Martinez had never organized a campaign on social media and does not consider himself a social media expert. But after ARG won the $ 100,000 grant, she ran focus groups, coordinated an advisory group of cancer organizations, built a team of co-researchers, and collaborated with the ARG communications specialist. “The young women made it very clear that they did not want to be told what to do,” Martinez says of the focus groups. “‘Drink less for your breasts’ felt more like a helpful suggestion.”
The planning of the social media campaign began, just as the pandemic forced a national closure. As the pandemic dragged on, alcohol consumption increased, especially among women. Days of heavy drinking among women, defined as four or more drinks within a few hours, increased by 41 percent, according to a study by RAND Corporation. (The study compared a baseline study of 1,540 adults conducted in the spring of 2019 with their responses during a follow-up in the spring of 2020.)
But it is not easy to push back against alcohol consumption. As the United States found during a disastrous period of ban from 1920 to 1933, opposition to alcohol is not popular. When Sharima Rasanayagam, chief researcher at Breast Cancer Prevention Partners in San Francisco, gives a lecture on environmental causes of breast cancer, her audience is thrilled – until she mentions alcohol. “People like to drink and they don’t like to hear it,” she says. She tells them that the crowd matters: “Drink at least less.”
It is a message she delivers with care, to avoid giving women a reason for self-blame if they develop breast cancer and wonder “Why me?” Cases of breast cancer cannot be linked to alcohol alone because many factors, including genetics and environmental influences, contribute to the disease, she explains in a YouTube video linked to the Breast Cancer Prevention Partners website. But Rasanayagam notes that risks add up – and alcohol is one that women can reduce. Fewer drinks, whether over time or in one day, means less exposure to acetaldehyde and potentially less effect on estrogen. “It has been shown that the less you drink, the lower your risk,” she says. (Breast Cancer Prevention Partners are advisors on the Drink Less for Your Breasts campaign.)
It’s a nuanced message, but in its own way a bold one, as framed in a social media campaign, says David Jernigan, an alcohol policy expert at Boston University who has worked in the field for 35 years. “What Priscilla is doing in California is groundbreaking,” he says.
Jernigan argues that the harm from alcohol — which also includes drink-driving and an association with violence — justifies a large-scale response similar to the efforts against tobacco. He notes that in Estonia there is a campaign calling for “Let’s drink less by half!” actually lowered consumption per. per capita by 28 percent. (Estonia’s alcohol policy also included restrictions on advertising, more law enforcement under the influence of laws, higher taxes and a focus on treatment.)
The World Health Organization is also developing a global action plan; the current draft sets a goal of reducing consumption per per capita by 20 percent by 2030 (with the level of consumption in 2010 as the baseline). It calls on nations to develop and enforce “high-impact policy options,” such as higher alcohol taxes, restrictions on advertising, and stresses awareness of health risks.
Jernigan calls that effort a good move that does not go far enough. He is in favor of the development of an international treaty on alcohol, similar to the “Framework Convention on Tobacco Control”, the first such one negotiated through the World Health Organization. It has been signed by 168 countries that have pledged to take steps to curb tobacco advertising, raise cigarette taxes and prevent youth smoking.