Reducing Harm Through Evidence‐Based Alcohol Policies: Challenges and Options

Abstract

This article examines challenges in implementing and sustaining effective alcohol policies and proposes several strategies to counter them. A narrative review was undertaken of recent publications that document challenges in implementing alcohol policies in various contexts. MEDLINE/PubMed were searched for publications in English between 2011 and 2018. Twenty‐five keywords and 25 scholar names were used in the search. From 1,169 hits, 168 full research papers and commentaries were examined. Eight main groups of challenges were identified: interventions of inadequate dose, support, scope, or fidelity; confounding impacts from alcohol industries and other sectors; uneven implementation or inadequate enforcement; popular policies are largely ineffective and effective policies unpopular; policy decision‐making focusing on short‐range perspectives and skewed to favor commercial interests; low awareness of alcohol as a health risk; challenges in getting information on relevant interventions, local data, and insider information; and insufficient capacity or training to implement a policy. Several strategies are offered to counter these challenges: provide evidence to policymakers: conduct assessment and pilot studies; provide enhanced training on alcohol issues and policy implementation; develop allies; promote strong leadership; use media advocacy; engage voices of those impacted by flawed policies; and promote a comprehensive approach.

Strategies for engaging policy stakeholders to translate research knowledge into practice more effectively: Lessons learned from the Canadian Alcohol Policy Evaluation project

“…Relevant stakeholders were identified in ministries and departments representing health‐sector roles relevant to alcohol policy or roles involving the financial oversight, regulation or retail distribution of alcohol across the provinces and territories in Canada. As recommended elsewhere [3,12,13,16–18], alcohol industry representatives were not considered as valid policy stakeholders due to their inherent conflict of interest and thus were not included in the study. The survey questionnaire was designed to gather feedback on the 2013 Project reports and dissemination strategy and to get input on the design and dissemination strategy for the follow‐up evaluation, which was about to begin.…”

“…While there is growing scientific evidence demonstrating the effectiveness of these and other strategies for reducing alcohol harms, there are often challenges to not only adopting these policies, but also to their consistent and comprehensive implementation across governments [3,5,8–11]. The competing interests of powerful industry lobbyists can also threaten the already arduous policy process, especially if they secure a stakeholder seat at the policymaking table, as their motivations are often more aligned with economic gain than healthy public policy [10,12–18].…”

Generating political priority for alcohol policy reform: A framework to guide advocacy and research

“…While such research is helpful, no studies-to our knowledge-have reviewed the barriers and enablers of political priority for alcohol control policy. Two reviews have investigated barriers to alcohol policy implementation [12,13], but these did not consider factors that influence the adoption of alcohol policy in political agendas. Furthermore, as noted by Cullerton et al [14] in the context of nutrition, most research on the drivers of policymaking has been gleaned from the retrospective analysis of policy events.…”

Global Policy Considerations in the Health Context

“…Ovissi and Hagaman also presented their “Trauma Informed Educational Program for Teens as a Tool for Addiction Prevention” at the Policy Studies Organization's 11th Annual Dupont Summit in Washington, DC, where World Medical & Health Policy put on two panels. Giesbrect, Bosma, and Reisdorfer's “Reducing Harm Through Evidence‐Based Alcohol Policies: Challenges and Options” (2019), presented at the same Dupont Summit, was published in fall 2019.…”