The effect of alcohol minimum unit pricing and cancer warning labels on cancer incidence and mortality in Canada: an epidemiological modelling study

Adam Sherk; Keegan W Lawrence; James M Clay; Erin Hobin; Tim Stockwell

doi:10.1016/S2468-2667(26)00006-X

The effect of alcohol minimum unit pricing and cancer warning labels on cancer incidence and mortality in Canada: an epidemiological modelling study

Lancet Public Health. 2026 Mar;11(3):e164-e175. doi: 10.1016/S2468-2667(26)00006-X.

Authors

Adam Sherk¹, Keegan W Lawrence², James M Clay³, Erin Hobin⁴, Tim Stockwell⁵

Affiliations

¹ Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada; Canadian Centre on Substance Use and Addiction, Ottawa, ON, Canada. Electronic address: asherk@uvic.ca.
² Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
³ Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; Department of Psychology, University of Victoria, Victoria, BC, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
⁴ Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁵ Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada; Department of Psychology, University of Victoria, Victoria, BC, Canada.

PMID: 41748236
DOI: 10.1016/S2468-2667(26)00006-X

Abstract

Background: Alcohol consumption increases cancer risk and is responsible for substantial cancer incidence and mortality. Alcohol policies have the potential to reduce cancer burden but remain under-implemented. Several Canadian jurisdictions are considering minimum unit pricing (MUP) and alcohol warning label (AWL) strategies. We aimed to assess the effect of these policies on cancer incidence and mortality in Canada.

Methods: We estimated baseline counts of alcohol-attributable cancer incident cases and mortalities in Canada, 2022, and modelled the effect of five alcohol policy scenarios comprised of MUP and AWLs. We used cancer registry and mortality data, representative alcohol use surveys, and product-level alcohol sales data. We used the International Model of Alcohol Harms and Policies to estimate alcohol-attributable burden at baseline and in each scenario. Scenarios tested were cancer warning labels (scenario 1); multi-message rotating labels, which consisted of a cancer warning label, a standard drink label, and a low-risk drinking guidelines label on a rotating basis (scenario 2); an MUP at CA$1·75 per standard drink (scenario 3); an MUP at $2·00 (scenario 4); and a combined scenario with a $2·00 at MUP and a cancer warning label (scenario 5).

Findings: Alcohol caused an estimated 9498 (95% uncertainty estimate 8950-10 049) cancer cases and 3866 (3624-4106) cancer deaths in Canada in 2022. All policy scenarios were estimated to reduce alcohol use and cancer burden, with stronger effects from more stringent interventions. For example, a $2·00 MUP with cancer labels was projected to reduce the number of incident cases of alcohol-attributable cancer by 674 (484-911; 7·1% [5·1-9·6]) and deaths by 216 (155-292; 5·6% [4·0-7·5]) when effects were fully realised. The largest proportional benefits were seen among lower-income populations and younger age groups.

Interpretation: Alcohol policies, particularly those combining pricing and labelling, could substantially reduce the cancer burden and health inequalities.

Funding: Canadian Institutes of Health Research.

MeSH terms

Adolescent
Adult
Aged
Alcohol Drinking* / adverse effects
Alcohol Drinking* / epidemiology
Alcoholic Beverages* / adverse effects
Alcoholic Beverages* / economics
Canada / epidemiology
Costs and Cost Analysis
Female
Humans
Incidence
Male
Middle Aged
Neoplasms* / epidemiology
Neoplasms* / mortality
Neoplasms* / prevention & control
Product Labeling*