Absence of Effective Policies

In many mature market countries, there are national alcohol policies and laws in place; for example, in regard to the sale of alcohol, driving while intoxicated, and alcohol taxation (which serves a public health goal as well as raising revenue). Shortcomings are often in the operational detail of such policies and laws, including whether the laws and licensing systems are being suffi­ciently well enforced, and whether sufficient resources are being put behind the most cost-effective policies.

Perhaps the weakest area of regulation is that concerned with alcohol advertising and other forms of marketing. In most mature markets, alcohol is heavily advertised. Many countries use a mix of partial restrictions on exposure to alcohol advertisements - in certain media or at certain times - and systems of industry self-regulation in regard to the content of alcohol advertisements.

There is little research or policy on other forms of marketing. For exam­ple, there are few studies of integrated marketing of the global alcohol brands that sponsor international sports events and reach loyal and potential drinkers across a range of mature and emerging markets.

Alcohol control often relies too heavily on classroom- based education of young people that seeks to reduce alcohol-related harm. Systematic reviews have consis­tently shown little or no evidence of effectiveness in terms of either medium- or longer-term behavior change or harm outcomes (Babor et al, 2003; Foxcroft, 2006).

However, in part because this approach has face validity and in part because it provides no challenge to vested interests and is actively promoted by industry-funded commentators (International Center for Alcohol Policies, 2004), educational interventions of this kind have been popular. Similarly, there is a focus on public information campaigns and social marketing approaches in some juris­dictions, where, once again, the evidence of effectiveness in reducing alcohol-related harm is lacking.

In emerging markets for alcohol, there is often very little in the way of alcohol policy and regulation, or very little enforcement of such laws as have been passed. Typ­ically, there are very few data on alcohol-related harm on which to base advocacy for government interventions, particularly for restrictive measures to protect public health that may appear contrary to trade principles.

The need for assistance with research and data collection, and to share information and technical expertise between countries with regional similarities, has been recognized by the World Health Organization. As in mature markets, there is a danger of over-reliance on less effective strate­gies, with active promotion of educational approaches despite the lack of a supportive policy environment.

Taxation, including tariffs on imported alcohol pro­ducts, is often a key policy and a source of government revenue, particularly in countries in which incomes and perhaps economic activity levels are low. For a number of countries, informal illegally produced alcohol or cross­border smuggling may reduce government revenue, and revenue would be increased if governments were able to reduce these nontaxed sources of alcohol.

Greater control over alcohol production and distribution would also allow them to increase tax (and therefore price to the consumer). Many emerging markets do not regulate or license the sale of alcohol by bars or stores; alcohol may be sold anywhere. A minimum age at which young people may be sold alcohol may exist in law but often goes unenforced.

It is in this context, that the World Health Organiza­tion has been commissioning research and presen­ting recommendations on effective policies to reduce alcohol-related harm.