Exploring the complex policy formulation process of the draft Control of Marketing of Alcoholic Beverages Bill in South Africa

This study by Adam Bertscher, posted on Open UCT  explores the complex policy formulation process in South Africa, using the draft Control of Marketing of Alcoholic Beverages Bill as a tracer case and focused on the alcohol industry, as a central actor, to understand how it – together with other actors – may influence this process. The study concludes that networks of actors with financial interest use diverse strategies to influence policy formulation processes to contest proposed regulation.  The implications are that measures to insulate policy development are needed to prevent industry influence potentially undermining public health goals, such as: government to moderate certain consultations with industry; industry to declare conflict of interest; guidelines for bureaucrats and policymakers to advise on whose evidence to consider; and guidelines for bureaucrats and policymakers to assess quality of evidence.

Increasing Prevalence of Annual Alcohol Use, High-Risk Drinking, and Alcohol Disorders in the United States, 2001-2002 to 2012-2013

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More Americans are drinking high amounts of alcohol, and the greatest increases are seen among women and older adults, according to a new study published in JAMA Psychiatry. In the new report, researchers at the National Institute on Alcohol Abuse and Alcoholism compared two large studies of people who self-reported their drinking habits. The first was a study of more than 43,000 adults from 2001-2002, and the second included more than 36,000 adults from 2012-2013.  A previous study had shown that between 1971 and 2011, alcohol advertising in the U.S. increased more than 400 percent. The author of the earlier study concluded that since overall per capita consumption of alcohol had not increased in that time, advertising did not affect drinking rates.  The new study raises the question as to whether increased advertising has a distinct influence on populations at risk of heavy drinking.

Media Coverage of Alcohol Issues: A Critical Political Economy Framework-A Case Study from Ireland

Growing literature documents news media representation of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. The case of Ireland from 2012 to 2017 illustrates the authors’ proposed framework empirically. Four main newspapers’ coverage of the Public Health (Alcohol) Bill and related policies are examined. The authors conclude that the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies.

Citation: Mercille J. Media Coverage of Alcohol Issues: A Critical Political Economy Framework-A Case Study from Ireland. Int J Environ Res Public Health. 2017;14(6).

Global developments in alcohol policies since 2010

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Trends in statutory regulation of alcohol marketing since 2010 by number of countries. Credit

A report on progress in implementation of the WHO global strategy to reduce the harmful use of alcohol since 2010 concludes that while the scope and intensity of national efforts to address alcohol-related harm have increased, resources have not, particularly in low- and middle-income countries where alcohol consumption and related harm are likely to be rising most rapidly. The report was prepared by David Jernigan as background for the WHO Forum on Alcohol, Drugs and Addictive Behaviours. Not a single low-income country reported increases in resources devoted to alcohol policy implementation since 2010.  The available evidence shows that progress has been skewed towards wealthier countries, with low- and middle-income countries experiencing increased challenges with alcohol consumption and alcohol control. The “slow-moving disaster” of harmful use of alcohol will not abate without significant further global and national commitment, investment, and coordinated action to increase regulatory and enforcement capacity

Cutting alcohol consumption in Scotland

A new Health Scotland report, Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2017, shows that in 2016, 10.5 litres of pure alcohol were sold per adult in Scotland, equivalent to 20.2 units per adult per week.  This means that enough alcohol was sold last year in Scotland for every adult to exceed the weekly guideline limit (of 14 units per week on a regular basis) every week.  “Alcohol has become more affordable in recent years as disposable income has increased,” said Lucy Giles, the report’s lead author. BMA Scotland council chair Peter Bennie said wide-ranging action was needed. ‘In particular, minimum-unit pricing – a policy that big alcohol producers have spent the last five years delaying, and trying to prevent – would have a significant impact on reducing alcohol harms and must be implemented as swiftly as possible.

Framing the tax and health nexus: a neglected aspect of public health concern


Previous studies have described various associations between tax policy and health. This article proposes a unifying conceptual framework of ‘Five R’s’ to stimulate awareness about the importance of tax to health improvement. First, tax can improve representation and democratic accountability, and help make governments more responsive to the needs of its citizens. Second, tax can create a revenue stream for a universal pool of public finance for health care and other public services. Third, progressive taxation when combined with appropriate public spending can help redistribute wealth and income and mitigate social and health inequalities. Fourth, the re-pricing of harmful products (e.g. tobacco, alcohol and unhealthy food) can help reduce their consumption. Fifth, taxation provides a route by which certain harmful industries can be regulated. The paper also discusses the barriers that hinder the full potential for taxation to be used to improve health, including: weak tax administrations, large ‘shadow economies’, international trade liberalisation, tax avoidance, transfer pricing by transnational corporations and banking secrecy.  The authors suggest that a greater awareness of the manifold associations between tax and health will encourage health practitioners to actively promote fairer and better taxation, thereby helping to improve health and reduce health inequalities.

Citation: Mccoy D, Chigudu S, Tillmann T. Framing the tax and health nexus: a neglected aspect of public health concern. Health Econ Policy Law 2017 Apr;12(2):179-194.

How the alcohol industry relies on harmful use of alcohol and works to protect its profits

The alcohol industry have attempted to position themselves as collaborators in alcohol policy making as a way of influencing policies away from a focus on the drivers of the harmful use of alcohol (marketing, over availability and affordability). Their framings of alcohol consumption and harms allow them to argue for ineffective measures, largely targeting heavier consumers, and against population wide measures as the latter will affect moderate drinkers. The goal of their public relations organizations is to ‘promote responsible drinking’. However, analysis of data collected in the International Alcohol Control study and used to estimate how much heavier drinking occasions contribute to the alcohol market in five different countries shows the alcohol industry’s reliance on the harmful use of alcohol. In higher income countries heavier drinking occasions make up approximately 50% of sales and in middle income countries it is closer to two-thirds.

Full citation: Casswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bayandorj T,Huckle T, Parker K, Railton R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev. 2016;35(6):661-664.

Alcohol Labeling in Europe: Who sets the standards?

A new report from the Commission to the European Parliament and Council regarding the mandatory labeling of the list of ingredients and the nutrition declaration of alcoholic beverages recommends the industry develop a voluntary labeling proposal.  Mariann Skar, Secretary General of the European Alcohol Policy Alliance noted: “We welcome the report as it clearly recognizes the need for better alcohol labeling and widespread support for it. Disappointingly, the conclusions do not seem to be in line as it asks for self-regulatory proposal from the industry. Self-regulation is not a suitable regulatory mechanism. Member States in the European Council should follow up and empower the European Commission to take regulatory actions.”

The Regulation of Alcohol Marketing: From Research to Public Health Policy

A new special issue of the journal Addiction examines the state of knowledge on regulating alcohol marketing.  In an overview, Maristela Monteiro, Thomas Babor, David Jernigan and Chris Brookes summarize three key themes in these papers: alcohol marketing causes harm to vulnerable populations; industry self-regulation is ineffective in protecting vulnerable populations; and alternatives are available to address the problem.  They conclude that renewed action by governments to control alcohol marketing is needed.

Youth Exposure to Alcohol Advertising in National Magazines in the United States, 2001-2011

A recent study used advertising industry standard sources to evaluate youth exposure to alcohol advertising, and relative advertising exposure of youths versus adults, in 168 national magazines published in the United States . The study found that from 2001 to 2011, magazine alcohol advertising seen by youths declined by 62.9%, from 5.4 billion impressions (single person seeing a single advertisement) to 2.0 billion impressions. Most alcohol advertising (65.1% of ads) was for spirits (e.g., vodka, whiskey). Since 2008, alcohol companies achieved 100% compliance with their limited guidelines. However, youths were overexposed to magazine advertising relative to adults on average 73% of the time. The authors concluded that despite improving compliance with placement guidelines in these magazines, most youth exposure to magazine alcohol advertising exceeded adult exposure, per capita. If alcohol companies adopted stricter guidelines based on public health risk assessments, youths would not be overexposed to alcohol advertising in magazines.

Full citation: Ross CS, Henehan ER, Jernigan DH. Youth Exposure to Alcohol Advertising in National Magazines in the United States, 2001-2011. Am J Public Health. 2017;107(1):136-142.

Another recent review article summarized the literature on the use of digital media to market alcohol.

Full citation: 1: Lobstein T, Landon J, Thornton N, Jernigan D. The commercial use of digital media to market alcohol products: a narrative review. Addiction. 2016. doi:10.1111/add.13493