The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland.

Changes to Scottish alcohol licensing ostensibly designed to enhance democratic engagement and promote public health, were as yet insufficient to change the system, or empower stakeholders, to fully achieve those goals.

SummaryObjectiveTo influence the planning of the 2014 Commonwealth Games such that the positive impacts are maximized and the negative impacts are mitigated.Study designParticipatory health impact assessment (HIA).MethodsA participatory HIA was performed using standard World Health Organization methods. A scoping event was held to involve decision makers in the process and to identify the key areas for consideration. A large community engagement exercise and a systematic review were conducted as part of the evidence-gathering phase. The results of the HIA were reported to the key decision makers involved in the Glasgow City Council legacy strategy.ResultsThe likely net health impact of hosting the Commonwealth Games was uncertain. It was suggested that the main mechanisms through which impacts were likely to be felt were: the economy; civic pride; engagement in decision making; the provision of new infrastructure; and participation in cultural events. A series of recommendations was produced in order to maximize positive health benefits and mitigate negative impacts.ConclusionsHIA is a useful tool for engaging communities and decision makers in the public health agenda. HIAs of major multi-sport events are limited by a lack of quality evidence and the inability to predict impacts reliably.