Posted: September 24, 2016
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Article SummaryOn September 14, 2016, Jennifer Chaussee of Wired Magazine emailed me about a story she was writing about “why there is such low awareness around the link between alcohol consumption and increased cancer risk.” She said she was particularly interested in how my hazard-versus-outrage concept might be used to explain public apathy about the drinking-and-cancer connection. My emailed response two days later did cover the ground she wanted me to cover: the ways in which drinking-and-cancer is low-outrage. But I also discussed some other risk perception aspects of the issue. Jennifer’s excellent September 22 story was called “The Muddled Link between Booze and Cancer,”and focused on controversies over research results about the link. Her planned sidebar on outrage and public perception was dropped for space reasons. I’m posting the email I sent her anyway. I’m posting it under precaution advocacy even though it doesn’t really address how to get drinkers more worried about alcohol-and-cancer; it’s a good explanation of why that’s a tough assignment.

Why Most People Don’t Pay Much Attention
to the Fact that Alcohol Is a Carcinogen

(a September 16, 2016 email in response to a query from
Jennifer Chaussee of Wired Magazine)
As published, Jennifer Chaussee’s
article on the alcohol-cancer connection did not draw from this email.

I don’t think it’s especially surprising that most people aren’t paying a lot of attention to “the link between alcohol consumption and increased cancer risk,”as you out it in your September 14 email to me.

Most drinkers know that heavy drinking is bad for them in all sorts of ways. The cancer link, to my understanding, is pretty far down on the list of risks that heavy drinkers incur. So drinkers may not pay that much attention to the alcohol-and-cancer story. Whether they see themselves as heavy drinkers or as light drinkers, that story doesn’t shed significant new light on their situation.

I’m guessing that most drinkers also have read that light drinking is good for them – again, in all sorts of ways. Scientists used to think the beneficial effects of alcohol were confined mostly to red wine; the conventional wisdom now seems to be that all alcohol has several health benefits. I don’t know what the evidence says about whether even light drinking is linked to some kinds of cancer. But it seems unlikely that the cancer risk of light drinking outweighs its various health benefits.

Not to mention that drinkers like drinking. It has lifestyle benefits apart from health.

Let me divide drinkers into three groups – not in terms of how much they drink but in terms of their attitudes toward their own drinking.

Group 1: Some drinkers are actively trying to quit or cut back, and are therefore diligently searching for new evidence that alcohol is harmful. Some relatives of drinkers are similarly motivated. For these audiences, news about the alcohol-cancer link would constitute valuable ammunition in their arguments with themselves or their loved ones. They’re information-seeking for bad news about alcohol, and they’re very unlikely to miss or ignore or forget the alcohol-cancer link.

Group 2: Some drinkers are contented with their own drinking. They’re neither searching for information that alcohol is harmful nor avoiding that information. So maybe they run into news stories about the cancer-alcohol link and maybe they don’t. If they do, maybe they pay attention to the link and maybe they don’t; maybe they remember it and maybe they don’t. It’s not loaded. Moreover, it’s not terribly important. It’s a comparatively minor downside of drinking compared to other much bigger downsides of heavy drinking, and compared to the much bigger upsides of light drinking.

Group 3: Some drinkers are defensive about their own drinking – either vis-à-vis disapproving friends and relatives or vis-à-vis their own self-disapproval. They’re under external or internal pressure to quit or cut back, but they don’t want to or feel they can’t. This is the group that would be hardest to reach with anti-drinking messaging of any kind. Anti-drinking messaging would arouse their cognitive dissonance – that is, it would make them feel worse about themselves and their alcohol consumption. So they actively (but mostly unconsciously) try to avoid seeing that sort of messaging; if they see it they try to ignore it; if they can’t ignore it they try to misperceive it; if they can’t misperceive it they try to forget it – all mostly unconsciously.

Information about the link between alcohol and cancer isn’t likely to be the most threatening sort of anti-drinking messaging that people in Group 3 work hard (mostly unconsciously) not to absorb. But it’s obviously in that category. For Group 2, it’s obviously information that’s neither threatening nor relevant. For Group 1 it’s useful information worth seeking out, absorbing, and remembering.

None of this is directly relevant to my “Risk = Hazard + Outrage”formula and the website article you referenced on sources of stakeholder outrage. But there are ways of applying that analysis as well, particularly if we turn our attention from drinkers to the people around them.

For example, some people (both drinkers and nondrinkers) are outraged about alcohol abuse, usually for understandable reasons. The basic principle of my “Risk = Hazard + Outrage” formula is that outrage exacerbates hazard perception. That is, when we’re angry or frightened about some risk, we tend to see that risk as bigger than we would otherwise. People often get the causality here backwards, imagining that we get upset because we think the hazard is serious. But decades of research show that the main effect is in the opposite direction: We think the hazard is serious because we’re upset.

So people who are in a state of high outrage about alcohol abuse – the child of an alcoholic, for example – may well be motivated not just to seek out information about the link between alcohol and cancer but also to exaggerate that link in their own minds and in their communications with others. Of course they would do the same thing with regard to other downsides of drinking, including much bigger ones. But it’s their overreaction to the small ones that best demonstrates their outrage.

In other words, people who over-respond to fairly small risks associated with some situation or behavior – not just the big ones – are very often reacting to some aspect of that situation or behavior that makes them outraged.

It’s possible you might be in this outraged-about-alcohol group yourself, which would account for your interest in the alcohol-and-cancer story. Others around you might see it as a pretty minor story, which would only exacerbate your outrage.

Finally I’m getting to what I think you wanted from me: For most people, alcohol and even alcoholism arouse less outrage than the hazard justifies. The reasons are rooted in the components of outrage:

  • Unfamiliar risks arouse a lot more outrage than familiar risks – and alcohol is very familiar.
  • Risks imposed by others arouse a lot more outrage than voluntary risks – and drinking is a voluntary behavior.
  • Risks controlled by others arouse a lot more outrage than risks we control ourselves – and drinkers are in charge of their own consumption.
  • Catastrophic risks arouse a lot more outrage than chronic risks – and both drinking and overdrinking are everyday behaviors.
  • Risks that science doesn’t understand well arouse a lot more outrage than well-understood risks – and the risk of alcohol is well-understood (even if the cancer link isn't).
    • Other outrage components go a long way toward explaining why alcohol and alcohol abuse are high-outrage for some people and low-outrage for others. Trust, for example, is a powerful component of outrage. If I have been endlessly lied to and betrayed by an alcoholic relative, for me alcohol is almost sure to be a high-outrage risk. But if my life experience doesn’t include that sort of mistreatment, not even getting harassed by drunks, then for me alcohol is probably a much lower-outrage risk.

      And again, if my outrage is high I’m likely to see the hazard as higher than it is. If my outrage is low, I’m likely to see the hazard as lower than it is.

      Copyright © 2016 by Peter M. Sandman

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