Public support for alcohol control initiatives across seven countries
Short report
Background
Alcohol use is a major preventable risk factor for disease, and is responsible for 5% of deaths each year worldwide (World Health Organizaton, 2018). The World Health Organization (WHO, 2017, 2018) recommends that Member States implement a range of evidence-based policy measures to prevent and reduce harm due to alcohol.
These measures include interventions relating to how alcohol-related information is communicated to the public, covering both the provision of information about risk (e.g., public education campaigns and requiring warning labels on alcohol containers) and the placement of restrictions on alcohol marketing (e.g., prohibiting sponsorships targeting young people). Other recommendations relate to pricing and the establishment of high-level national committees tasked with reducing alcohol harms (WHO, 2018).
The Alcohol Control Policy Index (ACPI) compares alcohol control policies internationally, and is therefore a useful way of concisely indicating uptake of alcohol policy at the national level and facilitating cross-country comparisons. The ACPI shows that statutory strictness of alcohol policies varies widely between countries, and greater strictness is typically associated with lower levels of alcohol use.
- For example, the United States has an ACPI score of 39.8 (out of 100) and per capita alcohol consumption of 9.8 litres.
- By comparison, India has an ACPI score of 81.8 and per capita consumption of 5.7 litres (WHO, 2018).
- Many sociocultural factors are likely to contribute to both the regulatory and alcohol consumption characteristics of different countries.
- In addition, these figures are likely to disguise substantial policy and consumption differences within countries (e.g., between different states within the US and India).
An important determinant of governments’ willingness to introduce new health policies is anticipated public support. Such support is also important in influencing compliance levels once new policies are introduced. As such, assessments of community sentiment towards specific alcohol policy solutions can assist governments in their deliberations on which alcohol policies to implement over which time frames, and can inform communications designed to reinforce support among receptive groups and address potential resistance among less-supportive groups.
To date, most research on public attitudes to alcohol policies has been conducted in higher-income countries and has found support to largely depend on the type of intervention and its perceived (personal) intrusiveness. Generally, support for policies aiming to inform and educate has been found to be higher than for policies that restrict the physical and economic availability of alcohol. This is problematic because while there is greater public support for less intrusive policies, more restrictive policies are likely to be more effective in minimising alcohol harm. However, given their greater acceptability, consumer information initiatives may represent an important entry point by ‘softening the ground’ among the public and governments for other forms of alcohol control policy in due course. In addition, the World Health Organization (2018) has observed that the lack of information on alcohol products is ‘remarkable’ in comparison to the basic requirements for other consumer food products.
Support for alcohol-related policies has also been found to vary by demographic and alcohol consumption characteristics. Older people, women, and abstainers/light alcohol users typically exhibit higher levels of support.
Less is known about public support for alcohol control policies across countries at varying levels of economic development, and notably among the highly populous countries of China and India. These countries are experiencing increasing per capita alcohol consumption due to rapid economic growth, and as such are important to include in future alcohol policy research.
To address this uneven knowledge across countries, the aim of the present study was to provide an international perspective on public support for a range of alcohol policy solutions across varying countries. The results have the potential to inform efforts to strengthen existing alcohol control efforts within and across different sociocultural contexts. Also of interest were any patterns in policy support according to various demographic and alcohol consumption characteristics.
Policy support
Across the total sample, means for each initiative ranged from 3.49 to 4.09 on a 5-point agreement scale, indicating generally favourable responses.
The researchers assessed levels of public support for 14 potential alcohol policy initiatives across seven countries.
- Australia,
- Canada,
- China,
- India,
- New Zealand,
- the United Kingdom, and
- the United States.
Overall, the results indicate generally supportive environments for most of the assessed initiatives in most of the included countries.
In terms of specific initiatives, policies relating to product labelling were strongly supported across countries, while those relating to alcohol advertising restrictions were less favoured but still directly supported by at least half of the respondents.
Abstract
Background
Public support for greater alcohol policy action is a key consideration in governments’ decisions to introduce new alcohol-related regulations, policies, and programs. The aim of this study was to asses public support for a range of recommended alcohol policy initiatives across seven countries with varying sociocultural profiles.
Methods
Adults (n = 7545; aged 18-91 years) from Australia, Canada, China, India, New Zealand, the United Kingdom, and the United States completed an online survey assessing demographic characteristics, alcohol consumption patterns, and support for 14 alcohol control initiatives.
Results
Across the total sample, means for each initiative ranged from 3.49 to 4.09 (on a 5-point agreement scale), indicating generally favourable responses. Stated support levels (i.e., selecting ‘Agree’ or ‘Strongly agree’) for specific initiatives in individual countries ranged from 33% to 86%.
Across countries, support was higher for initiatives related to product labelling (e.g., clearly visible standard alcoholic drink quantity information and pregnancy warning labels) and lower for initiatives related to alcohol advertising restrictions (e.g., prohibiting alcohol advertising during televised sporting programs and on road-side billboards).
Support levels varied by age, gender, income level, alcohol consumption status, and alcohol consumption frequency.
Conclusion
The high levels of support across countries for many of the assessed initiatives indicate that the public would be receptive to more stringent alcohol policies, especially in relation to product labelling and the dissemination of public education campaigns.
Further advocacy work appears to be required to foster higher levels of support for restricting alcohol companies’ marketing activities.