'I don't consider cancer when I'm grabbing the beer': Discursive strategies used by midlife New Zealanders to undermine alcohol-cancer risks

Abstract

Compared with other age groups, adults at midlife consume alcohol at relatively high levels. Alcohol has been linked to a number of long-term health risks, including cancer, although awareness of cancer risk is low. The current study aimed to examine how adults at midlife talk about, understand and consider alcohol-related cancer risks within their life contexts. Individual interviews were undertaken with 37 adults (41-64 years; 28 female, 9 male) about their alcohol consumption, views on the health risks of drinking, and understandings of the alcohol-cancer association. Interviews were transcribed verbatim, coded and subjected to a discursive analysis. Participants constructed their drinking as low-risk because it was controlled, responsible, and moderate. They used discursive strategies to undermine the evidence on the cancer risks of alcohol by contrasting it with (stronger) evidence for tobacco risk, drawing on personal accounts of exceptional cases, and displaying 'risk fatigue' because alcohol was just one of many carcinogens they navigate in daily life. The pleasure they derived from alcohol outweighed cancer risks. Cancer risk evidence was itself constructed as risky because people with cancer could be blamed for their disease. These findings show that public health messages about alcohol and cancer risk need to incorporate people's own sense-making about alcohol and risk within their lives, including notions of pleasure. Unintended consequences of current messaging include short-term risks (to health and wellbeing) and moral risks (potential for people to be blamed for cancer) and therefore may be ignored or resisted by target populations.