Alcohol Policy and Adolescent Drinking: Using Science in the Public Interest

1. Alcohol Policy and Adolescent Drinking: Using Science in the Public Interest Why be an alcohol policy advocate? Module 1

2. Remembering Dr Evelyn Gillan Chief Executive of Alcohol Focus Scotland and co-founder of the Zero Tolerance Campaign 1959–2015

3. Alcohol – the problem

4. Alcohol – the problem • Globally 5th leading cause of ill health & premature death • Harm to individual health includes increased risk of cancer (liver, breast, mouth, larynx…), ischemic heart disease, liver cirrhosis, poisoning, mental health • Harm to society includes: violent crime, social disorder, domestic abuse, rape, suicide, accidents, homicides, RTAs… • Harm throughout the life course: exposure during pregnancy can impair brain development of fetus, adolescent exposure increases risk of dependence in later life • Major determinant of health inequalities and inhibitor of economic development • Places huge strain on public services and economy

5. Why has alcohol become such a problem? • Changing nature of alcohol industry – alcohol is a global commodity • Mass marketing and global brands • ‘Emerging markets’ targeted • Affordability • Availability • Change in social perceptions

6. Alcohol: No ordinary commodity

7. Seven policy areas for intervention • Alcohol taxes and other price controls • Regulate physical availability through restrictions on time, place, and density of alcohol outlets • Regulate alcohol advertising and other marketing • Alter the drinking context • Drink-driving countermeasures • Conduct screening and brief intervention in health care settings; increase availability of treatment programmes • Education and persuasion: provide information to adults and young people especially through mass media, workplace and school-based alcohol education programmes * WHO ‘best buys’, endorsed by OECD

8. There is no silver bullet… A comprehensive framework of policies is needed to effectively tackle alcohol harm

9. Effective alcohol policy must… • Have a strong evidence base • Cover a range of policy areas • Be supported by and understood by the public • Be culturally sensitive • Target the population as a whole and support at-risk individuals • Be based on public health interests • Be free from vested commercial interests

10. Barriers to effective alcohol policies

11. Barriers to effective alcohol policies • Evidence based policy versus political expediency • Increased taxes and restrictions on alcohol politically unpopular • Population level approaches seen as state interference • Political priorities and other distractions • Economic arguments and influence of drinks industry

12. Policy windows of opportunity • Policy change occurs when three streams of activity collide: • Problem Stream (evidence of need for action) • Policy Stream (evidence of effective solution) • Political Stream (political will to act) • Policy entrepreneurs can work to bring these streams together to create windows of opportunity for policy change • Policy entrepreneurs can come from a range of backgrounds, including public interest NGOs & industry bodies

13. Three Policy Streams

14. Alcohol industry activities • Estimated US $1 trillion global industry • Fund Social Aspect PR Organizations • Promote ‘drink responsibly’ messages - puts focus and responsibility for harm on the drinker, not the product • Promote ineffective measures and oppose effective measures – e.g. voluntary codes on advertising (‘self regulation’) • Active engagement in alcohol policy arena - lobbying, political donations, policy development (especially in emerging markets) • Engagement in research - publishing, funding, sponsoring conferences, discredit research into effective policies

15. Role of alcohol policy advocates • The alcohol control movement works to reduce the devastating impact of alcohol harm on individuals, families and communities around the world • The movement needs advocates who can engage with politicians, opinion formers and the general public to raise their awareness of the importance of protecting people – especially children and young people – from exposure to alcohol harms

16. What do we want – the objectives of alcohol control advocacy • Fewer lives cut short as a result of alcohol • Fewer people suffering ill health and disability due to alcohol • Fewer people negatively affected by other people’s drinking We want children and young people to grow up in a society which protects them from exposure to alcohol harms

17. Strategic advocacy goals • Evidence-informed, population approaches to alcohol policy and in particular, controls on price and availability. • A clear distinction to be made in the public policy process between organizations representing the public interest and those representing commercial vested interests. • Measures which protect children and young people from exposure to alcohol harms, including increased regulation of alcohol marketing and restrictions on alcohol sponsorship of sports events and events with youth appeal.

18. A successful advocacy strategy will seek to influence both decision-makers, opinion leaders and grassroots groups. • Decision-makers = the people who make the decisions about what kind of alcohol policies will be implemented at local, national or international level. • Opinion leaders = the people who influence the decision-makers. • Grassroots = Everyday citizens/residents who when joined into groups and coalitions can influence decision makers and opinion leaders

19. Summary: Why be an alcohol policy advocate? • Alcohol has enormous health and social costs, particularly for young people • Policies are available that can reduce these costs, but they are not used consistently due to barriers • Advocacy in the policy arena can make a difference between good policy and bad policy