The Alcohol Environment Protocol: A new tool for alcohol policy.

Sally Casswell,Anne‐Marie Mackintosh,Steve Randerson,Surasak Chaiyasong,Pham Viet Cuong,Gaile Gray‐Phillip,Charles D H Parry,Ross Gordon,Sharon Halliday,Petal Petersen Williams,Renee Railton,Neo Morojele

doi:10.1111/dar.12654

Abstract

Introduction and AimTo report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high‐income to three high‐middle income countries, and one low‐middle income country.MethodThis study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross‐country comparison and change over time.ResultsAll countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High‐income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high‐ and middle‐income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink‐driving legislation was in place, it was less well enforced in middle‐income countries.ConclusionIn countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol‐related harm.

Highlights

Introduction and AimTo report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country
The Alcohol Environment Protocol (AEP) is one of the two tools used in the International Alcohol Control (IAC) study [1,2,3]
The AEP is a tool for comparative policy analysis, which allows a focus on both policy inputs and policy impacts [5] and will allow policy surveillance and, in future work, examination of the relationship with consumption [6]

Summary

Introduction

The Alcohol Environment Protocol (AEP) is one of the two tools used in the International Alcohol Control (IAC) study [1,2,3]. The AEP has been developed to allow countries to document and assess (in a comparable way) the environment, in which alcohol is sold and consumed, existing alcohol policies, levels of enforcement and document changes over time. This paper provides some illustrative data from six of the IAC countries using the AEP: Scotland, New Zealand, St. Kitts and Nevis, Thailand, South Africa and Vietnam (these are the countries for which data were available at the time of this analysis). The countries differ in terms of their current alcohol markets, including the proportions of the market comprising informal (untaxed alcohol) and recorded alcohol. They differ in terms of their levels of economic development, histories of alcohol use and forms of government. Open-ended questions allowed for key informants to comment further on enforcement and policies

Methodology

Results

Enforcement methods

Discussion

Conclusion