Alcohol Policy Development Research Articles

Continuities and change in alcohol policy at the global level: a documentary analysis of the 2010 Global Strategy for Reducing the Harmful Use of Alcohol and the Global Alcohol Action Plan 2022–2030

BackgroundThere are only two major statements which define alcohol policy development at the global level. There has not been any comparative analysis of the details of these key texts, published in 2010 and 2022 respectively, including how far they constitute similar or evolving approaches to alcohol harm.MethodsPreparatory data collection involved examination of documents associated with the final policy statements. A thematic analysis across the two policy documents was performed to generate understanding of continuity and change based on comparative study. Study findings are interpreted in the contexts of the evolving conceptual and empirical literatures.ResultsBoth documents exhibit shared guiding principles and identify similar governance challenges, albeit with varying priority levels. There is more emphasis on the high-impact interventions on price, availability and marketing in 2022, and more stringent targets have been set for 2030 in declaring alcohol as a public health priority therein, reflecting the action-oriented nature of the Plan. The identified roles of policy actors have largely remained unchanged, albeit with greater specificity in the more recent statement, appropriately so because it is concerned with implementation. The major exception, and the key difference in the documents, regards the alcohol industry, which is perceived primarily as a threat to public health in 2022 due to commercial activities harmful to health and because policy interference has slowed progress.ConclusionsThe adoption of the Global Alcohol Action Plan 2022-30 potentially marks a pivotal moment in global alcohol policy development, though it is unclear how fully it may be implemented. Perhaps, the key advances lie in advancing the ambitions of alcohol policy and clearly identifying that the alcohol industry should not be seen as any kind of partner in public health policymaking, which will permit progress to the extent that this influences what actually happens in alcohol policy at the national level.

Alcohol policy development in Sierra Leone: An assessment of the role of civil society

Objective: To assess the value addition of civil society collaboration with Government in the development of Sierra Leone’s National Alcohol Policy (NAP). Policy Development Process: We reviewed the entire process of lobby, advocacy, and support for the development of the NAP from 2015 when the Siera Leone Alcohol Policy Alliance (SLAPA) was formed to the launch of the NAP in 2023. It also assesses the level of collaboration between FoRUT, SLAPA and Ministry of Health of Health and Sanitation (MoHS). The MoHS coordinated the policy formulation process with substantive technical support from civil society. Results: The quality of the NAP was rated high as it reflected appropriate policy areas and interventions from the Global Strategy to Reduce the Harmful Use of Alcohol, the WHO SAFER initiative, and the Global Action Plan for Alcohol Control (202-2030). The NAP is a solid reference material for the development of a new alcohol bill. MoHS recognized FoRUT and SLAPA as the national champions for alcohol control in the country. FoRUT, directly and through SLAPA influenced the process of developing the NAP and its quality through advocacy, collaboration and technical and financial support. Conclusions: The development of the NAP in Sierra Leone truly reflects civil society-government collaboration, built on mutual trust and a common health and development agenda. Connecting national level lobby and advocacy with regional global advocacy actions to prioritize, influence, support, and monitor the alcohol control agenda is a critical catalyst for civil society to advancing the development of NAPs.

Alcohol, No Ordinary Commodity: policy implications for Canada.

Alcohol is a favorite psychoactive substance of Canadians. It is also a leading risk factor for death and disability, playing a causal role in a broad spectrum of health and social issues. Alcohol: No Ordinary Commodity is a collaborative, integrative review of the scientific literature. This paper describes the epidemiology of alcohol use and current state of alcohol policy in Canada, best practices in policy identified by the third edition of Alcohol: No Ordinary Commodity, and the implications for the development of effective alcohol policy in Canada. Best practices - strongly supported by the evidence, highly effective in reducing harm, and relatively low-cost to implement - have been identified. Measures that control affordability, limit availability, and restrict marketing would reduce population levels of alcohol consumption and the burden of disease attributable to it.

The role of civil society organizations in alcohol control during the COVID-19 pandemic across six countries in Africa

BackgroundThe differing global trends in alcohol consumption and policy measures implemented during the COVID-19 pandemic warrant a closer look at the actions taken by civil society organisations (CSOs) and community-led efforts to describe how they may influence and accelerate action for change in alcohol control measures. This paper analyses actions undertaken by CSOs at the national and local levels to safeguard communities and improve alcohol control policies during the COVID-19 pandemic in six African countries.MethodsA cross-sectional survey was distributed via email to CSOs involved in alcohol prevention, outreach and policy development in Kenya, Lesotho, Namibia, South Africa, Tanzania and Zimbabwe. Individuals (n = 19) working at CSOs responded to the questionnaire from February to March 2022. Questions related to the role of CSOs during the pandemic are analysed and synthesised in this paper. 19 CSOs respondents representing the six countries were included in the study.ResultsAction areas led by CSOs during the COVID-19 pandemic included: (i) direct lobbying advocacy, (ii) conducting public awareness media campaigns and (iii) legal and regulatory interventions linked to the pandemic.ConclusionsGiven the size of the challenges governments faced during the COVID-19 pandemic, the role of CSOs, during the ongoing pandemic and beyond, has become even more relevant to strengthen advocacy and public health interventions for alcohol control in Southern Africa. For this, CSOs should have a “seat at the table” when public health policies are designed, discussed and enforced.

Balancing the Drinking Act: A Grounded Theory of Youth Drinking, Policy and COVID-19 in Botswana

Stakeholder and consumer participation is generally seen as a critical part of effective alcohol policy making as it has a direct impact on policy implementation. In the advent of COVID-19, the views and experiences of stakeholders and consumers were integral to how countries responded to the virus. The involvement of alcohol stakeholders and consumers raises critical questions about policy making practices. Using Grounded Theory (GT) methods amongst 20 drinkers and six alcohol stakeholders, I examined the views and experiences of stakeholders and alcohol consumers in Botswana during COVID-19. I identified two interrelated core categories of Balancing the Drinking Act and Problematic Youth Drinking that were prominent as the country dealt with the COVID-19 pandemic. First, I argue that balancing the drinking act suggests the need for government to balance alcohol regulation with the needs of drinkers. Second, I highlight that problematic youth drinking relates to an emerging yet consistent belief that young people in Botswana are collectively responsible for alcohol “problems.” These key themes center consumer and stakeholder participation in alcohol policy development. Moreover, the current analysis demonstrates the interplay between alcohol use and prohibition during COVID-19, and how it might be mediated by cultural scripts used by consumers and stakeholders in Botswana.

Stakeholder Engagement in the Development of Public Health Economic Models: An Application to Modelling of Minimum Unit Pricing of Alcohol in South Africa.

Health economic models aim to provide decision makers with information that is contextually relevant, understandable and credible. This requires ongoing engagement throughout the research project between the modeller and end-users. We aim to reflect on how a public health economic model of minimum unit pricing of alcohol in South Africa benefited from, and was shaped by, stakeholders. We outline how engagement activities were used during the development, validation and communication phases of the research with input gathered at each stage to inform future priorities. A stakeholder mapping exercise was completed to identify stakeholders with the required knowledge, for example academics with expertise in modelling alcohol harm in South Africa, members of civil society organisations with lived experience of informal alcohol outlets, and policy professionals working at the forefront of alcohol policy development in South Africa. The stakeholder engagement consisted of four phases: developing a detailed understanding of the local policy context; co-producing model focus and structure; scrutinising model development and communication planning; and communicating research evidence to end-users. The first phase utilised 12 individual semi-structured interviews. Phases two to four centred around face-to-face workshops (two online) with both individual and group-based exercises employed to achieve required outputs. Phase one provided key learning on policy context and initiated working relationships. Phases two to four provided a conceptualisation of the problem of alcohol harm in South Africa and the choice of policy to model. Stakeholders chose population subgroups of interest and advised on both economic and health outcomes. They provided input on critical assumptions, data sources, priorities for future work, and communication strategies. The final workshop provided a platform to communicate the results of the model to a largely policy audience. These activities led to the production of highly contextualised research methods and findings that were able to be communicated widely beyond academia. Our programme of stakeholder engagement was fully integrated into the research programme. It resulted in a number of benefits including creating positive working relationships, guiding modelling decisions, tailoring the research to the context, and providing ongoing opportunities for communication.

Support for evidence-based alcohol policy in Ireland: results from a representative household survey.

Alcohol use is a leading risk factor for death and disability and there is a need for evidence-based policy measures to tackle excess alcohol consumption and related harms. The aim of this study was to examine attitudes towards alcohol control measures among the general public in the context of significant reforms undertaken in the Irish alcohol policymaking landscape. A representative household survey was conducted among individuals aged 18+ years in Ireland. Descriptive and univariate analyses were used. A total of 1069 participants took part (48% male) and there was broad support (>50%) for evidence-based alcohol policies. Support was strongest for a ban on alcohol advertising near schools and creches (85.1%) and for warning labels (81.9%). Women were more likely than men to support alcohol control policy measures while participants with harmful alcohol use patterns were significantly less likely to support these measures. Respondents with a greater awareness of the health risks of alcohol showed higher levels of support, while those who had experienced harms due to other people's drinking showed lower support compared with those who had not experienced such harms. This study provides evidence of support for alcohol control policies in Ireland. However, notable differences were found in levels of support according to sociodemographic characteristics, alcohol consumption patterns, knowledge of health risks and harms experienced. Further research on reasons behind public support towards alcohol control measures would be worthwhile, given the importance of public opinion in the development of alcohol policy.

Current Developments in European Alcohol Policy: An Analysis of Possible Impacts on the German Wine Industry

In February 2022, the European Parliament agreed on a far-reaching package of measures to regulate alcohol consumption in its vote on “Strengthening Europe in the fight against cancer”. This article therefore elaborates on the most important positions and directions of current European alcohol policy and discusses possible effects on the German wine industry based on existing literature. It can be shown that the attitudes towards alcohol consumption sometimes differ considerably within the European Union, but that there is increasing harmonization of consumption-regulating measures in the course of European integration. However, alcohol policies in the EU are limited by an unclear scientific assessment of “moderate” consumption. This is supplemented by moderate social awareness and the scientific discourse on the effectiveness of alcohol policy measures, as well as a lack of government initiative and legal barriers. Ultimately, the German wine industry finds itself confronted with new scientific findings, associated political demands and creeping changes in social attitudes towards alcoholic beverages.

Self-determination by First Nations Australians in alcohol policy: Lessons from Mbantua/Alice Springs (Northern Territory, Australia).

First Nations Australians have an internationally-recognised right to self-determination - a key social determinant of health. The recognition and application of this right varies within different regions and policy contexts but is currently unknown for First Nations Australians' engagement in alcohol policy development. This study seeks to: explore First Nations Australians' experiences of alcohol policy in Central Australia (Northern Territory); and identify how First Nations Australians' right to self-determination can be recognised and applied in the development of alcohol policy in Mbantua/Alice Springs. Using a blended yarning and appreciative inquiry approach, 24 interviews were conducted. Interviews were thematically coded in multiple stages, using diagrammatic methods. Four key themes emerged: (i) experiences of purchasing alcohol; (ii)communication of the current alcohol policy; (iii) experiences of policy described by participants (and their community); and (iv) self-determination in alcohol policy. Current pathways for contributing to alcohol policy have been ineffective in achieving meaningful engagement with Australia's First Nations community members. This study provides some guidance as to how self-determination can more effectively be incorporated in the development of alcohol policy in the NT.

First Nations Australians’ experiences of current alcohol policy in Central Australia: evidence of self-determination?

Alcohol is the leading cause of healthy years lost. There is significant variation in alcohol consumption patterns and harms in Australia, with those residing in the Northern Territory (NT), particularly First Nations Australians, experiencing higher alcohol-attributable harms than other Australians. Community leadership in the planning and implementation of health, including alcohol, policy is important to health outcomes for First Nations Australians. Self-determination, a cornerstone of the structural and social determinants of health, is necessary in the development of alcohol-related policy. However, there is a paucity of published literature regarding Indigenous Peoples self-determination in alcohol policy development. This study aims to identify the extent to which First Nations Australians experience self-determination in relation to current alcohol policy in Alice Springs/Mbantua (Northern Territory, Australia).Semi-structured qualitative yarns with First Nations Australian community members (n = 21) were undertaken. A framework of elements needed for self-determination in health and alcohol policy were applied to interview transcripts to assess the degree of self-determination in current alcohol policy in Alice Springs/Mbantua. Of the 36 elements, 33% were not mentioned in the interviews at all, 20% were mentioned as being present, and 75% were absent. This analysis identified issues of policy implementation, need for First Nations Australian leadership, and representation.Alcohol policy for First Nations Australians in the NT is nuanced and complicated. A conscious approach is needed to recognise and implement the right to self-determination, which must be led and defined by First Nations Australians.First Nations Australians’ experiences of current alcohol policy in Central Australia: evidence of self-determination?

Perceived barriers in the dissemination of an organisational alcohol policy as part of implementing an alcohol prevention programme among managers

PurposeAn alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation because of the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers.Design/methodology/approachA cross-sectional survey (n = 193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n = 18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers.FindingsSixty-five per cent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace’s approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers.Practical implicationsA thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention.Originality/valueThis study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.

Citizens’ juries and their role in improved alcohol policy: damp squib, or useful tool?

Background Increasing public participation has the potential to inform better alcohol policy. One method for increasing participation is the citizens’ jury – a strategy that has been both touted as a panacea for issues of democratic representation and dismissed as ineffective in impacting policy. Seeking to look past both hype and cynicism, we reflect on two Australian juries with an aim to identify both the potentials and pitfalls of the use of citizens’ juries in alcohol policy. Methods Using public documentation, we analyse two alcohol-related citizens’ jury processes – one in Adelaide, SA, and one in Sydney, NSW – with respect to their implications for alcohol policy development. We reflect on matters of participation, deliberation, authority, remit, and impact of recommendations. Findings The case studies indicate the importance of clear aims; whether these are instrumental and focussed on developing specific alcohol policy recommendations or focussed on broader epistemic democratic effects. Jury composition, the notion of vested interests, and the extent of juries’ authorising power are key considerations for juries deliberating on alcohol policy. Conclusions Due to the nature of policy-making, no single strategy can be a democratic panacea. However, we find that carefully considered and situationally aware elements of citizens’ juries may be useful in alcohol policy development.

First Nations Australians\u2019 self-determination in health and alcohol policy development: a Delphi study

BackgroundRecognition of the role of structural, cultural, political and social determinants of health is increasing. A key principle of each of these is self-determination, and according to the United Nations (2007), this is a right of Indigenous Peoples. For First Nations Australians, opportunities to exercise this right appear to be limited. This paper explores First Nations Australian communities’ responses to reducing alcohol-related harms and improving the health and well-being of their communities, with a focus on understanding perceptions and experiences of their self-determination. It is noted that while including First Nations Australians in policies is not in and of itself self-determination, recognition of this right in the processes of developing health and alcohol policies is a critical element. This study aims to identify expert opinion on what is needed for First Nations Australians’ self-determination in the development of health- and alcohol-related policy.MethodsThis study used the Delphi technique to translate an expert panel’s opinions into group consensus. Perspectives were sought from First Nations Australians (n = 9) and non-Indigenous Peoples (n = 11) with experience in developing, evaluating and/or advocating for alcohol interventions led by First Nations Australians. Using a web-based survey, this study employed three survey rounds to identify and then gain consensus regarding the elements required for First Nations Australians’ self-determination in policy development.ResultsTwenty panellists (n = 9 First Nations Australian) participated in at least one of the three surveys. Following the qualitative round 1 survey, six main themes, 60 subthemes and six examples of policy were identified for ranking in round 2. In round 2, consensus was reached with 67% of elements (n = 40/60). Elements that did not reach consensus were repeated in round 3, with additional elements (n = 5). Overall, consensus was reached on two thirds of elements (66%, n = 43/65).ConclusionsSelf-determination is complex, with different meaning in each context. Despite some evidence of self-determination, systemic change in many areas is needed, including in government. This study has identified a starting point, with the identification of elements and structural changes necessary to facilitate First Nations Australian community-led policy development approaches, which are vital to ensuring self-determination.

Management of Conflicts of Interest in WHO's Consultative Processes on Global Alcohol Policy.

The World Health Organization (WHO) has engaged in consultations with the alcohol industry in global alcohol policy development, including currently a draft action plan to strengthen implementation of the Global strategy to reduce the harmful use of alcohol. WHO's Framework for Engagement with Non-State Actors (FENSA) is an organization-wide policy that aims to manage potential conflicts of interest in WHO's interactions with private sector entities, non-governmental institutions, philanthropic foundations and academic institutions. We analysed the alignment of WHO's consultative processes with non-state actors on "the way forward" for alcohol policy and a global alcohol action plan with FENSA. We referred to publicly accessible WHO documents, including the Alcohol, Drugs and Addictive Behaviours Unit website, records of relevant meetings, and other documents relevant to FENSA. We documented submissions to two web-based consultations held in 2019 and 2020 by type of organization and links to the alcohol industry. WHO's processes to conduct due diligence, risk assessment and risk management as required by FENSA appeared to be inadequate. Limited information was published on non-state actors, primarily the alcohol industry, that participated in the consultations, including their potential conflicts of interest. No minutes were published for WHO's virtual meeting with the alcohol industry, suggesting a lack of transparency. Organizations with known links to the tobacco industry participated in both web-based consultations, despite FENSA's principle of non-engagement with tobacco industry actors. WHO's consultative processes have not been adequate to address conflicts of interest in relation to the alcohol industry, violating the principles of FENSA. Member states must ensure that WHO has the resources to implement and is held accountable for appropriate and consistent safeguards against industry interference in the development of global alcohol policy.

A long-brewing crisis: The historical antecedents of major alcohol policy change in Ireland.

The Public Health (Alcohol) Act 2018 in Ireland has been hailed as a world-leading package of alcohol policy reforms. Existing studies have identified the events that led to alcohol emerging onto the high-level policy agenda in Ireland, particularly after 2009. Using policy feedback theory, this study specifically investigates the political consequences of accumulating alcohol-related health and social harms for processes of policy change prior to 2009. The study traces the development of alcohol policy in Ireland over the past three decades. It draws on primary documents, secondary literature and interviews with public health advocates, medical doctors, public health experts and key decision-makers. The study documents a decades-long struggle to have alcohol recognised as a public health issue in Ireland. We identify 2008/2009 as the key turning point, where policy conditions decisively shifted in a public health direction. We show how insufficient institutional authority and the accumulation of the effects of earlier policy failures helped foster this dynamic. These two factors elevated the visibility of alcohol-related harm for key stakeholders, helping spur greater demand for major policy change. Not acting on the population health harms caused by alcohol can produce significant societal costs, particularly when consumption is rising, and entail subsequent political consequences. Understanding of innovations in alcohol policy decision making requires an appreciation of the historical context, including earlier policy failures.

Identifying how the principles of self-determination could be applied to create effective alcohol policy for First Nations Australians: Synthesising the lessons from the development of general public policy

Harmful alcohol consumption contributes to poorer health for all people. For Indigenous Peoples of Australia, Canada, and New Zealand alcohol impacts their wellbeing significantly, this is partially explained by both their experiences of colonisation and the resulting impact on structural and social determinants of health. Indigenous Peoples have a recognised right to self-determination, which includes their right to contribute to policy decisions that affect them. This right is based on international recognition and principles, and acknowledgement of historical culture and law. The aim of this narrative review is to examine the processes of inclusion of Indigenous Peoples in policy development processes for evidence of self-determination to inform alcohol policy development. Ninety-eight peer-reviewed journal articles were identified through four databases. Twenty papers describing the inclusion of Indigenous Peoples in policy development processes were included; one focusing on alcohol. Two authors reviewed and coded the papers by four domains of Indigenous inclusion in policy processes: Indigenous representation; method of inclusion; reasons for inclusion; and stage of inclusion. There is no single model for the integration of self-determination into policy. However, the nature of participation is key in ensuring that Indigenous Peoples' self-determination is recognised. While all the papers reported Indigenous Peoples being included in processes, there was little evidence of self-determination. Self-determination is a right, and critical to effective policy and action. The inclusion of Indigenous Peoples in policy development alone is not self-determination; however, creating the conditions that ensures Indigenous Peoples have influence throughout policy processes is one integral component of self-determination.

The combined impact of higher-risk on-license venue outlet density and trading hours on serious assaults in night-time entertainment precincts

BackgroundNight-time entertainment precincts (NEPs) are clusters of higher-risk on-licence venues, that pose a significant burden on health and social order services. Outlet density and trading hours are two of the most well researched contributors to alcohol availability within NEPs; increases in outlet density and late-night trading hours within NEPs have been independently associated with increased assaults. This is the first study to examine both factors across cities to predict alcohol-related assaults. MethodsLicensing data were used to investigate the effect of outlet density and trading hours on police recorded serious assaults in nine NEPs (9 cross-sectional units) across Queensland from January 2010 to July 2018 at monthly intervals (102 longitudinal units). Multi-level models were used to determine i) whether precinct-level trading hours moderated the relationship between outlet density and serious assaults; and ii) the impact of outlets closing before 12am, 3am, and 5am on serious assaults. FindingsThe positive relationship between outlet density and assaults was stronger in precincts with trading hours ending at 5am compared to 3am (IRR = 1.01, p = 0.03). The amount of venues closing before 12am was associated with reduced numbers of assaults (IRR = 0.97, p = 0.04), while venues closing between 12:01am-3am and 3:01am-5am were associated with increased assaults (IRR = 1.02, p<0.01; IRR = 1.01, p = 0.02). ConclusionsLate night service of alcohol creates more harm in areas of high outlet density, whereas early closing venues in areas where outlet density is low is associated with reduced number of assaults. This relationship should be taken into account in the development of future alcohol policies.

"Undisciplined" drinking, multi-sectoralism and political power: Examining problematisations in the Botswana alcohol policy.

The Botswana government has recently ramped up efforts to control alcohol consumption through various measures. These include the alcohol tax levy, reduction in trading hours for bars and other licenced premises and increased penalties for alcohol-related road offenses. Whilst these efforts have recently received considerable attention, the processes of alcohol policy development remain unknown and understudied. In this paper, I examine the alcohol policy processes in Botswana using What's the Problem Represented to be (WPR), a poststructural analytic approach that emphasises problematisations in policies. Drawing on alcohol-associated policy documents, I identify two key problematisations that relate to, (1) an emphasis on an "undisciplined" drinker, and (2) an appeal to an internationally-endorsed multi-sectoralism. I explore these problematisations as political formations and periodise them to the year 2008 when they were canonised. I argue that "undisciplined drinking" and an internationally-endorsed multi-sectoralism neglect the social and cultural contexts of drinking, pathologise drinking and do not consider other forms of knowledge. Unmaking current alcohol policy representations is needed to allow for the 'emergence' of alternative conceptualisations of the alcohol 'problem' in Botswana.

Coordination, framing and innovation: the political sophistication of public health advocates in Ireland.

Background and AimsThis study explores the role of the public health advocacy coalition in alcohol policy development in Ireland. Compared with industry actors, much less is known about the membership, activities and influence of public health advocates in alcohol policymaking. To address this gap, this paper identifies several advocacy strategies, drawn from the advocacy coalition framework and other policy theories, and then analyses them in the context of recent Irish developments.MethodsThe study used theory‐building process‐tracing to construct a record of the public health advocacy coalition and its campaign to promote the Public Health (Alcohol) Act 2018 in Ireland. Specifically, we drew upon 131 primary documents produced by advocates, 464 newspaper articles and 18 semi‐structured interviews with key advocates, public health experts and elected officials to undertake a thematic analysis.ResultsPublic health advocates in Ireland have developed sophisticated political strategies to foster major alcohol policy change. First, public health advocates led the formation of a broad‐based advocacy coalition that helped members to effectively pool their limited resources as well as coordinate their strategy and messaging. Secondly, issue‐framing and message discipline played a key role in the coalition's success. Advocates strategically focused upon the policy problem, specifically health harms, rather than the detailed content of the proposed measures. Finally, there is evidence of political learning, where advocates’ prior experiences and knowledge of the political system in Ireland spurred innovations in campaigning. These strategies were interdependent and mutually reinforcing, and succeeded in building support for public health advocates’ preferred policies among politicians and the general public.Discussion/conclusionThere are distinct capabilities that public health actors can mobilize in the policy process to win alcohol policy debates and capitalize on the constraints on industry influence on alcohol policymaking.

Obscuring Gendered Difference: The Treatment of Violence in Australian Government Alcohol Policy

Abstract Despite public debate about alcohol and public violence among young people in Australia, the issue of masculinities or gender is rarely visible in alcohol policy. Instead, policy recommendations aimed at reducing violence focus on changing the availability and consumption of alcohol. Drawing on concepts from feminist and science and technology studies scholarship, this article analyses how “alcohol-related violence” is constituted as a specific policy object, and how it coheres to obscure men’s contributions to and experiences of violence. Attention to the political effects of these policy practices is necessary for the development of more equitable alcohol policies.