alcohol harm”, “Government action to reduce the cost of healthy food”, “Providing free healthy lunches at schools” and “Taxes on sugary drinks if the money is used to make healthy food more available/affordable”). These policies should be a starting point for the Government to take action on reducing the rates of preventable cancers related to alcohol and diet in Aotearoa, thus preventing unnecessary illness and deaths and reducing pressure on our struggling health system.