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2.
BMJ Glob Health ; 8(Suppl 8)2023 10.
Article in English | MEDLINE | ID: mdl-37813444

ABSTRACT

INTRODUCTION: One of the WHO's 'best buys' in controlling non-communicable diseases and their risk factors is to impose health taxes. While the Indonesian political process inhibits the implementation of health tax policy, studies to discuss the issue remain limited. METHODS: We employed media analysis to document health tax policy dynamics, for example, the changes in policy timeline and key actors' statements. We conducted an article search in the Open-Source Intelligence database using appropriate terminology on three commodities, for example, tobacco, alcoholic beverages and sugar-sweetened beverages (SSB). RESULTS: Throughout the 15 years of implementation (2007-2022), tobacco has received the most policy attention compared with the other two commodities. This is mainly related to the increasing tariff and reforming the tax structure. As Indonesia is a Muslim-majority country, alcohol consumption is low, and a tax on alcoholic beverages was nearly unchanging and lacked media coverage. Ministry of Finance (MoF) officials are key opinion leaders often cited in the media for health taxes. MoF's support for health taxes is important to pass and implement health taxes. While SSB taxation is emerging, key opinion leaders' media statements imply policy contestation, leading to delayed implementation. The policy debates on tobacco taxation implied election years as a major challenge for health tax passages. During the political years, anti-health tax arguments emerged from politicians. While the political contestation on SSB concluded that accentuating the health tax arguments in favour of public health generates the strongest opposition against taxation from the industry. CONCLUSIONS: Politics of tobacco tax implementation are complex-compared with the other two commodities. The political context drives the divided views among policy-makers. Policy recommendations include generating public allies with key religious opinion leaders, continuing capacity building for politicians and Ministry of Health, and generating evidence-based arguments in favour of public health for MoF.


Subject(s)
Alcoholic Beverages , Sugar-Sweetened Beverages , Tobacco Products , Humans , Alcoholic Beverages/legislation & jurisprudence , Health Policy , Indonesia , Sugar-Sweetened Beverages/legislation & jurisprudence , Taxes , Tobacco Products/legislation & jurisprudence
4.
PLoS One ; 16(12): e0261280, 2021.
Article in English | MEDLINE | ID: mdl-34890422

ABSTRACT

BACKGROUND: Industry self-regulation is the dominant approach to managing alcohol advertising in Australia and many other countries. There is a need to explore the barriers to government adoption of more effective regulatory approaches. This study examined relevance and quality features of evidence cited by industry and non-industry actors in their submissions to Australian alcohol advertising policy consultations. METHODS: Submissions to two public consultations with a primary focus on alcohol advertising policy were analysed. Submissions (n = 71) were classified into their actor type (industry or non-industry) and according to their expressed support for, or opposition to, increased regulation of alcohol advertising. Details of cited evidence were extracted and coded against a framework adapted from previous research (primary codes: subject matter relevance, type of publication, time since publication, and independence from industry). Evidence was also classified as featuring indicators of higher quality if it was either published in a peer-reviewed journal or academic source, published within 10 years of the consultation, and/or had no apparent industry connection. RESULTS: Almost two-thirds of submissions were from industry actors (n = 45 submissions from alcohol, advertising, or sporting industries). With few exceptions, industry actor submissions opposed increased regulation of alcohol advertising and non-industry actor submissions supported increased regulation. Industry actors cited substantially less evidence than non-industry actors, both per submission and in total. Only 27% of evidence cited by industry actors was highly relevant and featured at least two indicators of higher quality compared to 58% of evidence cited by non-industry actors. CONCLUSIONS: Evaluation of the value of the evidentiary contribution of industry actors to consultations on alcohol advertising policy appears to be limited. Modifications to consultation processes, such as exclusion of industry actors, quality requirements for submitted evidence, minimum standards for referencing evidence, and requirements to declare potential conflicts, may improve the public health outcomes of policy consultations.


Subject(s)
Advertising/legislation & jurisprudence , Alcohol Drinking/epidemiology , Alcohol Drinking/prevention & control , Alcoholic Beverages/legislation & jurisprudence , Health Policy , Public Policy , Advertising/methods , Advertising/statistics & numerical data , Alcoholic Beverages/statistics & numerical data , Australia/epidemiology , Humans , Public Health
5.
S Afr Med J ; 111(9): 834-837, 2021 07 02.
Article in English | MEDLINE | ID: mdl-34949245

ABSTRACT

BACKGROUND: Coronavirus disease-19 (COVID-19) restrictions, particularly relating to the sale of alcohol and hours of curfew, have had a marked effect on the temporal pattern of unnatural deaths in South Africa. Methods. Death data were collected over 68 weeks from January 2020 to April 2021, together with information on the nature of restrictions (if any) on the sale of alcohol, and hours of curfew. Data were analysed using a simple ordinary least square (OLS) regression model to estimate the relative contribution of restrictions on the sale of alcohol and hours of curfew to the pattern of excess unnatural deaths. Results. The complete restriction on the sale of alcohol resulted in a statistically significant reduction in unnatural deaths regardless of the length of curfew. To the contrary, periods where no or limited restrictions on alcohol were in force had no significant effect, or resulted in significantly increased unnatural deaths. Conclusions. The present study highlights an association between alcohol availability and the number of unnatural deaths and demonstrates the extent to which those deaths might be averted by disrupting the alcohol supply. While this is not a long-term solution to addressing alcohol-related harm, it further raises the importance of implementing evidence-based alcohol control measures.


Subject(s)
Alcohol Drinking/legislation & jurisprudence , Alcoholic Beverages/legislation & jurisprudence , COVID-19 , Commerce/legislation & jurisprudence , Alcoholic Beverages/economics , Cause of Death , Humans , Social Control, Formal , South Africa , Time Factors
7.
Nutrients ; 13(9)2021 Aug 31.
Article in English | MEDLINE | ID: mdl-34578942

ABSTRACT

Alcohol is toxic to human health. In addition to providing nutritional information, labels on alcohol products can be used to communicate warnings on alcohol-related harms to consumers. This scoping review examined novel or enhanced health warning labels to assess the current state of the research and the key studied characteristics of labels, along with their impact on the studied outcomes. Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched between January 2010 and April 2021, and 27 papers were included in the review. The results found that most studies were undertaken in English-speaking populations, with the majority conducted online or in the laboratory setting as opposed to the real world. Seventy percent of the papers included at least one cancer-related message, in most instances referring either to cancer in general or to bowel cancer. Evidence from the only real-world long-term labelling intervention demonstrated that alcohol health warning labels designed to be visible and contain novel and specific information have the potential to be part of an effective labelling strategy. Alcohol health warning labels should be seen as tools to raise awareness on alcohol-related risks, being part of wider alcohol policy approaches.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Product Labeling/legislation & jurisprudence , Product Labeling/methods , Humans
10.
Nutrients ; 13(8)2021 Aug 19.
Article in English | MEDLINE | ID: mdl-34445006

ABSTRACT

Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.


Subject(s)
Alcohol Drinking/legislation & jurisprudence , Alcoholic Beverages/legislation & jurisprudence , Health Policy , Public Health , Alcohol Drinking/adverse effects , Alcoholic Beverages/economics , COVID-19/epidemiology , Canada , Commerce/economics , Commerce/standards , Costs and Cost Analysis , Government Programs , Government Regulation , Humans , Pandemics , Product Labeling/legislation & jurisprudence , Public Policy , SARS-CoV-2/isolation & purification
11.
J Stud Alcohol Drugs ; 82(2): 219-227, 2021 03.
Article in English | MEDLINE | ID: mdl-33823969

ABSTRACT

OBJECTIVE: In June 2012, Baltimore City, MD, enacted legislation (commonly referred to as the Mosby Bill) prohibiting all liquor stores (outlets that primarily sell alcoholic beverages) from selling "any food, goods, wares, supplies, or other merchandise to any person under the age of 18." Three years after enactment, we evaluated the impact of this legislation on non-alcohol product sales among youth. METHOD: Research assistants (RAs) ages 16-20 were trained in using a standardized observational tool to quantify and record characteristics of the outlets, including products sold. A trained pair comprising one RA age 16 to 20 and one RA exactly age 18 were sent into every liquor store (i.e., packaged goods stores and bar/taverns with packaged goods sales) in Baltimore to conduct the assessment and make a non-alcohol purchase. Since the research was not conducted in concert with the police, the 18-year-old RA made the purchase attempt while the other (age 16 to 20) RA completed the assessment. RESULTS: Purchase attempts were made at 502 liquor stores, and 352 of those attempts were successful (able to make purchase without being asked for identification or age; noncompliance rate = 68.1%). Noncompliance was highest among packaged goods stores compared with bar/taverns, and in neighborhoods with a lower median household income and a higher proportion of African American residents (p < .050). Noncompliant outlets were also located closer to public schools (p < .050). CONCLUSIONS: This evaluation demonstrates that, in the absence of enforcement, ordinances are neither likely to be honored nor to achieve the intended public health benefits.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Commerce/legislation & jurisprudence , Adolescent , Baltimore , Humans , Male , Public Health , Residence Characteristics , Young Adult
12.
J Stud Alcohol Drugs ; 82(2): 279-287, 2021 03.
Article in English | MEDLINE | ID: mdl-33823975

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the arguments used by the alcohol industry and actors aligning with it as a lobbying strategy on Twitter to influence the reform of the Finnish alcohol law during its preparation phase between 2014 and 2017, when the original purpose of the law reform was changed from reducing alcohol-related harm to liberalizing alcohol policy. METHOD: Primary data were collected on Twitter between 2014 and 2017 from six alcohol industry actors (n = 1,085 tweets). The Twitter data were analyzed by coding using Microsoft Excel and by content and thematic analyses using a modified version of the European Centre for Monitoring Alcohol Marketing's (2011) seven key messages of the alcohol industry. RESULTS: The findings identified three main arguments used on Twitter by the alcohol industry and actors aligning with it, namely: (1) application of liberal alcohol policies generates more revenue, (2) liberties should be generally prioritized above bureaucracy and control, and (3) education about responsibility is the best solution to alcohol-related problems. CONCLUSIONS: Social media applications such as Twitter offer the alcohol industry unlimited opportunities for promoting its traditional public relations arguments.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Industry/legislation & jurisprudence , Public Policy , Finland , Humans , Politics , Social Media
17.
Health Promot J Austr ; 32 Suppl 2: 212-217, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33439536

ABSTRACT

ISSUE ADDRESSED: Exposure to alcohol advertising has been found to be associated with more positive attitudes toward alcohol and heavier drinking among youth. Appropriate regulation of alcohol advertising is thus crucial for reducing use among members of this population group. To assist policy makers in their alcohol control efforts, this study explored the scope of Australian alcohol advertising codes and the extent to which they address issues relating to youth exposure. METHODS: Two researchers assessed 628 unique alcohol advertisements against youth-related provisions of the Alcohol Advertising Review Board (AARB) Code and Alcohol Beverages Advertising Code (ABAC). A third researcher resolved discrepancies. The ads sampled were those that had been the subject of formal complaints to the AARB. RESULTS: Most (94%) ads were assessed as violating at least one of the AARB Code provisions relating to youth, while 36% were found to violate at least one of the ABAC youth provisions. The most frequently violated AARB Code provision related to placement, with 88% of ads located in places or broadcast at times where young people were likely to be exposed. The most frequently violated ABAC provision related to appeal to minors (33%). CONCLUSIONS: Results indicate that self-regulation is an ineffective means of protecting youth from alcohol advertising, with the ABAC failing to capture many ads featuring content that appeals to youth. SO WHAT?: Greater efforts are required to protect youth from alcohol advertising. Findings from the present study reinforce calls for mandatory, evidence-based regulation that is administered independently of the alcohol industry. SUMMARY: An analysis of 628 unique alcohol advertisements found that the vast majority were in violation of the AARB Code's youth-related provisions whereas substantially fewer were in violation of the ABAC, supporting arguments that self-regulation is an ineffective means of protecting youth from alcohol advertising.


Subject(s)
Advertising , Alcoholic Beverages , Adolescent , Advertising/legislation & jurisprudence , Alcoholic Beverages/legislation & jurisprudence , Australia , Humans
18.
Alcohol Clin Exp Res ; 45(1): 234-241, 2021 01.
Article in English | MEDLINE | ID: mdl-33443773

ABSTRACT

BACKGROUND: We evaluated the effectiveness of Alcohol Impact Areas (AIA) in reducing crime around off-premise alcohol outlets in 3 AIAs in Spokane and Tacoma, Washington, using an interrupted time series design with comparison groups. AIAs only exist in Washington and include designated areas in a city where specific brands of malt liquor are restricted. We hypothesized that mandatory restrictions on malt liquor sales in AIAs would be significantly associated with decreases in crime, especially less-serious crime. METHODS: In Spokane and Tacoma, targets were 3 AIAs and 3 comparison areas with demographically similar neighborhoods without malt liquor restrictions in the same respective city. Nine different crime outcomes were evaluated: Part I selected crimes, Part II selected crimes (further split into nuisance crimes and other Part II crimes), assaults, vandalism, narcotics, disorderly conduct, and all selected crimes combined. Crime was typically compared 3 years prior to and 3 years following policy adoption using time series and negative-binomial modeling. Separate models were run for each area and each crime. RESULTS: Study hypotheses were partially supported. Malt liquor restrictions in AIAs were associated with significant decreases in crime, particularly certain Part II crimes and assaults (simple and aggravated) in 12 of the 23 models. The strength of the observed associations varied by AIA. Average monthly crime counts across all crime categories decreased more in the Tacoma AIA than in Spokane AIAs, and average monthly crime decreased more in Spokane AIA 2 (East Central) than in AIA 1 (Downtown Core). Malt liquor restrictions were significantly associated with increases in disorderly conduct in the Tacoma AIA; the increase, however, was small. CONCLUSIONS: Findings suggest that malt liquor policies such as AIAs may be one of a number of tools local officials can use to reduce alcohol-related crime in cities, especially less-serious crime.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Crime/prevention & control , Cities/statistics & numerical data , Crime/statistics & numerical data , Humans , Washington
19.
Alcohol Clin Exp Res ; 45(1): 242-250, 2021 01.
Article in English | MEDLINE | ID: mdl-33337550

ABSTRACT

OBJECTIVE: This research evaluated the South Carolina Alcohol Enforcement Team impact for reducing retail alcohol access to underage persons to decrease drinking and driving crashes among that population. METHODS: The natural research experiment used interrupted time-series (ITS) analyses of drinking and driving crashes involving under 21-year-old drivers from July 2006 through December 2016 (126-month period = 4,782 Driving Under Influence [DUI] crashes for under 21-year-old drivers, µ = 38 crashes per month). Additional data analyzed included the monthly total number of retail compliance checks (total during 126-month period = 64,954 compliance checks completed, µ = 515.5 checks per month), the average percentage of underage alcohol purchases (total completed during 126-month period = 8,814 purchases, µ = 70 purchases per month), and a calculated measure of the percent of the population under 21 years old exposed to compliance checks each month. We used drinking and driving crashes for 21-year-old and over drivers as a control time series (total number over a 126-month period = 52,180 DUI crashes for 21 and older drivers, µ = 414.1 crashes per month). RESULTS: The results show a decline in drinking and driving crashes for drivers under 21 when compliance checks increase, and when compliance checks decline, traffic crashes increase. Stable Alcohol Enforcement Team implementation over 78 months produced an overall 18 to 29% decline in such crashes. A visual examination of the crash time series demonstrated that under-21-age-driver crashes declined during the first wave of implementation and increased following a lag when enforcement declined, which provided additional empirical support for a South Carolina Alcohol Enforcement Team impact on retail alcohol availability. An ITS analysis of the prestable period compared to the stable period was statistically significant (T = -3.78, p < 0.001). A cross-check of these results using single-vehicle nighttime crashes using identical Autoregressive Integrated Moving Average models was also statistically significant (T = -8.18, p < 0.001). CONCLUSIONS: This longitudinal study provides strong evidence of sustained reductions in alcohol availability to underage youth can subsequently reduce alcohol-related traffic crashes. Reductions found in this study continued over several years, considerably longer than any previous equivalent research has shown.


Subject(s)
Accidents, Traffic/statistics & numerical data , Alcoholic Beverages/legislation & jurisprudence , Law Enforcement , Underage Drinking , Accidents, Traffic/prevention & control , Humans , Longitudinal Studies , South Carolina
20.
Drug Alcohol Rev ; 40(1): 31-40, 2021 01.
Article in English | MEDLINE | ID: mdl-32239601

ABSTRACT

INTRODUCTION AND AIMS: The Trans-Pacific Partnership Agreement (TPP) included novel rules for wine and spirits requiring parties to allow wine and spirits importers to display information required by the importing country on a supplementary label rather than on the standard label. Since the TPP negotiations concluded, alcohol-specific supplementary labelling rules have begun to appear in other trade agreements. The aim of this paper was to map the new instruments containing these rules and examine developments in the rules with implications for health information on alcohol containers. DESIGN AND METHODS: Trade agreements signed after the TPP negotiations concluded were retrieved and searched for alcohol-specific labelling provisions. A legal analysis of these provisions and related exceptions was undertaken. RESULTS: Supplementary labelling rules similar or identical to those in the TPP have been included in five subsequent trade agreements. The United States-Mexico-Canada Agreement also includes several additional provisions about alcohol labelling. Exceptions in the agreements provide some space for governments to defend labelling measure that might otherwise breach the rules, in the event of a dispute. DISCUSSION AND CONCLUSIONS: By securing these rules, the alcohol industry is better positioned to claim the space on the standard label as industry 'real estate' and to oppose mandatory health information incorporated into the standard labelling. These risks can be mitigated by stemming the adoption of supplementary labelling rules in further trade agreements; clarifying the text of agreements and ensuring that regulators understand that the rules do not prevent the use of 'best-practice' warning labels.


Subject(s)
Alcoholic Beverages/legislation & jurisprudence , Commerce , Food Labeling/legislation & jurisprudence , International Cooperation , Canada , Humans , Mexico , Product Labeling , Public Health , United States
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