A composite index of provincial alcohol control policy implementation capacity in Thailand

Abstract

BackgroundThere is a well-published literature on the effectiveness and stringency of alcohol control policies, but not many studies focus on policy implementation, where policies transform into impact. The objective of this study is to create a composite index that measures the capacity for implementing effective alcohol control policies across all provinces in Thailand. MethodsBased on the international literature, we developed a list of key indicators for tracking the implementation of alcohol policies at the subnational level. To ensure these indicators were relevant to the Thai context, we obtained feedback from Thai experts. We collected primary data according to the developed indicators using questionnaires filled in by key informants at the implementing agencies and gathered secondary data at the provincial level. On this basis, we developed indices that reflect the status of alcohol control policy implementation. We then investigated the association between the indices and the prevalence and pattern of alcohol consumption and alcohol-related harms while adjusting for potential confounders using multiple linear regression and negative binomial regression, respectively. ResultsScores on the Provincial Alcohol Policy Implementation Capacity (PAPIC) Index ranged between 39 and 79. We found that each 1-point increase in PAPIC score was associated with a 1.98 % reduction in the quantity of alcohol consumed in grams per day (coefficient: −0.02; 95 %CI: −0.03, −0.00; p-value<0.05; e−0.02= 0.9802). We also found that for each 1-point increase in PAPIC score, the proportion of regular drinkers reduced by 0.30 per cent (coefficient: −0.30; 95 %CI: −0.55, −0.05; p-value<0.05). However, we did not find any association between the indices and alcohol-related harms. ConclusionThe level of implementation of alcohol control policy at the sub-national level is associated with alcohol consumption levels. The findings suggest the value of allocating resources to the implementation of alcohol control policy.