Alcohol prevention strategies: Prevention efforts should be different for men and women

Over the past few weeks in class, we’ve had conversations about alcohol use and risks associated with it. The NIAAA described the health risks associated with excessive drinkings such as heart disease, cancer, problems of the liver, pancreas and others such as sexually transmitted infections, violence, suicide. Most researchers believe that risks associated with alcohol drinking outweigh any potential health benefits from moderate drinking. As an example, Professor Walter Willett of epidemiology and nutrition at Harvard T.H. Chan School of Public Health thinks that heavy drinking is harmful.

What’s moderate drinking?


  The CDC  and NIAA defines the term “moderate drinking” as  

       1. Beer 12 ounces (5% alcohol content).

       2. For malt liquor 8 ounces  (7% alcohol content).

       3. For wine 5 ounces  (12% alcohol content).

       4. 1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whisk


A new study on  Alcohol: Balancing Risks and Benefits concluded that there’s no amount of alcohol consumption that’s safe for overall health — a finding that’s likely to surprise moderate drinkers, and that has left some experts unconvinced.

The federal, state and local authorities in the US work together to minimize health risks associated with alcohol drinking.  

In this blog, I’m sharing some of the alcohol prevention strategies I’ve learned for the past few weeks while taking a class in Special topics in Epidemiology on alcohol and women.

  • Prohibitions of alcohol sponsorship of public events – Alcohol sponsorship by alcohol companies has been a  debated issue in recent months. According to a Sponsorship Today report, more than $1 billion was spent on sports sponsorships by beer companies alone in 2012. prohibition by integrating sports sponsorship with responsible consumption messages. 
  • Increases in price through excise taxes –Increase taxes have consistently been found to reduce alcohol consumption and problems, especially among youth. Alcohol excise taxes affect the price of alcohol and are intended to reduce alcohol-related harms, raise revenue, or both. Alcohol taxes are implemented at the state and federal level, and are beverage-specific (i.e., they differ for beer, wine, and spirits). In the US, Alabama and Washington’s state have some of the highest taxes on alcohol
  • Controls on alcohol advertising (especially on billboards, sides of buses, and in other public areas)-The alcohol industry are among the leading advertisers on billboards. Billboards advertising beer and hard liquor are readily visible to children. These advertisements expose and encourage excessive drinking among youth. Laws of Billboard advertisement in Georgia prohibits advertising alcoholic drinks and tobacco products at children, educational and medical institutions, culture and sports organizations within 100 meters radius of them is prohibited.

  • Limiting hours of sale:    –Another strategy to prevent excessive alcohol consumption and related harms is to limit access by limiting the hours during which alcohol can legally be sold.  In the US they differ from one state to another. In Atlanta, Georgia, packaged liquor may be sold between 12:30 p.m. and 11:30 p.m. on Sunday, and between 8:00 a.m. and 11:45 p.m., Monday through Saturday. Packaged beer and wine may be sold at any time except between midnight Saturday night and 12:30 p.m. Sunday afternoon, or between 11:30 p.m. Sunday night and 12:01 a.m. on Monday.  Alcoholic beverages may be served in bars and restaurants between 12:30 p.m. and midnight on Sunday, and between 9:00 a.m. and 2:30 a.m., Monday through Saturday.


Should we make these strategies different for women and men?

The answer to this question is YES. Alcohol offers each group a different spectrum of risks. It is necessary for everyone, especially policymakers to understand that alcohol affects women’s bodies differently. Unlike males, women are more likely to suffer the health and social effects of alcohol consumption. Also, women are vulnerable to the secondhand effects or alcohol harms of excessive alcohol consumption among others.

With a recent report on an increase in the number of women who drink, there should be an awareness of these health risks and make informed decisions about alcohol use. As such, it should be given special attention.

We also need to be aware that women are the target for more recent alcohol ads and campaigns. Advertisers market liquor as “diet” or “natural” in an effort to appeal to health-conscious women. 

Alcohol Harm in Women

The harm alcohol can cause women has been proven, but it is still widely unknown amongst people, hence, the growing amount of women who are consuming alcohol. Because women’s bodies absorb more alcohol than men, it takes a longer time for the body to metabolize and rid the body of it, so there is a greater risk for long-term health problems.

The CDC reports that 46% of adult women reported drinking in the last 30 days, and 12% of women reported binge drinking 3 times per month–averaging 5 drinks per binge. Women may have adverse health outcomes from these behaviors related to reproduction and fertility, liver disease, brain function, heart function, an increased risk of cancer, and an increased risk of sexual assault. 

The relationship between alcohol consumption and breast cancer has also been heavily researched. The Susan G. Koman website reports that from an analysis of 53 studies, it was found that for each alcoholic beverage consumed each day, the relative risk of breast cancer increased 7%. Some may argue that there has been proven benefits for the heart with drinking alcohol, but as this article states–is this a fair trade when the risk of breast cancer is also increased? With such overwhelming evidence that there is a relationship between alcohol consumption and breast cancer (and other diseases), how can we make sure women are receiving the message that alcohol is harmful to our health? 

Doctors should get involved, and ask screening questions about alcohol use. Doctors should be able to educate women on the adverse health outcomes of alcohol consumption.

Brief interventions have been proven to reduce drinking alcohol among women. These interventions were performed in clinical settings and healthcare services, and the study showed that there was an decrease in both the number of days alcohol was consumed and the amount. The effectiveness of these brief interventions was noted to be related to the impact on reproductive health and the lower social acceptance of female consumption.  However, young people are less interested in having babies now more than ever. We also know it is becoming increasingly acceptable for women to consume alcohol.

This article discusses the cultural shift and how pop culture seems to “celebrate women who drink rather than warn against it.” This makes it difficult to identify what kind of interventions would be successful. 

There have been public campaigns against harmful substances such as tobacco and e-cigs, as well as campaigns against drunk driving and texting while driving.  Perhaps a campaign about the gender-specific effects of alcohol on women would be helpful. I, for one, have these campaigns in the back of my mind when I see people smoking cigarettes or texting while they are driving. It is a tricky issue because some may see this kind of campaign as an attack on women. Most importantly, I believe conversations like those tweeting #GSUwhyshedrinks must continue, as awareness is key for solving this growing issue. 

Raising awareness on the harms of alcohol for women

Alcohol is know to have it’s dangers; from developmental delays if exposed too young, to lowered inhibitions often leading to risky behaviors, the harms it can cause are no secret, and often seen as worth it for the relaxation a small drink can bring. However, as research and technology move forward, new findings often come to light. Included in this are the recent publications that show how drinking can be much more dangerous for woman than men. Examples include higher prevalence of liver disease, increased dependency issues, and the critical issue of growing rates of breast cancer among women who drink regularly compared to those who don’t.

Beyond the extensive problems themselves these issues can bring,  there is an additional pressing matter in that  often these risks aren’t as well known as others. Without having all of the facts of the dangers of the substance, it’s not completely possible to make an informed decision regarding alcohol.  There are a variety of tactics that can be enacted to educate the population, and seeing how crucial these concerns are, it’s time to implement some of these changes.  

In a 2018 analysis, effectiveness of mass media campaigns targeting alcohol were assessed. Looking at 24 campaigns all placed throughout different areas in developed countries, testing for effectiveness was evaluated by how well consumers recalled information and if any steps or actions were taken that could be directly related to the issue of drinking. The campaigns mainly focused on distribution through materials and media in the form of TV and radio adverts. However, many also utilized billboards, social media ads, and ads along transportation modes and routes.

The results of the analysis showed that while individuals were not necessarily changing their drinking behaviors or attitudes after being exposed to the campaigns, they were recalling the information provided even after substantial amounts of time had passed since being exposed. The graph, summarizes the most notable results of the campaigns after each had aired. Awareness, understanding and recollection were present after in almost each campaign. While none of the studies focused on spreading awareness for the link between alcohol and breast cancer, or any other adverse effects for women, they are effectively showing that these media blitz  advertisements can still work towards making the population aware of certain health issues they may be facing. 

Beyond traditional media efforts that public health organizations can take, there are newer modes that I believe could help spread the issue surrounding this link. Information hidden under the disguise of an internet quiz, listicle, or even a meme. For example, everyone is familiar with Buzzfeed completely pointless and sometimes sponsored quizzes. Mattel sponsored one entitled “Which Barbie doll are you” and the quiz went on to be viewed over 1 million times with almost 200,000 shares on Facebook.

While the idea may be unheard of, if a health related organization put out content in a way that seems maybe less threatening and more Gen z friendly, for example a sponsored quiz or listicle “Are your drinking habits healthy” with a short series of questions that could indicate a need for further research on the users part. It’s private, not intimidating, and exposure could reach a lot of younger women who are coming of drinking age. These sponsored ‘articles’ could be just a small stepping stone towards legitimate information and could provide additional websites or sources to visit for additional information.  It might seem odd and unprofessional in a way but if the goal is to increase awareness around the link between alcohol and breast cancer, and it is, then this is simply another method to increase public awareness for all women in all age ranges. 

Public health organizations and officials who are trying to educate on the dangers of drinking for women should implement some traditional informational techniques, such as media targeted campaigns, while attempting strategies to connect with younger populations. These campaigns need to be targeted, they need to address the issues plainly, and these to be present widespread in spaces where women will access. Through this education, women well at least have the chance to be better informed and hopefully make better decisions regarding long term health. While there is a separate issue of actually mobilizing these populations to change their behaviors around some of the risk factors of alcohol, first and foremost should be the issue of spreading accurate information. 


Alcohol consumption causes breast cancer: Did you know?

It is clear that many women still don’t know about the harm alcohol can cause, including breast cancer. How can we better disseminate these messages?

Unfortunately, there are several women and girls who are not aware of the consequences of alcohol. Through my current research using the YRBS 2017 survey, it appears that high school girls are starting to drink earlier than before, and Black and Hispanic girls are engaging in binge drinking more than their male counterparts.

During my time in middle and high school, health teachers only discussed that alcohol and sex is wrong and should be avoided completely, but they did not tell us what the side effects are of engaging in drinking. They basically only said that we would not be able to drive after drinking, and that our vision would be blurry. Nothing about cancer.

Many people, including myself get to college not knowing that alcohol causes more problems than just liver cancer. One drink and we’ll be fine right? But one drink can contain 4 shots of vodka. Don’t you think that affects your body, especially if you continue with that mindset? The answer is YES. And to my women friends, did you know that the more alcohol we drink, the more we increase our chances of developing breast cancer? Yeah, neither did I until a few weeks ago….and I’m 23. 

Here is an excerpt from

“Research consistently shows that drinking alcoholic beverages — beer, wine, and liquor — increases a woman’s risk of hormone-receptor-positive breast cancer. Alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells.”

Did you know that before reading this blog? 

–Yeah, I didn’t think so. This goes to show that important information related to alcohol and cancer has not been given often to the general public. 

What we should do to disseminate this information better:

  1. Provide healthy drinking guidelines to high school and college students. 
    • Here’s an infographic on what excessive alcohol use is. I strongly believe pictures describe 1,000 words.
  2. Once in college, Resident Assistants (RAs) should be responsible for giving a safe drinking lecture and holding an exercise to demonstrate how much is okay to drink and what kind of diseases can come from drinking. Speaking from experience, college students learn more from people their own age– neither professors nor administrators. 
  3. I strongly believe in community programs. Macon, Georgia is a relatively large city and puts together something called “Open Streets” every year. During this program, the streets are blocked off in the city, and open for people to partake in exercise classes and ride their bikes all across town! Atlanta has a similar thing called Atlanta Streets Alive. These programs are super successful. So, maybe at these programs, alcohol lectures can be given! 
  4. Fliers!!! Fliers are so powerful! Pictures. Words. Colors. It’s eye-catching. One of the best ways I got information about events and programs in college was through fliers. Location is key! They need to be placed where young people go, such as the mall, the grocery store, the movies, etc. 
  5. Advertisements on social media. Recently, I have noticed advertisements about the JUUL on Snapchat. Every post I look at, there’s an advertisement about how the JUUL leads to certain health issues. I think social media is an easy and effective way to reach young people and the population that drinks the most. 


Works cited:

Read This Before You Order Your Next Drink

Six weeks ago, I had one of the worst days of my life. I had just gotten back from a fantastic anniversary trip with my husband the day before. My parents had been strangely insistent that I call them the day after we got back. It’s not unusual for me to call them after a trip to let them know we made it back safe and share some of the high points with them. But this time they seemed a lot more persistent than normal. When I did call on that pretty spring Sunday, my mom cut me off in the middle of me enthusiastically describing a park we had visited on our trip. “We have to tell you something,” She said, “I have breast cancer”, and just like that, every ounce of oxygen left my body. It took me weeks to start to begin to wrap my head around it. In those weeks, I did the one thing everyone tells you not to do. I looked my mom’s cancer up on the internet. I dug through articles, papers, statistics, and survival rates. Looking for an answer to the question we’ll likely never be able to answer, why my mom?

Imagine my shock one day in class to learn that after all my weeks of research, I came across something new. Alcohol has been linked to breast cancer. In all of my hours of research, I had read nothing suggesting that alcohol could be a risk factor for breast cancer. Now, my mother has never been much of a drinker not even in her younger, more explorative years, so it’s likely not the cause for my mom’s cancer. But I’ve always enjoyed a nice beer or 2 and, like millions of college-aged women, had enjoyed more than a few too many at one time or another. Maybe it’s because now that I have a history of breast cancer from not only my mother, but my paternal grandmother who had been diagnosed at just 37 years old and I have been forced to acknowledge my very real risk of developing breast cancer one day myself. But this hit me particularly hard.

An entire month every year is dedicated to breast cancer awareness. Famous athletes wear pink, millions of people march and run thousands of miles every year to raise money for breast cancer research. Breast cancer is the second most common type of cancer among women and the second leading cause of cancer death among women. It’s estimated that over 200,000 women in the U.S. will be diagnosed with breast cancer just this year. Yet despite all the information about breast cancer awareness and prevention screening, in a recent survey in the UK only 20% of the 205 women undergoing cancer treatment who participated knew that alcohol was a risk factor for breast cancer. Things aren’t looking much better in another survey conducted in the US which found 70% of Americans also did not know that drinking alcohol was a risk factor for breast cancer.

This begs me to ask this question, if all the pink ribbons, charity walks, billboards, bus signs, and tv commercials aren’t teaching us about the risk alcohol poses to women, what else can we do? A valuable, and perhaps obvious, the first step could be to increase and improve education. A woman’s physician is her best weapon in this never-ending battle against cancer. They could provide women with more comprehensive education about the risks of breast cancer at their yearly checkups. Breast cancer screenings and visits for breast cancer symptoms also provide some of the most teachable moments. Women are likely more open to this information when the threat seems so near. It wouldn’t take much, just 5 minutes at the beginning of their visit highlighting the biggest risk-factor and prevention methods.

Starting education even earlier seems like the best way to prevent more cases of breast cancer. We all remember those horrifically uncomfortable sex education classes, even if we wished we didn’t. What if we started educating girls on the risk of drinking alcohol for breast cancer when they are the most likely to start experimenting with alcohol? Maybe they wouldn’t listen. Maybe they’d just roll their eyes and turn away. But maybe it would plant a seed. Maybe if they’re presented with the evidence often enough, they’ll think twice before having their next drink. Maybe a few with family histories of breast cancer like me would decide it wasn’t worth it. I’m not 14 or 21 anymore, and I can’t speak for everyone, but even a craft beer enthusiast like me is opting for water or tea a lot more than I used to,  before I knew.

Alcohol and Harm: Breast Cancer

Before attending our class on Women and Alcohol, I was unfamiliar with the relationship between alcohol and breast cancer. I had some awareness that alcohol was harmful, but did not know about its direct links to cancers. It is interesting to me that I, along with my peers, can recall learning that one glass of red wine may be beneficial to one’s health, but very few women I have asked remember learning about alcohol and its link to cancer.

As it turns out, this factsheet says that researchers have found no association between a small consumption of red wine, but all the research says that there is no doubt that alcohol is significantly associated with certain cancers. Since many of us enjoy drinking some red wine, this may be the reason why we have “tunnel vision” and are only remembering hearing about a positive effect for our behaviors and not the negative effects. I feel like a lot of the time individuals tune out information that they do not like or information that goes against what they regularly do and like to do because it is not something that they want to hear. Most people do not like to hear that something they are doing is not positive and healthy behavior. It is also really hard to make behavior changes so most people do not want to learn that they have to change their behavior.


I think we need to work harder to create prevention programs that better disseminate these messages. One idea would be to find a way to target the vulnerable population, women. This could be done by creating more ads/commercials on television channels that women frequently watch such as ABC, E and Bravo. Another way to target women would be by requiring alcohol companies to put a warning label on their alcohols about links to breast cancer. Specifically, it would be important to put these warning labels on “women targeted alcohol” such as the low calorie drinks like Truly or Wines. These drinks are commonly drunk by women. Another prevention program idea is to put up factsheets and advertisements in some locations that are commonly frequented by women such as grocery stores or shopping malls. I think that it is important to create advertisements that would attract women and catch their attention. This can be done using bright colors. This is also something that doctors should talk about during primary care and gynecological visits. During my doctor visits, I am asked about my alcohol use, but I have never had a doctor discuss the links between alcohol use and cancers.


Sober Curious: A Night Life Alternative

 Consuming alcohol has almost become synonymous with going out on the weekend with your friends especially if the pre-determined meeting location is a bar. The situation usually plays out by one friend getting there earlier, and ordering a drink from the bar while they wait for the rest of the group. Then the rest of the friends or group arrives, and you all order another round of drinks while you wait for the food, and then maybe one more round of drinks before you all leave for the night and head your separate ways.

Now, one can say that this may be a scenario that can be quite expensive with the group in the example ordering three round of drinks and according to an article entitled The Recent Evolution of How we Get Tipsy“, that covered an NPR alcohol report, it actually is! This report found that as production of alcohol in America has become more efficient, alcohol prices have declined 39% from 1982 to 2012. During that same time span, the prices of alcohol at bars and restaurants has increased 79%.Prices of Booze At Home and Away That increase of price is coupled with the fact that bars and restaurants are now starting to focus more on the sale on alcohol rather than the sale of food. This led to Americans in 2012 to spend an estimated 40% of their expenses at bars and restaurants on alcohol, in comparison to just 24% in 1982. 

So with Americans spending a majority of their money while eating out on something that is unhealthy, in bars and restaurants where the alcohol is getting more expensive, what happens if you want to escape this culture for a weekend or two but still want to attend a bar-esque atmosphere with your friends?

Well, that is where the phenomena of “Sober curious” or “Sober Sometimes” comes in. NPR did a piece on this new social club that is mostly made up of women in their 30s, and the NPR piece stated that one of the main reasons behind the women joining the club was due to the fact that they “have demanding jobs and simply do not want to feel foggy or hungover anymore.” 

These social clubs usually have bars dedicated to them where people can gather, eat, listen to music, and socialize all while consuming non-alcoholic beverages. This gives individuals a healthy alternative to going to bars that serve alcohol but still allowing them to enjoy all of the other aspects that comes with night life.


Source: Julia Robinson for NPR

But, the question begs itself, how effective could this new initiative be, especially in a climate where drinking and going out is seen as the norm?. Well, the first step would to be establish more bars that are strictly dedicated to serving non-alcoholic beverages to its patrons. But to be competitive, these bars need to still offer the same amenities and activities that bars that serve alcohol do which would be good music, good food, and good service. That accompanied with word of mouth of the atmosphere of the bar being just as fun, then the growth for these types of establishments is endless, and will slowly become culturally accepted. But, for the latter to happen, individuals must be educated on the harms of drinking and how even taking a small break, if you choose not to become completely sober, is still a healthier option, and non-alcoholic bars are the way to go. But, if the value is seen in these sober bars, then potentially investments can be made into these types of establishments that will make them bigger and better than ever, and will make these bars an excellent alternative to individuals that want to go out and socialize with friends but do not want to drink.