A University of Victoria-led project revealed worsening alcohol policy grades across the country and proposed detailed steps to repair Canada’s alcohol policy.
News of alcohol’s harms and costs has dominated headlines post-COVID. The Canadian Alcohol Policy Evaluation (CAPE) Project, led by UVic’s Canadian Institute for Substance Use Research (CISUR), brought together researchers from institutions across Canada to evaluate alcohol control policies federally and in all 13 provinces and territories.
This is about more than asking individuals to consider cutting down on their [alcohol use]. Yes, that can be important, but governments need to make changes to the broader [alcohol] environment.
CAPE offers a scientific evaluation of where our governments are at in terms of health-oriented alcohol policy, while also giving the tools they need to improve.”Dr. Tim Naimi, CISUR director and lead of the CAPE Project
While the project offers a less than rosy picture of where government alcohol policy sits today, it comes with solutions.
CAPE has prepared a detailed report card for each of the provinces and territories and the federal government, which shows them how they are faring in 11 different policy domains.
CAPE offers tailored recommendations for how they can improve their scores and strengthen their policies in support of public health.
- pricing and taxation,
- physical availability,
- alcohol control system,
- impaired driving countermeasures,
- marketing and advertising controls,
- minimum legal age,
- health and safety messaging,
- liquor law enforcement,
- screening and treatment interventions,
- alcohol strategy, and
- monitoring and reporting.
Some of these recommendations include creating minimum prices tied to alcohol content and indexed to inflation, moving the oversight of alcohol regulation and sales to a government ministry focused on health or safety rather than finance, reducing hours of sale, mandating warning labels for alcohol containers or officially endorsing the new Canadian Guidance on Alcohol and Health,” explains Dr Naimi, as per UVic News.
Governments could also develop an alcohol strategy on a provincial or territorial level or create a federal Alcohol Act.”Dr. Tim Naimi, CISUR director and lead of the CAPE Project
Many of these well-proven and ambitious policies are in place in some parts of Canada today. If governments were to implement the best existing policies consistently across Canada’s provinces and territories, they could score 80% or an A-.
3rd evaluation of alcohol policy across Canada’s provincial, territorial and federal governments
This is the CAPE Project’s third evaluation of alcohol policy across Canada’s provincial, territorial and federal governments – and the results are sobering.
Every single jurisdiction got an overall failing grade, with the lowest scoring jurisdiction, Northwest Territories, only getting 32%. The highest-scoring jurisdictions—Manitoba and Quebec—only scored 44% and 42%, respectively. The federal government’s score was just 37%.
This reflects ‘red tape reduction’, ‘modernizing’ initiatives and other erosions of public-health-focused alcohol policies we have seen in recent years,” says Dr Naimi.
We were starting to see it ramp up when we released our last evaluation in 2019, and during the COVID-19 pandemic we have only seen it get worse.”Dr. Tim Naimi, CISUR director and lead of the CAPE Project
Findings on the federal level
On the federal level, the government scored just 37%, with particularly poor marks on Minimum Legal Age, Health and Safety Messaging, and Marketing and Advertising Controls.
The 10 policy domains in this assessment form part of a comprehensive and synergistic approach to preventing and reducing different types of alcohol harms. Policies examined fall under federal control, and each domain reflects the current evidence and is weighted based on its effectiveness and scope of reach. This results in a ranked order from one (i.e., highest overall impact) through 10 (see next page). However, all the domains are necessary to create a health-focused alcohol policy environment.
WHAT THE FEDERAL GOVERNMENT IS DOING WELL: SELECTED EXAMPLES
Legislation requires all federal commercial imports into Canada to be imported exclusively via government authority. The maximum volumes for duty-exempt personal alcohol imports meet the recommended limits.
Screening and treatment interventions
Federal funding supported development of national alcohol and health guidance. Federal funding is available to support alcohol screening, brief intervention, and referral (SBIR) initiatives at the provincial/territorial (P/T) level. SBIR resources and treatment services are available to federal corrections and military populations.
Monitoring and reporting
Comprehensive monitoring and reporting of alcohol-related indicators is conducted and publicly funded; all data are publicly reported with most released annually. There is leadership, Canadian Centre on Substance Use and Addiction, and knowledge translation activities occurring.
WHERE THE FEDERAL GOVERNMENT NEEDS WORK: SELECTED EXAMPLES
Pricing and taxation
There are no federal incentives to encourage minimum pricing implementation at the P/T level. Federal sales and excise taxes applied to alcohol fall below the recommended levels. Excise taxes are not currently set based on a unified graduated ethanol-based rate.
Status of Federal Alcohol Excise Taxation in 2022
|Best practice policies||Yes||Partly*||No|
|Excise taxes set at a unified rate across beverage types||Yes|
|Excises taxes tied directly to alcohol content (e.g., $/L of absolute alcohol)||Yes|
|Excise rates graduated based on alcohol content (e.g., higher rates for higher strength beverages)||Yes|
|Excise taxes indexed to annual inflation||Yes|
Marketing and advertising controls
The current CRTC code does not include restrictions on volume, content, and placement of ads, or on price-based promotions for any advertisers nor does it restrict content beyond broadcast media.
There is no mandatory pre-screening of alcohol ads by an enforcement authority independent of industry and no online complaints system; CRTC penalties can only be imposed on broadcasters. Alcohol industry marketing activities are not monitored or publicly reported.
Impaired driving counter-measures
The Criminal Code threshold for driving under the influence is set higher than a BAC of 0.05%. Federally regulated professional drivers such as commercial pilots and truck drivers are not all subject to a maximum BAC of 0.02% or lower.
STEPS TO IMPROVE FEDERAL GOVERNMENT’S CAPE POLICY SCORES
The policy domains below are listed in order of impact based on their effectiveness and scope (see page 2 for details).
All recommended policies should be developed and implemented without alcohol industry involvement, without incorporating exceptions, and enacted in legislation or regulation where possible.
|Pricing & Taxation||39% (F)||– Offer financial incentives to encourage implementation of minimum prices at the P/T level.|
– Implement an indexed minimum unit price for all alcohol sold on federally controlled lands and waters (e.g. parks, military installations).
– Increase the level of federal sales taxes applied to alcohol to 12% (e.g. GST or other ad valorem federal alcohol sales tax).
– Increase the level of alcohol excise tax imposed on alcohol products, prior to applying the GST rate, to a unified alcohol volumetric rate of $13.04/L* ethanol (high strength spirits) and $8.75/L* ethanol (non-spirit and low strength spirit beverages). (*based on annually indexed rate from 1991).
– Set volumetric excise taxes to reflect ethanol alcohol content across all major beverage categories (i.e. in addition to spirit above 7% ABV).
|Marketing & Advertising Controls||10% (F)||– Implement restrictions on advertising quantity (e.g. ad bans and volume restrictions), content (e.g. beyond CRTC rules), placement (e.g. physical location near youth etc.), and price-based promotions/sponsorships for all advertisers (e.g. government or private retailers, non-licensees or third parties such as food delivery services) and all media types (e.g. broadcast, internet, social media).|
– Appoint an independent health-focused enforcement authority to conduct mandatory pre-screening of all alcohol ads, host responsive online complaint system geared to the public, and enforce penalties applicable to government and private advertisers. Provide the authority with sufficient enforcement powers to impose commensurate escalating sanctions for violations by all advertisers (not just broadcasters); require monitoring and public reporting of alcohol industry marketing activities.
|Impaired Driving Counter-measures||40% (F)||– Make it a Criminal Code offence to drive with a BAC of ≥0.05%.|
– Make it a Criminal Code offence for federally regulated professionals to operate commercial or passenger vehicles, trains, plane, and boats with a BAC > 0.02%.
– Provide police with Criminal Code powers to demand an evidentiary blood sample in any situation where they are authorized to demand an evidentiary breath sample.
& Safety Messaging
|10% (F)||– Enact legislation requiring for enhanced alcohol labelling components.|
Implement mandatory alcohol labelling as a manufacturer requirement, developed independently of the alcohol industry. Labels should include a variety of evidence-based warning messages (e.g. cancer risk, standard drinks, national alcohol guidance, calories), be prominently displayed using contrasting colours, be fully legible and accompanied by pictorials, rotate equally across all products at least annually, and support consumers in making informed decisions about product use; alcohol warning messages must be displayed front-of-package.
– Implement ongoing alcohol-specific public health media campaigns run by Health Canada and developed free of industry involvement that include comprehensive health and safety topics.
|Physical Availability||100% (A+)||– Federal controls on commercial and personal alcohol imports meet recommendations.|
|Control System||12% (F)||– Implement a Federal Alcohol Act with an explicit mandate/intent to protect public health that includes evidence-based policy areas (e.g. pricing and taxation, marketing and advertising controls, impaired driving countermeasures, health and safety messaging etc.).|
– Provide federal incentives (e.g. tax breaks) to encourage P/T governments to retain ownership and operation of the retail sale and distribution of alcohol.
– Strengthen existing trade law exemptions in the interests of protecting public health and safety to include specific mention of alcohol.
– Increase the proportion of government licensed, owned, and operated Duty-Free outlets (versus privately owned and operated outlets); move towards full government control.
– Require public health guidance from health ministries or other public health stakeholders for alcohol-related decision-making and legislative changes; implement a formal public consultation process to engage with under-represented groups (e.g. non-industry stakeholders, priority populations) about alcohol.
|Minimum Legal Age||0% (F)||– Set a federal minimum age of 21 for individuals to whom alcohol can be lawfully sold under the Criminal Code; extend the federal minimum age to apply to alcohol sold on federal controlled land/waters.|
|Alcohol Strategy||40% (F)||– Develop an updated public facing standalone alcohol strategy, without alcohol industry involvement, that addresses alcohol as a public health issue.|
– Allocate dedicated funds for strategy development, implementation and assessment and appoint an identified leader (individual position or working group free of alcohol industry involvement) to implement the strategy; set an implementation timeline (e.g. 5 years) and require on-going publicly reported implementation assessments.
– Provide formal federal endorsement of the alcohol strategy.
|Screening & Treatment Interventions||67% (C+)||– Provide formal federal endorsement of national alcohol and health guidance that has been developed free from alcohol industry involvement.|
– Implement earmarked funds for supporting alcohol-specific treatment beyond SBIR at P/T level (e.g. health transfer funds).
– Extend tracking and reporting of screening, brief intervention, referral, and treatment for populations under federal administration to include Corrections.
(Treatment indicators measure existence of services only, not quantity or quality.)
|Monitoring & Reporting||88% (A-)||– Increase frequency of regular reporting on alcohol-related morbidity, cost, and policy change indicators to annually.|
– Implement an online public centralized reporting system for all alcohol-related indicators.
The CAPE Project is a collaborative project involving researchers from the Centre for Addiction and Mental Health (CAMH), Western University, St Francis Xavier University, Dalhousie University, and the Canadian Institute for Health Information.
The institutions worked together to create the evidence-based scoring rubric, collect relevant policy data from across the country, and score the individual provincial, territorial and federal governments on how they fared across the 11 different policy domains. The project also relied on stakeholders within the government to validate the data and ensure its accuracy.
This was a massive, scientifically rigorous project that could only be achieved via these strong partnerships with institutions and governments across Canada,” says Norman Giesbrecht, scientist emeritus at CAMH’s Institute for Mental Health Policy Research who has been a key part of CAPE since its first iteration.
We are grateful to be able to do this evaluation for a third time and build on the excellent work that began with the first CAPE in 2011.”Norman Giesbrecht, scientist emeritus at CAMH’s Institute for Mental Health Policy Research
The CAPE Project was funded by Health Canada and the Public Health Agency of Canada.
CAPE has a track record of strengthening Canada’s response to alcohol-related harm. The project was initially developed and implemented in 2013 (CAPE 1.0), then updated, refined, and expanded in 2019 (CAPE 2.0). CAPE 3.0 launched in 2022 along with the national alcohol policy community of practice. Results for CAPE 3.0 were released in May 2023.