The alcohol marketing policy environment and adolescent drinking in Sri Lanka: A qualitative exploration of stakeholder perspectives

Abstract

Adolescents continue to be exposed to alcohol marketing, despite the existence of alcohol control policies in Sri Lanka. National‐level policies restrict all forms of alcohol advertising, promotions, and sponsorship and sale to minors. The act calls for the need to protect children and adolescents from exposure to the harm of alcohol. This article investigates stakeholders' perceptions of the alcohol marketing policy environment in Sri Lanka, with a specific focus on policies designed to prevent or curtail adolescent drinking. Between May and July 2019, in‐depth interviews were conducted with policy stakeholders in Colombo, Sri Lanka. Thematic analysis was conducted on the audio‐recorded interviews that were transcribed and translated and imported to NVivo12. Fifteen policy stakeholders from government and nongovernment organizations participated in this study. The overarching theme identified a lukewarm alcohol marketing policy environment. This situation was facilitated by the alcohol industry acting as the vector, an amber light approach towards public health programs, and other factors contributing to the perceived ineffectiveness of the alcohol marketing policy environment. A unified public health approach supported by policy and political commitment may pave the way for better alcohol control in Sri Lanka.

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

“…Five key barriers to national policymaking included industry influence, such as through lobbying, marketing and corporate responsibility programs [6–8, 12, 15–17, 33, 34, 39–48, 50, 51, 53, 56, 58–61, 63, 65, 68–75], structural barriers to public health advocacy [6, 7, 15, 34, 41–43, 45, 48, 51, 53, 55, 56, 58, 60, 61, 63, 72–74], limited advocate capacity [16, 39, 41, 50, 51, 68, 70, 76], contested framing [15, 17, 33, 34, 37, 41, 43, 49, 55, 60, 63, 66, 68–70, 74–76] and lack of political leadership [12, 15, 40, 41, 51, 56, 61].…”

“…Seven national‐level strategies to generate political priority were identified: exclude industry from public health policy processes [15, 17, 48, 58, 60, 73], secure a group to lead advocacy efforts, ideally with independent, sustainable funding [6, 41, 50, 60, 68], develop a clear, unified solution [8, 12, 15, 41, 42, 51, 55, 69, 75], develop the skills of a policy entrepreneur [6, 8, 12, 15, 37, 42, 55–57, 60, 62], build wide coalitions [8, 12, 15, 41–43, 54, 57, 59, 60, 63], secure a political champion [8, 12, 15, 42, 54–56, 69, 75] and amplify the frame [8, 12, 15, 41–43, 45, 55, 56].…”

“…Three local‐level barriers included: normalisation of alcohol and positive perceptions of industry [12, 15–17, 34, 42, 65, 75, 80], lack of public voice [12, 15, 16, 39, 64] and structural barriers to public participation (e.g., policy working groups that hinder meaningful civil society engagement) [39, 61, 64].…”

Incidence and Patterns of Liver Cancers in Sri Lanka from 2001 to 2010: Analysis of National Cancer Registry Data

“…20 On the other hand, a decreasing trend in the prevalence of smoking is observed in Sri Lanka since the late 1970s. 21 Therefore, the role of smoking and alcohol in the incidence of HCC is not clear. Other risk factors such as exposure to dietary aflatoxin are unlikely to be important factors in the etiology of liver cancer in Sri Lanka.…”