1. Module 5- The Policy Arena
Part One- Alcohol Policy and Public Health
Module 5- The Policy Arena
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2. Learning Objectives
Upon completion of this module you will be able to:
Define alcohol policy and who is responsible for its making
Describe alcohol policy areas
Upon completion of this module you will be able to: define alcohol policy and who is responsible for its making as well as describe the various alcohol policy areas.
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3. Alcohol Policy
Governmental or non-governmental efforts to minimize or prevent alcohol-related problems
Implementation of a specific strategy
Allocation of resources to prevention or treatment
Examples: taxation and pricing, regulating the physical availability of alcohol, marketing restrictions, drink-driving countermeasures
Alcohol policy is broadly defined as any purposeful effort or authoritative decision on the part of governments to minimize or prevent alcohol-related consequences. Policies may implement a specific strategy with regard to alcohol problems (e.g., increase alcohol taxes or controls on drinking and driving) or allocate resources toward prevention or treatment services. Examples of alcohol policies considered in subsequent modules of this course are: taxation and pricing, regulating the physical availability of alcohol, marketing restrictions, drink-driving countermeasures, school-based prevention programs and treatment and early intervention services.
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4. The International Context of Alcohol Policy cont.
International trade agreements, common markets, industry self-regulation  weakening of alcohol policies
In the developing countries of Asia, Africa and Latin America, the brewing industry has made major investments in local and regional production
Alcohol industry targeting young people with large-scale marketing campaigns
Factors behind the weakening of national and local alcohol policies have been the impact of international trade agreements and common markets, and the promotion of industry self-regulation. In the developing countries of Asia, Africa and Latin America, the brewing industry has made major investments in local and regional production, and has begun to target young people with large-scale marketing campaigns, as adolescents represent a gold mine of current and future profits. Alcohol industries allocate significant resources to research consumers’ preferences, developing new products that appeal young people and promote then on an international level.
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5. The Policy Arena
Alcohol policy is the product of competing interests, values and ideologies
The process of alcohol policy creation needs to be better understood, more transparent, and more responsive to the needs of citizens
Alcohol policy is made and implemented at the local, national and international levels. It is often the product of competing interests, values, and ideologies. The major constituency groups and stakeholders involved in the policymaking process are government, Nongovernmental organizations, public health professionals, alcohol scientists, the public, and the alcohol industry. While there is now a growing scientific basis to support alcohol policy initiatives, much less is understood about the way in which governments, interest groups and communities operate within the policy arena to apply this information in the interests of public health. The process of alcohol policy creation needs to be better understood, more transparent, and more responsive to the needs of the citizens who are the end consumers of emerging policies.
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6. Alcohol Policy and Public Health
Alcohol is a major determinant of ill health
Alcohol policies serve the interests of public health through their impact on:
Per capita alcohol consumption
Drinking patterns
The drinking environment
The health services available to treat problem drinkers
By locating alcohol policy within the realm of public health and social policy, and integrating evidence-based knowledge from other fields, this virtual course draws attention to the growing tendency for governments, both national and local, to approach alcohol as a major determinant of ill health. The pursuit of health as one of modern society’s most highly cherished values accounts for the growing interest in alcohol policy. But it also creates a special challenge because public health often competes with other social values such as free trade, open markets, and neoliberal consumerism. Alcohol policies serve the interests of public health through their impact on per capita consumption, drinking patterns, the drinking environment, the provision of tools for informed choices and the health services available to assist problem drinkers. In relation to alcohol policy there is an imbalance between the resources of the commercial sector and that of both government and NGOs.
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7. Public Health Policy A public health approach provides:
An important vehicle to manage the health of populations in relation to the use and misuse of beverage alcohol
Help to communities and nation-states in designing better preventative and curative services
Public health concepts provide an important vehicle to manage the health of populations in relation to the use and misuse of beverage alcohol and towards healthier relationships with alcohol. Public health concepts can help communities and nation states design better preventative and curative services.
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8. Who makes alcohol policy?
Federal and national law-makers
Non-governmental organizations
Health professionals
Mass media
Alcoholic beverage industry and related groups involved in for-profit production and sales
Federal and national laws often establish the legislative framework pertaining to alcohol. In many nations non-governmental organizations represent the public interest. Alcohol issues have increasingly become the concern of health professionals. The mass media can have a significant influence on the policy debate. The alcoholic beverage industry and related groups involved in for-profit production and sales are often key players. Note – The alcohol industry should not be involved in making alcohol policies, especially should not in educational programs, as such involvement could actually lead to an increase in harm. (Anderson P. School for Public Health and Primary care, Maastricht University, Maastrich, The Netherlands)
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9. Role of NGOs and Civil Society
Advocate for policy changes
Provide a “human face” to public health problems related to alcohol
Contribute to policy-making
Support and advocate for sometimes unpopular policies
Accountability for government actions
In the current global environment there has been a major growth in NGOs; there are now 30,000 world-wide operating internationally. The largest number of (well-coordinated) NGOs is focused on tobacco (the Alliance on Tobacco Control). At a time of relative increase in front organizations funded by the alcohol producers, the lack of resources for national and international alcohol-specific NGOs is a major concern. Citizens must participate in the design, implementation and evaluation of new public policies that determine their own health and social conditions. Governments consider that civil society participation is not only an issue of rights and equity, but also the best way to face the challenge of promoting the efficient use of resources invested in public policy. It is not possible to design an effective alcohol public policy, neither fair nor efficient, nor of quality and satisfaction, if there is not a strong participation of civil society.
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10. Role of Health Professionals
Essential partners for health
Leadership
Provide a credible, independent voice
Expertise and advocacy for public health
Counterbalance to commercial interests
Mobilizing society
Informational systems to monitor alcohol consumption
Create networks
Health professionals are essential partners for a public health approach to alcohol policies. They provide leadership and a credible, independent voice in the policymaking process. They have the expertise to advocate for public health measures, which and serve to counterbalance commercial interests. Health professionals and other professional groups have an important role to play in mobilizing society to protect the public interest. They can do this by learning more about effective alcohol policies, developing information systems to monitor alcohol consumption, and by creating networks of key constituency groups committed to the reduction of alcohol-related harm.
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11. The International Context of Alcohol Policy
National and local alcohol policies under international pressure
Gradual decline in alcohol control in most jurisdictions in recent decades
Alcohol taxes not used to their full potential
In many developed countries, general alcohol policies affecting the whole population have been weakened or dismantled
National and local alcohol policies have increasingly come under pressure at the international level. There has been a gradual decline in alcohol control in most jurisdictions in recent decades, with changes such as privatization of alcohol retail sales. Alcohol taxes have not been used to their full potential: in some countries they have not been raised to match inflation; in others they have been used ineffectively (raising for liquors but not beer, e.g.) or not used at all in others. The collapse of the communist system in the former Soviet Union and Eastern Europe has meant that the control of alcohol availability has lost much of its effect in these countries. In many developed countries, general alcohol policies affecting the whole population have been weakened or dismantled, often under pressure from international development agencies. Factors behind the weakening of national and local alcohol policies have been the impact of international trade agreements and common markets, and the promotion of industry self-regulation.
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12. From Science to Action
Focus on a vulnerable population: youth, pregnant women, children of alcoholics
Or a high-risk group: drink drivers
Pick a popular topic: preventing HIV/AIDS, fetal alcohol effects, drink driving, binge drinking by youth
Collect statistics, demonstrate need, advance targeted alcohol policies
Neutralize alcohol industry with counter-arguments
The lessons learned from a variety of different countries indicate that effective alcohol policies are most likely to be implemented when they focus on an identifiable group that may be particularly vulnerable to alcohol’s effects, such as young people or pregnant women, or on a dangerous group such as drunk drivers. Some of the most popular topics for advancing alcohol policies are preventing HIV/AIDS, fetal alcohol effects, drink driving, binge drinking by youth. The most effective way to change alcohol policy is to collect statistics, demonstrate need, and advance targeted alcohol policies that are supported by scientific evidence. Another important role of public health policy advocates is to neutralize the influence of the alcohol industry with counter-arguments based on scientific evidence and public health needs.
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13. Strategies and Interventions Reviewed and Evaluated
Pricing and Taxation
Regulating Physical Availability
Altering the Drinking Context
Education and Persuasion
Regulating Alcohol Promotion
Drinking-Driving Countermeasures
Treatment and Early Intervention
Alcohol’s burden is highly avoidable. Cost-effective approaches can reduce the health and social burden caused by alcohol. The policies, strategies, and interventions discussed in the next six modules cover the most currently favoured policy options where there is a related research base capable of review based on a comprehensive review of the literature and published in the book Alcohol: No Ordinary Commodity. Module 6 covers policies aimed at changing the affordability of alcohol through price controls and taxation. Module 7 examines policies aimed at changing the physical availability of alcohol. Modules 8 and 9 address a broad range of strategies aimed at preventing or minimising important alcohol-related harms and consequences. Module 10 examines the evidence on impact of marketing and current approaches to regulating alcohol promotion, and Module 11 evaluates education and persuasion approaches to primary prevention. Both of these modules cover strategies that generally try to influence individual perceptions about alcohol. Finally, Module 12 discusses from a public health perspective the effectiveness of treatment programs and early interventions designed to prevent the progression of alcohol problems.
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14. REFLECTION Describe the policy arena in your country:
Who are the main players?
What are the key concerns?
What are the challenges and opportunities for a new alcohol policy in your country?
Why?
Describe the policy arena in your country: who are the main players? What are the key concerns? What are the challenges and opportunities for a new alcohol policy in your country? Why?
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