“Everyone Has the Right to Drink Beer”: A Stakeholder Analysis of Challenges to Youth Alcohol Harm-Reduction Policies in Lebanon

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 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.

Special Issue: Alcohol Policy and Public Health—Contributing to the Global Debate on Accelerating Action on Alcohol

“…For example, Knai et al [9] found that both the production and uptake of responsibility pledges by responsibility deal partners in the UK, including organisations with commercial interests, were largely driven by the interests of partners themselves, and this made it possible for them to resist change. A somewhat similar finding emerged in a study conducted in Lebanon [13], where it was noted that industry representatives argued against evidence-based policies in reducing alcohol harm experienced by youth. A study by Hessari and colleagues [10] found that alcohol industry funded organisations were significantly more likely to tweet about behavioural aspects of drinking and less likely to mention (breast) cancer risk [10].…”

“…The articles clearly illustrate that addressing alcohol-related harms involves multi-level governance including organizational, local, state/provincial, and national levels. Despite rising levels of consumption in LMICs, most of the papers (12/15) focused on high income countries, with just one each from Lebanon [13] and South Africa [20]. The most common methodology used in the studies published in this Special Issue was qualitative case studies, followed by pre-post designs ( Table 1).…”

“…The five papers which included a focus on alcohol and advertising industry practices [9,10,13,14,16] add to a growing evidence base about such practices. For example, Knai et al [9] found that both the production and uptake of responsibility pledges by responsibility deal partners in the UK, including organisations with commercial interests, were largely driven by the interests of partners themselves, and this made it possible for them to resist change.…”

Alcohol use, alcohol use disorder and heavy episodic drinking in the Eastern Mediterranean region: A systematic review

“…A significantly higher prevalence of alcohol use was estimated in the adult as well as the young general population of West Asia. The high prevalence in West Asia is mainly reflecting the high estimate of alcohol use in Lebanon, which has the highest proportion of non‐Muslims and a lax policy regarding alcohol use compared to the rest of the region [28–30]. Insufficient studies were available for the East Africa and Gulf subregions.…”

Pharmaceutical subsidy policy in Iran: a qualitative stakeholder analysis

“…Accordingly, to achieve a transparent and evidence-based approach for decision-making, it is necessary to thoroughly evaluate and investigate various factors that affect the adoption and implementation of the foreign currency subsidy policy. In this regard, stakeholder analysis is a key tool for assessing multiple issues [ 48 – 50 ].…”