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Alcohol Policy and Public Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (20 April 2020) | Viewed by 78671

Special Issue Editors


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Guest Editor
Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7505, South Africa; Department of Psychiatry, Stellenbosch University, Cape Town 7602, South Africa
Interests: alcohol and drug epidemiology; burden of disease and policy; alcohol use and HIV/TB treatment; and fetal alcohol spectrum disorders

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Guest Editor
UK Centre for Tobacco & Alcohol Studies, Institute for Social Marketing, University of Stirling, Stirling FK9 4LA, United Kingdom
Interests: alcohol policy evaluation (pricing, premises licensing, drink driving); conflicts of interest; framing in policy debates; alcohol in pregnancy

Special Issue Information

Dear Colleagues,

The Global Strategy to Reduce the Harmful Use of Alcohol was released by the WHO in 2010 with the expectation that it would encourage member states to more systematically institute evidence-based strategies to address alcohol problems. This strategy has had mixed success, with some now calling for stronger collective action at an international level, including implementation of a Framework Convention on Alcohol Control (FCAC). There has also been growing awareness of initiatives by the alcohol industry within countries, and more broadly through exploiting international trade agreements, to thwart effective national alcohol policy implementation. The purpose of this Special Issue is to be a platform for articles of relevance to stimulating effective action to promote and sustain alcohol policy reform at international, regional (e.g. the EU), national, and sub-national (e.g. provincial) levels. This Special Issue of IJERPH therefore welcomes submissions focusing on the relationship between alcohol policy and consumption, or alcohol policy and related harms, and on how to facilitate and achieve the formulation and implementation of evidence-informed policy changes at international/regional, national, and sub-national levels. Submissions may include a focus on activities that may impede or facilitate the formulation and implementation of promising alcohol policies, including working collaboratively with policy makers, improving advocacy strategies, and exposing and countering conflicts of interest and/or the actions of industry actors.

It also welcomes manuscripts that look at how to improve coherence across alcohol, tobacco, and nutrition policies in order to increase the likelihood of policy formulation and impact; how to better evaluate the effectiveness of single or multiple alcohol policies at country level; and how to measure the state of alcohol policy formulation and implementation at country level and changes over time. While the focus will be on empirical articles, articles with an editorial style or which propose methodological innovations will also be considered.

Prof. Dr. Charles D.H. Parry
Dr. Niamh Fitzgerald
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • alcohol control
  • alcohol policy
  • public health
  • alcohol industry
  • global strategy
  • indicators
  • policy evaluation
  • unhealthy commodities
  • framing
  • conflicts of interest

Published Papers (16 papers)

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Editorial

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7 pages, 299 KiB  
Editorial
Special Issue: Alcohol Policy and Public Health—Contributing to the Global Debate on Accelerating Action on Alcohol
by Charles D. H. Parry and Niamh Fitzgerald
Int. J. Environ. Res. Public Health 2020, 17(11), 3816; https://doi.org/10.3390/ijerph17113816 - 28 May 2020
Cited by 3 | Viewed by 2438
Abstract
In July 2018, under our guidance, IJERPH put out a call for papers to be considered for publication in a Special Issue on “Alcohol and Public Health” [...] Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)

Research

Jump to: Editorial, Other

12 pages, 671 KiB  
Article
Evaluation of Minimum Unit Pricing of Alcohol: A Mixed Method Natural Experiment in Scotland
by Clare Beeston, Mark Robinson, Lucie Giles, Elinor Dickie, Jane Ford, Megan MacPherson, Rachel McAdams, Ruth Mellor, Deborah Shipton and Neil Craig
Int. J. Environ. Res. Public Health 2020, 17(10), 3394; https://doi.org/10.3390/ijerph17103394 - 13 May 2020
Cited by 15 | Viewed by 5262
Abstract
In May 2018, Scotland became the first country in the world to implement minimum unit pricing (MUP) for all alcoholic drinks sold in licensed premises in Scotland. The use of a Sunset Clause in the MUP legislation was a factor in successfully resisting [...] Read more.
In May 2018, Scotland became the first country in the world to implement minimum unit pricing (MUP) for all alcoholic drinks sold in licensed premises in Scotland. The use of a Sunset Clause in the MUP legislation was a factor in successfully resisting legal challenges by indicating that the final decision on a novel policy would depend on its impact. An overarching evaluation has been designed and the results will provide important evidence to inform the parliamentary vote on the future of MUP in Scotland. The evaluation uses a mixed methods portfolio of in-house, commissioned, and separately funded studies to assess the impact of MUP across multiple intended and unintended outcomes related to compliance, the alcoholic drinks industry, consumption, and health and social harms. Quantitative studies to measure impact use a suitable control where feasible. Qualitative studies assess impact and provide an understanding of the lived experience and mechanism of change for key sub-groups. As well as providing important evidence to inform the parliamentary vote, adding to the international evidence on impact and experience of alcohol pricing policy across a broad range of outcomes, this approach to evaluating novel policy interventions may provide guidance for future policy innovations. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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18 pages, 2807 KiB  
Article
The Association between the Australian Alcopops Tax and National Chlamydia Rates among Young People—an Interrupted Time Series Analysis
by William Gilmore, Tanya Chikritzhs, Hamish McManus, John Kaldor and Rebecca Guy
Int. J. Environ. Res. Public Health 2020, 17(4), 1343; https://doi.org/10.3390/ijerph17041343 - 19 Feb 2020
Cited by 4 | Viewed by 2915
Abstract
A national tax increase, which became known as the “alcopops tax”, was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver [...] Read more.
A national tax increase, which became known as the “alcopops tax”, was introduced in Australia on the 27th April 2008 on ready-to-drink alcoholic beverages, which are consumed predominantly by young people. The affordability of alcohol has been identified as the strongest environmental driver of alcohol consumption, and alcohol consumption is a well-known risk factor in the spread of sexually transmitted infections via its association with sexual risk-taking. We conducted a study to investigate whether there was any association between the introduction of the tax and changes in national chlamydia rates: (i) notification rates (diagnoses per 100,000 population; primary outcome and standard approach in alcohol taxation studies), and (ii) test positivity rates (diagnoses per 100 tests; secondary outcome) among 15–24 and 25–34-year-olds, using interrupted time series analysis. Gender- and age-specific chlamydia trends among those 35 and older were applied as internal control series and gender- and age-specific consumer price index-adjusted per capita income trends were controlled for as independent variables. We hypothesised that the expected negative association between the tax and chlamydia notification rates might be masked due to increasing chlamydia test counts over the observation period (2000 to 2016). We hypothesised that the association between the tax and chlamydia test positivity rates would occur as an immediate level decrease, as a result of a decrease in alcohol consumption, which, in turn, would lead to a decrease in risky sexual behaviour and, hence, chlamydia transmission. None of the gender and age-specific population-based rates indicated a significant immediate or lagged association with the tax. However, we found an immediate decrease in test positivity rates for 25–34-year-old males (27% reduction—equivalent to 11,891 cases prevented post-tax) that remained detectable up to a lag of six months and a decrease at a lag of six months for 15–24-year-old males (31% reduction—equivalent to 16,615 cases prevented) following the tax. For no other gender or age combination did the change in test positivity rates reach significance. This study adds to the evidence base supporting the use of alcohol taxation to reduce health-related harms experienced by young people and offers a novel method for calculating sexually transmitted infection rates for policy evaluation. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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13 pages, 2120 KiB  
Article
Alcohol Outlet Density and Deprivation in Six Towns in Bergrivier Municipality before and after Legislative Restrictions
by Yasmin Bowers, Adlai Davids and Leslie London
Int. J. Environ. Res. Public Health 2020, 17(3), 697; https://doi.org/10.3390/ijerph17030697 - 21 Jan 2020
Cited by 3 | Viewed by 2982
Abstract
Introduction. In 2016, after the Western Cape Liquor Act was enacted, alcohol outlets were mapped in the six towns from a previous 2008 study to determine: (1) alcohol outlet density; (2) the association between deprivation and alcohol outlet density; (3) geospatial trends [...] Read more.
Introduction. In 2016, after the Western Cape Liquor Act was enacted, alcohol outlets were mapped in the six towns from a previous 2008 study to determine: (1) alcohol outlet density; (2) the association between deprivation and alcohol outlet density; (3) geospatial trends of alcohol outlet densities; and (4) the impact of alcohol legislation. Methods. Latitude and longitude coordinates were collected of legal and illegal alcohol outlets, and alcohol outlet density was calculated for legal, illegal and total alcohol outlets by km2 and per 1000 persons. To determine the impact of legislation, t-tests and hot spot analyses were calculated for both 2008 and 2016 studies. Spearman coefficients estimated the relationship between alcohol outlet density and deprivation. Results. Although not statistically significant, the number of alcohol outlets and the density per 1000 population declined by about 12% and 34%, respectively. Illegal outlets were still more likely to be located in more deprived areas, and legal outlets in less deprived areas; and a reduction or addition of a few outlets can change a town’s hot spot status. Conclusions. Further studies with larger sample sizes might help to clarify the impacts of the Liquor Act, and the more recent 2017 Alcohol-Related Harms Reduction Policy on alcohol outlet density in the province. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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16 pages, 1301 KiB  
Article
Improving Knowledge that Alcohol Can Cause Cancer is Associated with Consumer Support for Alcohol Policies: Findings from a Real-World Alcohol Labelling Study
by Ashini Weerasinghe, Nour Schoueri-Mychasiw, Kate Vallance, Tim Stockwell, David Hammond, Jonathan McGavock, Thomas K. Greenfield, Catherine Paradis and Erin Hobin
Int. J. Environ. Res. Public Health 2020, 17(2), 398; https://doi.org/10.3390/ijerph17020398 - 07 Jan 2020
Cited by 45 | Viewed by 10888
Abstract
Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol–cancer link and support for alcohol policies, this study examined whether increases [...] Read more.
Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol–cancer link and support for alcohol policies, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol polices. Cancer warning labels were applied to alcohol containers at the intervention site, and the comparison site did not apply cancer labels. Pre-post surveys were conducted among liquor store patrons at both sites before and two-and six-months after the intervention was stopped due to alcohol industry interference. Limiting the data to participants that completed surveys both before and two-months after the cancer label stopped, logistic regression was used to examine the association between increases in knowledge and support for policies. Support for pricing and availability policies was low overall; however, increases in individual-level knowledge of the alcohol-cancer link was associated with higher levels of support for pricing policies, specifically, setting a minimum unit price per standard drink of alcohol (OR = 1.86, 95% CI: 1.11–3.12). Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies. International Registered Report Identifier (IRRID): RR2-10.2196/16320 Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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17 pages, 1035 KiB  
Article
Implications of Cardioprotective Assumptions for National Drinking Guidelines and Alcohol Harm Monitoring Systems
by Adam Sherk, William Gilmore, Samuel Churchill, Eveline Lensvelt, Tim Stockwell and Tanya Chikritzhs
Int. J. Environ. Res. Public Health 2019, 16(24), 4956; https://doi.org/10.3390/ijerph16244956 - 06 Dec 2019
Cited by 8 | Viewed by 3812
Abstract
The existence and potential level of cardioprotection from alcohol use is contested in alcohol studies. Assumptions regarding the risk relationship between alcohol use and ischaemic heart disease (IHD) are critical when providing advice for national drinking guidelines and for designing alcohol harm monitoring [...] Read more.
The existence and potential level of cardioprotection from alcohol use is contested in alcohol studies. Assumptions regarding the risk relationship between alcohol use and ischaemic heart disease (IHD) are critical when providing advice for national drinking guidelines and for designing alcohol harm monitoring systems. We use three meta-analyses regarding alcohol use and IHD risk to investigate how varying assumptions lead to differential estimates of alcohol-attributable (AA) deaths and weighted relative risk (RR) functions, in Australia and Canada. Alcohol exposure and mortality data were acquired from administrative sources and AA fractions were calculated using the International Model of Alcohol Harms and Policies. We then customized a recent Global Burden of Disease (GBD) analysis to inform drinking guidelines internationally. Australians drink slightly more than Canadians, per person, but are also more likely to identify as lifetime abstainers. Cardioprotective scenarios resulted in substantial differences in estimates of net AA deaths in Australia (between 2933 and 4570) and Canada (between 5179 and 8024), using GBD risk functions for all other alcohol-related conditions. Country-specific weighted RR functions were analyzed to provide advice toward drinking guidelines: Minimum risk was achieved at or below alcohol use levels of 10 g/day ethanol, depending on scenario. Consumption levels resulting in ‘no added’ risk from drinking were found to be between 10 and 15 g/day, by country, gender, and scenario. These recommendations are lower than current guidelines in Australia, Canada, and some other high-income countries: These guidelines may be in need of downward revision. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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10 pages, 766 KiB  
Article
Effects of a Risk-Based Licensing Scheme on the Incidence of Alcohol-Related Assault in Queensland, Australia: A Quasi-Experimental Evaluation
by Smriti Nepal, Kypros Kypri, John Attia, Tiffany-Jane Evans, Tanya Chikritzhs and Peter Miller
Int. J. Environ. Res. Public Health 2019, 16(23), 4637; https://doi.org/10.3390/ijerph16234637 - 21 Nov 2019
Cited by 6 | Viewed by 2849
Abstract
Amid concerns about increasing alcohol-related violence in licensed premises, Queensland introduced a system of risk-based licensing (RBL) in 2009, the first of five Australian jurisdictions to do so. Under RBL, annual license fees are supposed to reflect the risk of harm associated with [...] Read more.
Amid concerns about increasing alcohol-related violence in licensed premises, Queensland introduced a system of risk-based licensing (RBL) in 2009, the first of five Australian jurisdictions to do so. Under RBL, annual license fees are supposed to reflect the risk of harm associated with the outlet’s trading hours and record of compliance with liquor laws. The objective is to improve service and management practices thereby reducing patron intoxication and related problems. Using police data, we defined cases as assaults that occurred during so-called ‘high-alcohol hours’, and compared a pre-intervention period of 2004–2008 with the post-intervention period 2009–2014. We employed segmented linear regression, adjusting for year and time of assault (high vs. low alcohol hours), to model the incidence of (1) all assaults and (2) a subset that police indicated were related to drinking in licensed premises. We found a small decrease in all assaults (β = −5 per 100,000 persons/year; 95% CI: 2, 9) but no significant change in the incidence of assault attributed to drinking in licensed premises (β = −8; 95% CI: −18, 2). Accordingly, we concluded that the results do not support a hypothesis that RBL is effective in the prevention of harm from licensed premises. There may be value in trialing regulatory schemes with meaningful contingencies for non-compliance, and, in the meantime, implementing demonstrably effective strategies, such as trading hour restrictions, if the aim is to reduce alcohol-related violence. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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10 pages, 322 KiB  
Article
Help or Hindrance? The Alcohol Industry and Alcohol Control in Portugal
by Maria Margarida Paixão and Mélissa Mialon
Int. J. Environ. Res. Public Health 2019, 16(22), 4554; https://doi.org/10.3390/ijerph16224554 - 18 Nov 2019
Cited by 9 | Viewed by 3954
Abstract
The influence of the alcohol industry, also known as “corporate political activity” (CPA), is documented as one of the main barriers in implementing effective alcohol control policies. In Portugal, despite an alcohol consumption above the European average, alcohol control does not feature in [...] Read more.
The influence of the alcohol industry, also known as “corporate political activity” (CPA), is documented as one of the main barriers in implementing effective alcohol control policies. In Portugal, despite an alcohol consumption above the European average, alcohol control does not feature in the current National Health Plan. The present research aimed to identify and describe the CPA of the alcohol industry in Portugal. Publicly-available data published between January 2018 and April 2019 was extracted from the main websites and social media accounts of alcohol industry trade associations, charities funded by the industry, government, and media. A “Policy Dystopia” framework, used to describe the CPA strategies of the tobacco industry, was adapted and used to perform a qualitative thematic analysis. Both instrumental and discursive strategies were found. The industry works in partnership with health authorities, belonging to the national task force responsible for planning alcohol control policies. Additionally, it emphasizes the role alcohol plays in Portuguese culture as a way to disregard evidence on control policies from other countries. This paper presents the first description of CPA by the alcohol industry in Portugal and provides evidence for the adoption of stricter control policies in the country. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
10 pages, 742 KiB  
Article
The Impact of Liquor Restrictions on Serious Assaults across Queensland, Australia
by Nicholas Taylor, Kerri Coomber, Richelle Mayshak, Renee Zahnow, Jason Ferris and Peter Miller
Int. J. Environ. Res. Public Health 2019, 16(22), 4362; https://doi.org/10.3390/ijerph16224362 - 08 Nov 2019
Cited by 9 | Viewed by 3543
Abstract
Aims: This study aimed to explore the relationship between a 00:00 liquor restriction, introduced on 1 July 2016, and alcohol-related harm by examining its impact on serious assault numbers during high-alcohol hours (20:00–6:00 Friday and Saturday night), from 1 January 2009 to [...] Read more.
Aims: This study aimed to explore the relationship between a 00:00 liquor restriction, introduced on 1 July 2016, and alcohol-related harm by examining its impact on serious assault numbers during high-alcohol hours (20:00–6:00 Friday and Saturday night), from 1 January 2009 to 30 June 2018. Methods: Two types of locations only impacted by the liquor restriction were identified: designated safe night precincts (SNPs) and other local government areas (LGAs). A times series autoregressive integrated moving average analysis was used to estimate the influence of liquor restrictions on police-recorded serious assaults in the two years following the policy introduction, for SNPs and LGAs separately. Results: Contrarily to our predictions, monthly police-recorded serious assaults did not significantly change within SNPs or LGAs following the introduction of liquor restrictions. Conclusion: The implementation of the Queensland liquor restriction did not result in a clear, unique reduction in serious assault trends. Further investigation should consider the impact of liquor restrictions in conjunction with other policy changes as public perception of restrictions and their cumulative impact may produce varied outcomes. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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17 pages, 332 KiB  
Article
Recruiting the “Heavy-Using Loyalists of Tomorrow”: An Analysis of the Aims, Effects and Mechanisms of Alcohol Advertising, Based on Advertising Industry Evaluations
by Nason Maani Hessari, Adam Bertscher, Nathan Critchlow, Niamh Fitzgerald, Cécile Knai, Martine Stead and Mark Petticrew
Int. J. Environ. Res. Public Health 2019, 16(21), 4092; https://doi.org/10.3390/ijerph16214092 - 24 Oct 2019
Cited by 27 | Viewed by 7705
Abstract
Restricting alcohol advertising and marketing is a cost-effective intervention for reducing alcohol harms. However, the alcohol industry maintains that advertising does not affect consumption, claiming that its purpose is to help consumers choose brands, it is not aimed at young people, it only [...] Read more.
Restricting alcohol advertising and marketing is a cost-effective intervention for reducing alcohol harms. However, the alcohol industry maintains that advertising does not affect consumption, claiming that its purpose is to help consumers choose brands, it is not aimed at young people, it only promotes “responsible consumption”, and any relationships with consumption are not causal. We reviewed 39 case studies (1981–2016) published by the advertising industry, which evaluate the effects of alcohol advertising campaigns. We used these to examine these industry claims. 30/39 (77%) of the case studies mentioned increasing/maintaining market share as an objective, or used this to assess the effectiveness of advertising campaigns. Most (25/39, 64%) found that campaigns increased consumption-related outcomes. Some campaigns targeted women, and heavy drinkers (e.g., Stella Artois lager, Famous Grouse whisky). Campaigns often (13/39, 33%) targeted younger drinkers. These data show that advertising does influence market share. Other effects reported in the case studies include changing the consumer profile towards: younger drinkers, women, new/lapsed drinkers, and heavy drinkers. They also present evidence of a causal relationship between advertising and consumption. In conclusion, this analysis, based on industry data, presents significant new evidence on (i) the effects of alcohol advertising on consumption-related outcomes, and (ii) the mechanisms by which it achieves those effects. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
17 pages, 330 KiB  
Article
“Everyone Has the Right to Drink Beer”: A Stakeholder Analysis of Challenges to Youth Alcohol Harm-Reduction Policies in Lebanon
by Rima T Nakkash, Lilian A Ghandour, Nasser Yassin, Sirine Anouti, Ali Chalak, Sara Chehab, Aida El-Aily and Rima A Afifi
Int. J. Environ. Res. Public Health 2019, 16(16), 2874; https://doi.org/10.3390/ijerph16162874 - 12 Aug 2019
Cited by 3 | Viewed by 4422
Abstract
Background: Alcohol use is a major risk factor in premature death and disability, especially among youth. Evidence-based policies to prevent and control the detrimental effect of alcohol use have been recommended. In countries with weak alcohol control policies—such as Lebanon, stakeholder analysis provides [...] Read more.
Background: Alcohol use is a major risk factor in premature death and disability, especially among youth. Evidence-based policies to prevent and control the detrimental effect of alcohol use have been recommended. In countries with weak alcohol control policies—such as Lebanon, stakeholder analysis provides critical information to influence policy interventions. This paper assesses the views of stakeholders regarding a national alcohol harm reduction policy for youth. Methods: We interviewed a total of 22 key stakeholders over a period of 8 months in 2015. Stakeholders were selected purposively, to include representatives of governmental and non-governmental organizations and industry that could answer questions related to core intervention areas: affordability, availability, regulation of marketing, and drinking and driving. We analyzed interview transcripts using thematic analysis. Results: Three themes emerged: Inadequacy of current alcohol control policies; weak governance and disregard for rule of law as a determinant of the status quo; and diverting of responsibility towards ‘other’ stakeholders. In addition, industry representatives argued against evidence-based policies using time-worn strategies identified globally. Conclusions: Our findings indicate that alcohol harm reduction policies are far from becoming a policy priority in Lebanon. There is a clear need to shift the narrative from victim blaming to structural conditions. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
21 pages, 322 KiB  
Article
Local Alcohol Policy Implementation in Scotland: Understanding the Role of Accountability within Licensing
by Alex Wright
Int. J. Environ. Res. Public Health 2019, 16(11), 1880; https://doi.org/10.3390/ijerph16111880 - 28 May 2019
Cited by 8 | Viewed by 3578
Abstract
Scotland has been ambitious in its policy and legislative efforts to tackle alcohol-related harm, efforts which include the innovative feature of a ‘public health objective’ within local alcohol licensing. However, the persistence of alcohol-related harms and inequalities requires further examination of both the [...] Read more.
Scotland has been ambitious in its policy and legislative efforts to tackle alcohol-related harm, efforts which include the innovative feature of a ‘public health objective’ within local alcohol licensing. However, the persistence of alcohol-related harms and inequalities requires further examination of both the overarching Scottish alcohol strategy and its specific implementation. A qualitative case study was undertaken to explore how alcohol policy is implemented locally in Scotland, with data generated from (i) documentary analysis of 12 relevant policies, legislation, and guidance documents; and (ii) a thematic analysis of semi-structured interviews with 54 alcohol policy implementers in three Scottish localities and nine national-level stakeholders. The data suggest there is a tension between the intentions of licensing legislation and the way it is enacted in practice, and that accountability emerges as an important factor for understanding why this occurs. In particular, there are a lack of accountability mechanisms acting upon Scottish Licensing Boards to ensure they contribute to the public health goals of the Scottish alcohol strategy. From a public health perspective, this has perpetuated a system in which Licensing Boards continue to act with autonomy from the rest of the alcohol policy implementation system, creating a challenge to the achievement of public health goals. Alcohol policy in Scotland is likely to fall short of intended goals as long as the tension between licensing legislation and enacted licensing practices remains. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
18 pages, 1162 KiB  
Article
Deterring Drunk Driving: Why Some States Go Further Than Others in Policy Innovation
by Suk Joon Hwang and Frances Berry
Int. J. Environ. Res. Public Health 2019, 16(10), 1749; https://doi.org/10.3390/ijerph16101749 - 17 May 2019
Cited by 2 | Viewed by 4249
Abstract
Policy innovation and diffusion studies have, since 1990, generally focused on a specific policy over time. Yet, few studies have considered if and why states adopt related multiple policies—a package of reforms—in a policy area. Are more innovative states in DUI policy likely [...] Read more.
Policy innovation and diffusion studies have, since 1990, generally focused on a specific policy over time. Yet, few studies have considered if and why states adopt related multiple policies—a package of reforms—in a policy area. Are more innovative states in DUI policy likely to adopt a comprehensive set of policies or use them as substitutes for each other? In this study, we assess how overall state innovativeness relates to the adoption of sixteen DUI (Driving Under the Influence) laws. We find that state innovativeness in traffic safety policies (but not overall policy innovativeness), organizational size, and professionalism of a state highway department increase the likelihood that a state will adopt a more comprehensive bundle of DUI laws. Furthermore, we also test whether institutional or competitive bandwagon effects are found across this policy area and demonstrate that national institutional bandwagon effects are an important factor related to the increased comprehensiveness of state adoption of DUI policies. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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12 pages, 303 KiB  
Article
Alcohol Industry CSR Organisations: What Can Their Twitter Activity Tell Us about Their Independence and Their Priorities? A Comparative Analysis
by Nason Maani Hessari, May CI van Schalkwyk, Sian Thomas and Mark Petticrew
Int. J. Environ. Res. Public Health 2019, 16(5), 892; https://doi.org/10.3390/ijerph16050892 - 12 Mar 2019
Cited by 35 | Viewed by 9713
Abstract
There are concerns about the accuracy of the health information provided by alcohol industry (AI)-funded organisations and about their independence. We conducted a content analysis of the health information disseminated by AI-funded organisations through Twitter, compared with non-AI-funded charities, to assess whether their [...] Read more.
There are concerns about the accuracy of the health information provided by alcohol industry (AI)-funded organisations and about their independence. We conducted a content analysis of the health information disseminated by AI-funded organisations through Twitter, compared with non-AI-funded charities, to assess whether their messages align with industry and/or public health objectives. We compared all tweets from 2016 from Drinkaware (UK); Drinkaware.ie (Ireland); and DrinkWise (Australia), to non-AI-funded charities Alcohol Concern (UK), Alcohol Action Ireland, and FARE (Australia). Industry-funded bodies were significantly less likely to tweet about alcohol marketing, advertising and sponsorship; alcohol pricing; and physical health harms, including cancers, heart disease and pregnancy. They were significantly more likely to tweet about behavioural aspects of drinking and less likely to mention cancer risk; particularly breast cancer. These findings are consistent with previous evidence that the purpose of such bodies is the protection of the alcohol market, and of the alcohol industry’s reputation. Their messaging strongly aligns with AI corporate social responsibility goals. The focus away from health harms, particularly cancer, is also consistent with previous evidence. The evidence does not support claims by these alcohol-industry-funded bodies about their independence from industry. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
14 pages, 1842 KiB  
Article
The Public Health Responsibility Deal: Using a Systems-Level Analysis to Understand the Lack of Impact on Alcohol, Food, Physical Activity, and Workplace Health Sub-Systems
by Cécile Knai, Mark Petticrew, Nick Douglas, Mary Alison Durand, Elizabeth Eastmure, Ellen Nolte and Nicholas Mays
Int. J. Environ. Res. Public Health 2018, 15(12), 2895; https://doi.org/10.3390/ijerph15122895 - 17 Dec 2018
Cited by 47 | Viewed by 6854
Abstract
The extent to which government should partner with business interests such as the alcohol, food, and other industries in order to improve public health is a subject of ongoing debate. A common approach involves developing voluntary agreements with industry or allowing them to [...] Read more.
The extent to which government should partner with business interests such as the alcohol, food, and other industries in order to improve public health is a subject of ongoing debate. A common approach involves developing voluntary agreements with industry or allowing them to self-regulate. In England, the most recent example of this was the Public Health Responsibility Deal (RD), a public–private partnership launched in 2011 under the then Conservative-led coalition government. The RD was organised around a series of voluntary agreements that aim to bring together government, academic experts, and commercial, public sector and voluntary organisations to commit to pledges to undertake actions of public health benefit. This paper brings together the main findings and implications of the evaluation of the RD using a systems approach. We analysed the functioning of the RD exploring the causal pathways involved and how they helped or hindered the RD; the structures and processes; feedback loops and how they might have constrained or potentiated the effects of the RD; and how resilient the wider systems were to change (i.e., the alcohol, food, and other systems interacted with). Both the production and uptake of pledges by RD partners were largely driven by the interests of partners themselves, enabling these wider systems to resist change. This analysis demonstrates how and why the RD did not meet its objectives. The findings have lessons for the development of effective alcohol, food and other policies, for defining the role of unhealthy commodity industries, and for understanding the limits of industry self-regulation as a public health measure. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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Other

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8 pages, 287 KiB  
Brief Report
Alcohol Harms over a Period of Alcohol Policy Reform: Surveys of New Zealand College Residents in 2004 and 2014
by Kypros Kypri, Brett Maclennan and Jennie Connor
Int. J. Environ. Res. Public Health 2020, 17(3), 836; https://doi.org/10.3390/ijerph17030836 - 29 Jan 2020
Cited by 4 | Viewed by 2287
Abstract
Background: We estimated the change in the prevalence of harms attributed by students to their drinking and to others’ drinking, over a decade of concerted effort by university authorities to reduce antisocial behaviour and improve student safety. Interventions included a security and liaison [...] Read more.
Background: We estimated the change in the prevalence of harms attributed by students to their drinking and to others’ drinking, over a decade of concerted effort by university authorities to reduce antisocial behaviour and improve student safety. Interventions included a security and liaison service, a stricter code of conduct, challenges to liquor license applications near campus, and a ban on alcohol advertising. Methods: We used a pre-post design adjusting for population changes. We invited all students residing in colleges of a New Zealand University to complete web surveys in 2004 and 2014, using identical methods. We estimated change in the 4-week prevalence of 15 problems and harms among drinkers, and nine harms from others’ drinking among all respondents. We adjusted for differences in sample sociodemographic characteristics between surveys. Results: Among drinkers there were reductions in several harms, the largest being in acts of vandalism (7.1% to 2.7%), theft (11% to 4.5%), and physical aggression (10% to 5.3%). Among all respondents (including non-drinkers), there were reductions in unwanted sexual advances (14% to 8.9%) and being the victim of sexual assault (1.0% to 0.4%). Conclusion: Alcohol-related harm, including the most serious outcomes, decreased substantially among college residents in this period of alcohol policy reform. In conjunction with evidence of reduced drinking to intoxication in this population, the findings suggest that strategies to reduce the availability and promotion of alcohol on and near campus can substantially reduce the incidence of health and social harms. Full article
(This article belongs to the Special Issue Alcohol Policy and Public Health)
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