Abstract
The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland.
Highlights
Alcohol consumption is the leading cause of death amongst 15–49 year-olds worldwide [1]and is a major contributor to the preventable burden of disease in the UK and internationally [2,3].There are over 1 million alcohol-related hospital admissions a year in England, and in 2013 there were6592 alcohol-related deaths, a 10% increase from 2003 [4]
This study aimed to explore how these public health actors attempted to influence local alcohol licensing policies and decisions in Scotland towards the licensing objective of “protecting and improving public health”, and to identify factors felt to have helped or hindered their efforts
Interviewees provided rich free-flowing descriptions of their experiences in seeking to orient local alcohol licensing towards a public health objective, outlining what they did and why, how others reacted, how they perceived the outcome of their efforts and what they had been surprised by or felt they had learned in the process
Summary
Alcohol consumption is the leading cause of death amongst 15–49 year-olds worldwide [1]and is a major contributor to the preventable burden of disease in the UK and internationally [2,3].There are over 1 million alcohol-related hospital admissions a year in England, and in 2013 there were6592 alcohol-related deaths, a 10% increase from 2003 [4]. Alcohol consumption is the leading cause of death amongst 15–49 year-olds worldwide [1]. There are over 1 million alcohol-related hospital admissions a year in England, and in 2013 there were. 6592 alcohol-related deaths, a 10% increase from 2003 [4]. Alcohol consumption is associated with adverse social outcomes like crime, job loss, and violence [5,6,7], causing a significant burden of harm to those other than the drinker. There is no definitive estimate of the economic cost of alcohol consumption, the most recent estimate for England and Wales is an annual cost of at least. There have been recent downward trends in harms, these have been from a
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