Alcohol and Cancer Message Testing Experiment

Public Health Messaging Survey

Alcohol increases the risk for at least seven cancers, yet recent estimates suggest only between one-third and one-half of US adults are aware of this risk. The current study aims to develop and test alcohol-cancer messages designed for a mass media public health campaign. The messages will be informed by theory-based constructs proximal to health behavior change (e.g., perceived likelihood/severity of harm, response efficacy). We will evaluate messages via an online, cross-sectional message testing randomized experiment. Participants will be US adults aged 21+ recruited from Qualtrics Panels.

Study Overview

• Status: Not yet recruiting
• Conditions: Alcohol; PME; Message Perception
• Intervention / Treatment: Behavioral: Alcohol health harm message exposure

Detailed Description

Rational:

Alcohol increases the risk for at least seven cancers, yet recent estimates suggest only between one-third and one-half of US adults are aware of this risk. Raising public awareness of the alcohol-cancer link can encourage better informed choices about alcohol and promote reduced consumption, yet the most effective strategies for raising such awareness remain to be determined.

One potential strategy is the use of alcohol-cancer risk messages, which could be disseminated through various communication channels (e.g., public service announcements, communication campaigns). However, such messages can differ in numerous ways, including their substantive content and the specific language used to communicate risk, and the optimal design of these messages and their effects on audiences remains to be determined.

Ours and others' prior work has tested different alcohol-cancer warning label messages in experimental studies. These experiments have tested the effects of using causal vs. hedging language, the utility of adding pictograms in warning labels, different ways to frame the alcohol-cancer risk relationship, and the type of cancer to communicate in warning labels. The overarching goal of these studies was to develop effective warning labels that could be added to alcohol beverages.

The current study aims to extend this work by developing and preliminarily evaluating alcohol-cancer messages designed for a mass media public health campaign. These messages will be informed by theory-based constructs proximal to health behavior change (e.g., perceived likelihood/severity of harm, response efficacy). We will evaluate messages via an online, cross-sectional message testing randomized experiment. Participants will be US adults aged 21+ recruited from Qualtrics Panels.

Objective:

The primary objective of this study is to identify how different alcohol-cancer message frames affect message-related perceptions and related health outcomes (e.g., perceived message effectiveness, risk beliefs, drinking intentions). Findings will help inform future alcohol harm reduction health communication efforts.

Guiding research question:

1. Do different alcohol-cancer message frames affect people's a) message receptivity, b) alcohol-related attitudes and risk perceptions, and c) drinking intentions?
2. Do any factors moderate the effects of exposure to different alcohol-cancer message frames (e.g., drinking status as a moderator)?

• Study Type: Interventional
• Enrollment (Estimated): 1400
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jacob A Rohde, PhD, MPH; Phone Number: (860) 486-2834; Email: jacob.rohde@uconn.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• currently reside in the US;
• be aged 21 years or older; and
• speak English.

Exclusion Criteria:

- none beyond failure to meet the inclusion criteria.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

7

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Perceived likelihood frame; Exposure to two alcohol-cancer messages that convey the probability of experiencing a health harm (i.e., cancer) from a particular hazard (i.e., drinking alcohol). The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
Experimental: Harm reduction frame; Exposure to two alcohol-cancer messages that encourage reducing how much alcohol people drink. The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
Experimental: Perceived severity frame; Exposure to two alcohol-cancer messages that convey how serious getting alcohol-associated cancer will be. The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
Experimental: Response efficacy frame; Exposure to two alcohol-cancer messages that emphasize the effectiveness of protective behaviors for reducing alcohol-associated cancer risk. The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
Experimental: Harm prevention frame; Exposure to two alcohol-cancer messages that emphasize completely abstaining from drinking alcohol. The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
Active Comparator: Surgeon General's frame; Exposure to two alcohol-cancer messages that do not discuss alcohol-associated cancer risk. Instead, the messages use language from the existing U.S. Surgeon General's warning on alcoholic beverages. The intervention will be administered in an online survey experiment as static images displayed to participants.	Behavioral: Alcohol health harm message exposure; Randomized exposure to one of five alcohol-cancer health campaign message frames, or a non-cancer alcohol harms frame.
No Intervention: Control; Participants randomized to control will not be exposed to any message stimuli.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived message effectiveness - effects perceptions	A 3-item scale adapted from prior effects perception PME and substance use literature. After each message exposure, participants will be asked to respond to the following items: 1) This message discourages me from wanting to drink alcohol; 2) This message makes me concerned about the health effects of drinking alcohol; and 3) This message makes drinking alcohol seem unpleasant to me. Items will be assessed on a 5-point scale ranging from strongly disagree (1) to strongly agree (5). We will assess internal consistency using Cronbach's alpha. Assuming adequate measure reliability, we will average the items into a single composite PME measure.	Day 1; post intervention exposure

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Drinking intentions	Intentions will be assessed with a 3-item scale adapted from prior substance use and health communication research. Participants will answer each of the following questions: How likely is it that you will drink alcohol in the... 1) next week, 2) next month, and 3) next year. Responses will be on 5-point scales ranging from "not at all" (1) to "extremely" (5). We will assess internal consistency using Cronbach's alpha. Assuming adequate measure reliability, we will average the items into a single composite measure.	Day 1; post intervention exposure
Message reactance	Message reactance will be assessed with a brief 3-item scale used in prior research. Participants will respond to the following statements: 1) This message is trying to manipulate me, 2) The health effect in this message is overblown, and 3) This message annoys me. Responses will be assessed on 5-point scales ranging from "strongly disagree" (1) to "strongly agree" (5). We will assess internal consistency using Cronbach's alpha. Assuming adequate measure reliability, we will average the items into a single composite measure.	Day 1; post intervention exposure
Non-alcoholic beer message perceptions	A single item that has participants respond to the following statement: "This message makes me think drinking non-alcoholic beer is healthier than alcoholic beer." This item will be assessed on a 5-point scale ranging from strongly disagree (1) to strongly agree (5).	Day 1; post intervention exposure
Perceived message effectiveness - message perceptions	A 5-item scale assessing perceptions of each message, adapted from prior work. After each message exposure, participants will respond to the following items: 1) "This message grabs my attention"; 2) "This message is believable"; 3) "This message is credible"; 4) "This message is trustworthy"; and 5) "I learned something new from this message." Items will be assessed on a 5-point scale ranging from strongly disagree (1) to strongly agree (5). We will assess internal consistency using Cronbach's alpha. Assuming adequate measure reliability, we will average the items into a single composite measure.	Day 1; post intervention exposure
Attitudes toward alcohol	A 3-item measure assessing attitudes toward drinking alcohol. Participants will rate drinking alcohol on three 5-point bipolar scales: 1) harmful/safe; 2) bad/good; and 3) unhealthy/healthy. We will assess internal consistency using Cronbach's alpha. Assuming adequate reliability, we will average the items into a single composite attitude measure.	Day 1; post intervention exposure
Intentions to reduce alcohol use	Assessed only among participants who currently drink alcohol. Participants will be asked, "How likely are you to reduce how much alcohol you drink?" Responses will be assessed on a 5-point scale ranging from not at all (1) to very much (5).	Day 1; post intervention exposure
Alcohol-cancer causal beliefs	Causal beliefs will be assessed with a single item: "How likely do you think it is that alcohol causes cancer?" Responses will be assessed on a 5-point scale ranging from not at all (1) to very much (5).	Day 1; post intervention exposure
Intentions to quit drinking alcohol	Participants who currently drink alcohol will be asked, "How likely are you to quit drinking alcohol?" Responses will be assessed on a 5-point scale ranging from not at all (1) to very much (5).	Day 1; post intervention exposure
Alcohol-cancer risk beliefs	We will assess risk beliefs using a 3-item scale assessing affective, experiential, and deliberative perceptions of cancer risk among participants who currently drink alcohol. The measure stem will state, "If you continue to drink alcohol at your current level…" Participants will then answer the following items: 1) "How worried are you about eventually getting cancer?"; 2) "To what extent could you see yourself eventually getting cancer?"; and 3) "How likely do you think it is that you will eventually get cancer?" Items will be assessed on a 5-point scale ranging from not at all (1) to very much (5). We will assess these items separately, as they tap into different tri-risk constructs; however, for exploratory purposes we will also assess internal consistency of the three items using Cronbach's alpha. Assuming adequate reliability, we will average the items into a single composite measure.	Day 1; post intervention exposure
Support for message on alcohol containers	Assessed with a single item: "I believe a message like this should be added to alcohol beverage containers." Responses will be assessed on a 5-point scale ranging from strongly disagree (1) to strongly agree (5).	Day 1; post intervention exposure
Perceived effectiveness of message on alcohol containers	Assessed with a single item: "Seeing a message like this on an alcoholic beverage would make me think twice about drinking alcohol." Responses will be assessed on a 5-point scale ranging from strongly disagree (1) to strongly agree (5).	Day 1; post intervention exposure

Collaborators and Investigators

• Sponsor: University of Connecticut

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: September 17, 2026
• First Submitted That Met QC Criteria: September 23, 2026
• First Posted (Actual): September 30, 2026

Study Record Updates

• Last Update Posted (Actual): September 30, 2026
• Last Update Submitted That Met QC Criteria: September 23, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Message testing experiment; Alcohol risk messages; Alcohol and cancer
• Additional Relevant MeSH Terms: Neoplasms; Organic Chemicals; Alcohols; Ethanol
• Other Study ID Numbers: B2026-0294; Faculty Startup Funds (Other Identifier: UConn College of Agriculture, Health, and Natural Resources)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

We will share anonymized IPD with researchers upon reasonable request to the project Principal Investigator.

IPD Sharing Time Frame

IPD will be available on an ad hoc basis upon reasonable request for at least three years after the experiment is completed.

IPD Sharing Access Criteria

Other researchers who provide a reasonable request about how they will use the data (e.g., validation, secondary analyses, etc).

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No