ABSTRACTIntroductionExtending research observing an association between awareness that alcohol causes cancer and support for alcohol policies, this study examined if believing or accepting alcohol causes cancer moderates the relationship between awareness of alcohol as a carcinogen and policy support.MethodsAdult alcohol consumers (n = 5180) in Canada completed an online survey in March–April 2023. Four separate logistic regression models were conducted with policy support affecting alcohol availability, pricing, marketing and labelling as outcomes to assess if believing alcohol causes seven types of cancer moderates the relationship between awareness of the alcohol–cancer link and support for alcohol policies. An interaction between awareness and belief was included as a predictor, adjusting for covariates.ResultsOverall, 29.3% were aware alcohol causes seven types of cancer and, of those aware, 83.6% believed this link. Those both aware of and believing that alcohol causes cancer had higher odds of supporting policies restricting alcohol availability (OR 1.76, 95% CI 1.13, 2.74) and marketing (OR 1.75, 95% CI 1.16, 2.64) than those not aware and did not believe. Consumers who were both aware of and believed the alcohol–cancer link had higher odds of supporting labelling policies (OR 1.59, 95% CI 1.05, 2.40), although this was not significant after adjusting for multiple comparisons.Discussion and ConclusionsThis study highlights that believing alcohol is a carcinogen moderates the relationship between awareness of the alcohol–cancer link and support for policies restricting alcohol availability and marketing. Future longitudinal studies are needed to test interventions for effectively raising awareness and strengthening belief and acceptance of alcohol‐related cancer risks.

Short Communication: What interest and influence do Directors of Public Health in London have in local gambling policy?

Abstract This study used The Alcohol Policy model (TAP), a newly-developed proportional multi-state lifetable model, to estimate the avoidable alcohol-related disease, injury and healthcare cost burden in the Australian adult population (aged ≥ 15 years). The model base year was 2020. Changes in alcohol consumption were modelled to lead to changes in incident cases and mortality from alcohol-related diseases and injuries, long-term health outcomes summarized as health adjusted life years (HALYs), and healthcare costs. No discounting was applied. Over 25 years, elimination of alcohol consumption could prevent 25.9 million cases of disease and injury (23.1 million from acute causes) and avert 211,697 deaths, the majority of which would be from cancers (114,948). This translated to 5.1 (95% uncertainty interval [UI] 4.0 to 6.2) million HALYs gained and Australian dollars (AU$) 55 (95%UI 36 to 75) billion saved in healthcare costs. Over 60 years, the benefits were 17 (95%UI 14 to 21) million HALYs and AU$ 68 (95%UI 9.6 to 130) billion. These findings support investment in polices that reduce alcohol consumption.

Alcohol's harm to others: A new paradigm seeking its application.

WHO Launches New Collaborating Centre on Alcohol Policy and Public Health Research.

The proportion of midlife Australian women (45-64years) whose alcohol consumption is defined as 'long-term risky drinking' increased between 2001 and 2019, with serious health, economic and social impacts. Although overall population consumption trends towards a decline, consumption for this population remains stable, suggesting that current alcohol reduction policies and strategies are ineffective for this population. In this paper, we employ sociological theory on hope to argue for developing alcohol policies that are structured to enable women's hopes for a future that includes alcohol reduction. Drawing on humanistic and positive sociology that is concerned with future-focused enquiries, we undertook semi-structured interviews with 26 midlife women, exploring 'if' they could reduce their drinking, then what hopes might be enabled through alcohol reduction. Women talked about imagined alcohol-reduced futures as enabling hopes for control, responsibility, stability and health in their lives, to support them to care for others and be 'normal'. Quixotic hopes around excitement, freedom and having a 'good life' were expressed to a lesser extent than expected. Our study and findings are analysed in relation to sociological and (post-structural) feminist theories of oppression and political transformation, with implications for alcohol policy scaffolded by engagement with Freire's pedagogy of hope.

Alcohol consumption is higher in the Northern Territory (NT) than the rest of Australia. There is large regional variation in alcohol policy implementation, but no contemporary basic epidemiological data demonstrating variation in consumption. This study replicates and updates Gray and Chikritzhs' work from 2000, which showed substantial regional differences. Quarterly wholesale data was provided by NT Liquor Licensing for 2022 and 2023. Per capita alcohol consumption of adults (15 years+) by beverage type was estimated across four regions (Top End, Lower Top End, Barkly and Central). We used independent t-tests to compare mean quarterly litres of pure alcohol consumption between Top End (the most populated region) and other regions. We also compared the proportion of beverage types. Since Gray and Chikritzhs' work, consumption has fallen in all regions, by between 4.94% and 34.4%. Mean quarterly per capita consumption was significantly lower in Central (2.65 L) compared to Top End (3.24 L). Across all regions there were clear seasonal trends, with lowest consumption in Quarter 1 (January-March) and highest consumption in Quarter 3 (July-September). Despite reductions, in most NT regions alcohol consumption remains higher per capita than the national average. Cask wine consumption has notably decreased since previous estimates. The decrease in cask wine is likely attributable to policies which targeted this beverage specifically. Per capita consumption in the Central Australian region is now lower than the national average, which is inconsistent with the greater rates of alcohol-related harms, and further investigation of moderating factors is warranted.

BackgroundAlcohol use accounts for a huge proportion of the global burden of disease, and many countries grapple with its severe negative social and health consequences. In 2018, Zambia adopted a national alcohol policy with the aim to reduce the prevalence and impact of harmful alcohol use. However, five years post-adoption, the policy implementation has been slow. This study sought to explore the implementation determinants of the national alcohol policy five years post-enactment in Zambia. Implementation determinants, a concept from Bullocks theoretical framework, refer to the enabling and inhibiting factors that shape the alcohol policy and related implementation outcomes among implementing agents and teams.MethodsWe employed a qualitative case study design using data collected from 25 semi-structured interviews targeting government ministries, civil society, and agencies responsible for enforcing the alcohol policy. We applied both inductive and deductive manifest thematic analysis using Bullock’s analytical framework for understanding the determinants of implementing evidence-based policies.ResultsThe alcohol policy was generally viewed by key stakeholders as comprehensive framework for action, yet its policy directives remained unclear. A restructured policy coordination committee enhanced the organisational capacity to implement joint action for this policy. However, weak collaboration between the council and state police hampered the enforcement of alcohol laws. Implementing agencies faced obstacles such as lack of financial and human resources, absence of rehabilitation services, and misapplication of alcohol selling licences. Further, community inaction and resistance to alcohol control laws affected the policy implementation. The socio-political environment contributed to implementation challenges through framing alcohol as an economic development issue and culturally tolerating harmful alcohol use. Additionally, changes in government affected policy ownership while unregulated illicit alcohol production and the sale of traditional and imported spirits further hampered the implementation of the policy.ConclusionOvercoming implementation hurdles to the alcohol policy demands comprehensive strategies such as engaging communities, challenging cultural norms, strategically assigning funding, and fostering collaboration among implementing agencies. This may entail leveraging enablers such as stakeholder recognition of the policy framework and the restructured committee for the coordination of the alcohol policy implementation. Key actions should include empowering local government to enforce measures to reduce unregulated alcohol availability and ensure adequate resource allocation for alcohol control activities among implementation agents, including those providing treatment and rehabilitation services.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13690-025-01737-7.

Abstract Introduction This study examines alcohol policy restrictiveness in Eastern European Union (EU) countries-Bulgaria, Croatia, Czechia, Hungary, Poland, Romania, Slovakia and Slovenia-a region with high alcohol consumption, especially among men. Using a modified Bridging the Gap (BtG-M) scale to measure alcohol policy restrictiveness, we analysed its association with alcohol consumption and alcohol-attributable disease burden. Methods Data on alcohol policy were collected from national legal documents and scored using the BtG-M scale, where higher scores indicate more restrictive alcohol policies. Disease burden measures were obtained from the Global Burden of Disease database. Data on total per capita alcohol consumption (APC) were obtained from the World Health Organization. Associations between BtG-M scores and outcomes were analysed using Spearman's Rank correlation and panel regression models. Results Poland maintained the highest level of restrictiveness, while Bulgaria, Croatia and Slovenia started with lowest scores, although Croatia and Slovenia increased their policy restrictiveness after 2000. Alcohol-attributable disease burden, but not total APC, was inversely associated with policy changes. However, the associations were complex: BtG-M scores correlated negatively with both disease burden and total APC only in Croatia, Czech Republic, Romania and Slovenia, and not in the other four countries. Conclusions To our knowledge, this study provides the first comprehensive evaluation of the link between changes in alcohol policy and alcohol-attributable disease burden in Eastern EU countries. We found a complex relationship: in half of the investigated countries, stricter alcohol policies were associated with lower levels of alcohol consumption and related disease burden. In the remaining countries, societal, cultural, demographic and economic factor beyond the scope of the alcohol policy scale appear to have a greater impact on policy effectiveness. Key messages • Despite the complex interplay between alcohol policy restrictiveness and alcohol-related disease burden, we found an association in the Eastern European Union countries. • To our knowledge, this is the first study assessing the longitudinal association between alcohol policy and disease burden in this region.

The combined impact of campus and state alcohol policies on college drinking and harms.

Relationships of Changing State Cannabis Policies With Alcohol Policy Effectiveness and Alcohol or Cannabis Involvement in Motor Vehicle Fatalities.

Are alcohol restrictions bad for tourism? An exploratory study of tourism trends in Western Australia.

High-level commitments to engage the private sector in governance and limited attention to managing conflict of interest (COI) have enabled alcohol industry actors to engage with policy development processes. This is recognised as a key barrier to developing effective alcohol policy, and as important to the industry's efforts to position itself as contributing to sustainable development. This paper examines alcohol industry perspectives on governance, particularly with respect to partnerships and COI, submitted during the development of the WHO Global Alcohol Action Plan. A frame analysis of 111 submissions from alcohol industry actors to two public consultations held in the development of the WHO Global Alcohol Action Plan 2022-2030. Alcohol industry actors engaged with two broad frames in their submissions, collaborative and adversarial. Industry submissions overwhelmingly employed the collaborative frame, positioning the alcohol industry as a partner by claiming alignment with policy goals and referencing forms of governance that prioritise industry involvement. Respondents also engaged with a contrasting adversarial frame, most commonly articulated by public health actors, by rejecting the relevance of COI; resisting restriction of the industry's role in governance; and dismissing a potential binding global instrument for alcohol. The alcohol industry places significant value on participating in policy initiatives and is resistant to challenges to its engagement. The WHO Action Plan's continued ambivalence towards the alcohol industry may point towards a challenging environment for effective policy. This underscores a need for stronger norms around COI and a more cautious approach to the alcohol industry.

In 2015, 193 nations adopted the United Nations' Sustainable Development Goals (SDGs). Alcohol was included as a specific focus in target 3.5 (substance abuse), highlighting its relevance in the global development agenda. It is also recognized as a cross-cutting issue and a barrier to achieving several SDGs. We aimed to examine in this research how countries in the Americas reported on alcohol use, alcohol-related harms, and alcohol policy measures in their efforts to meet the SDGs. We conducted a content analysis of Voluntary National Reviews (VNRs) presented at the UN High-Level Political Forum between 2016 and 2022. Our sample included 54 documents from 32 countries. More than half (57%) of the reports from 21 countries made reference to alcohol. Most of these references appeared under SDG 3, especially target 3.5. Only six countries referred to alcohol as a cross-cutting issue. Reducing alcohol consumption - a leading cause of death and disability in the Americas - was not frequently acknowledged in the VNRs. Many countries may be missing an opportunity to highlight their efforts. More likely, however, they fail to recognize alcohol as a critical public health issue that must be addressed to achieve the SDGs.

Kerala has grappled with public policy dilemmas regarding the Liquor Sector, raising questions about the effectiveness of the state's alcohol policy. Recent discretionary state policies on alcohol have led to unintended outcomes, spanning from the emergence of illegal substitutes to the escalation of the drug menace. Therefore, the policy changes are needed to control illegally available substances in the context of rising concerns of public health, violence and social distress.

The Joint Action project on Cancer and other Non-communicable Diseases (NCDs) prevention, Action on Health Determinants, includes a dedicated workstream on structural and population-level interventions. The overarching objective of this workstream is to strengthen the compliance, coherence, implementation and enforcement of evidence-based regulatory measures that support governmental efforts to reduce the burden of NCDs. The workstream adopts a multi-method approach, informed by existing academic literature and previous European studies. Key methodologies include policy mapping, evidence reviews, behavioural assessments, policy impact modelling, and pilot testing. Governmental alcohol and tobacco policies will be evaluated using comparative policy scales, while the health and economic impacts of health taxation policies will be projected through and microsimulation modelling. Nutrient profile modelling and food composition databases will be developed to inform strategies for food reformulation. The effectiveness of labelling interventions will be examined. Tools for monitoring digital marketing exposure will be developed, and the impact of environmental policy impact will be assessed. The workstream is expected to deliver comprehensive policy analyses, demonstrate the potential impact of health taxation, propose harmonized nutrient profiling frameworks, assess the effectiveness of food and alcohol labelling practices and contribute to the development of cross-national structures for public food procurement. Additionally, it will provide guidance on the implementation of effective measures and evaluate divergences in national policy approaches across Europe. The workstream will generate actionable evidence and documentation to inform and support public policy processes, thereby contributing to reductions in the burden of preventable disease across the region.

Racial and Ethnic Disparities in Alcohol Consumption and Mortality in the U.S.

Implementation of a multi-component alcohol policy in Ireland: A qualitative study exploring barriers and facilitators to implementation.

Alcohol use causes significant harms and is extensively regulated by governments, but alcohol-related questions are under-explored in public health ethics. To inform future work in this area, I conducted interviews with key informants from alcohol research and policy work in Australia. Thematic analysis of interviews identified a range of ethical issues that can be categorized under six themes: ethical issues in alcohol research; ethical issues raised by judgements about alcohol use; ethical issues raised by alcohol policies; ethical issues in policy processes; ethical questions about policy aims; and ethical issues in how alcohol problems are defined. The study provides direction for future research on problems that are underexplored in the ethics literature. These include problems arising from the influence of industry in alcohol research and policy, the question of how to develop research and policy without generating stigma, and social justice issues connected to alcohol-related stereotypes and judgements.

Kenya faces numerous public health challenges, including alcohol abuse. Studies show that alcohol and drug abuse can disrupt nutrition, contributing to preventable diseases and deaths. Although nutrient deficiencies in alcoholism may be managed through nutrition therapy, the role of nutrition rehabilitation in Kenya remains underexplored. This study assessed the biochemical nutritional status of Albumin, Calcium, Magnesium, and Zinc among alcohol-dependent patients before and after rehabilitation. A pre–post experimental design was used among 62 consecutively sampled patients, assessed on admission and after 90 days. Data were collected using semi-structured questionnaires, and blood samples were analyzed for nutrient biomarkers and compared with reference standards. Nutrient adequacy proportions and mean levels before and after rehabilitation were compared using Chi-square and T-tests. Mean serum calcium increased significantly (t=2.428, P=0.018), while serum albumin and zinc showed slight, non-significant increases (t=0.742, P=0.461; t=0.445, P=0.658). Serum magnesium declined slightly (t=0.912, P=0.36). A significant increase in the number of patients with adequate nutrient levels was observed for albumin (χ2=7.3518, P=0.0067), magnesium (χ2=91.782, P=0.001), and zinc (χ2=8.1986, P=0.0042). Post-rehabilitation adequacy improved notably: albumin from 32.4% to 56.8%, zinc from 21.6% to 45.9%, and magnesium from 13.5% to 100%. Rehabilitation was associated with improved nutrient levels and biochemical adequacy among patients, highlighting its role in recovery. Based on these findings, comprehensive nutrition care should be integrated into alcohol rehabilitation programs. The government and program managers should consider developing and implementing a national alcohol and nutrition rehabilitation policy to support recovery outcomes.