In: Alcohol and alcoholism: the international journal of the Medical Council on Alcoholism (MCA) and the journal of the European Society for Biomedical Research on Alcoholism (ESBRA), Band 39, Heft 6, S. 471-476
In New Zealand as in other industrialised countries the pattern of recreational drug use reflects the pattern of availability, with use of the legal drugs alcohol and tobacco more widespread than that of illegal drugs. These two drugs have been the major focus of political activity during the past decade. In the case of tobacco, major public health advances have been achieved by means of legislative change. In contrast, changes in alcohol legislation have resulted in a liberalisation of alcohol availability, but the public health debate continues at the level of policy implementation. Relatively little public or political attention has been paid to illicit drug use during the past decade, but there are signs that this may change in the near future.
This article is concerned with two evaluations of community alcohol action programmes in New Zealand. The first programme was a demonstration programme using a quasi-experimental design to examine the effect of a media campaign and alcohol community organisers in provincial New Zealand cities for a two-year period in the early 1980s. The second was a project run in one city for three months in 1987, consisting of enforcement of drunk -driving laws and community coordination. This article sets out a summary of the programmes; distinguishes between evaluation of demonstration programmes versus other potentially less research-driven programmes; highlights the importance of an individual assessment of what evaluation is appropriate for any such programme; and stresses using a range of appropriate formative, process and outcome evaluation methods right across the lifecycle of a programme.
Community interest in controlling the sale and supply of alcohol and reducing alcohol-related problems has seen a number of responses in New Zealand and elsewhere. These have included the growth of popular temperance movements last century, sometimes accompanied by votes for national or local prohibition. In some regions in New Zealand the local population instituted community-owned licensing trusts to operate licensed premises upon restoring alcohol sales to their districts. Government reviews of licensing law have responded to public dissatisfaction with drinking conditions. A recent substantial review of the sale of liquor in the late 1980s revived public interest in the control of alcohol. Submissions from a public health perspective concentrated on restricting access. The final legislation, however, saw a liberalising of availability and deregulation of the licensing system. Nevertheless, emphasis is given to the control of alcohol-related problems, highlighted in the object of the act. The response of licensing and enforcement agencies to that objective will have important implications for the control of problems in the community.
Alcohol consumption and contextual data collected from a sample of 983 men and 894 women were analysed using multivariate statistical methods in an attempt to identify different types of drinkers. The sample was derived from three thousand face-to-face interviews randomly conducted in Auckland, the major metropolitan centre of New Zealand. The multivariate analysis was based on those who had consumed alcohol in the week preceding their interview. Factor analysis was used as a form of data reduction, while cluster analysis was used to assign individuals into groups characterised by particular aspects of their drinking practices that were different from average. The clusters were cross-tabulated by demographic and alcohol-related problem variables. Twelve male and ten female clusters were identified. The choice of target clusters for health promotion activities is discussed.
This article discusses the concepts of formative and process evaluation, and their application in the field of health promotion and disease prevention. Process evaluation fulfills the need for information on program implementation, which is important in interpreting program outcomes, and informing future efforts in similar areas. Formative evaluation aims to help develop and improve programs from an early stage, when opportunities for influence are likely to be greatest. Greater application of formative and process evaluation to such programs in thefuture has the potential to lead to better designed and more effective programs, and improved understanding of the factors influencing program outcomes.
Implementation of effective alcohol control policies is a global priority. However, at the global and national levels, implementing effective policies is still challenging, as it requires commitment from multiple stakeholders. This review provides a synthesis of barriers and facilitators to implementing effective alcohol control policies. We conducted a scoping review from two main databases: Scopus and Web of Science, and the grey literature from the World Health Organization's website. We included any studies investigating barriers and facilitators to implementing four effective policies: Alcohol pricing and taxation, control of physical availability, alcohol marketing control, and drink-driving policy. Articles published between 2000 and 2021 were included. The search yielded 11,651 articles, which were reduced to 21 after the assessment of eligibility criteria. We found five main barriers: resource constraint; legal loopholes; lack of evidence to support policy implementation, particularly local evidence; low priority of policy implementation among responsible agencies; and insufficient skills of implementers. Facilitators, which were scarce, included establishing monitoring systems and local evidence to support policy implementation and early engagement of implementing agencies and communities. We recommend that national governments pay more attention to potential barriers and facilitators while designing alcohol control regulations and implementing effective policies.
Alcohol use has been identified in major United Nations (UN) initiatives, such as the Sustainable Development Goals and the Non-Communicable Disease Action Plan, as a major contributor to the global burden of disease. As a result, levels of alcohol use serve as an official indicator of progress towards these UN-set goals. Given current trends, UN targets for reduced alcohol consumption are unlikely to be met. Moreover, in many countries, especially in low- and middle-income countries, the alcohol-attributable burden of disease continues to increase. Pressure will need to be exerted on national and international decision-makers to arrive at more powerful and normatively persuasive instruments, such as a treaty.
Zusammenfassung: Hintergrund und Ziele: Dieser Artikel fasst die Ergebnisse und Schlussfolgerungen der dritten Ausgabe des Buches "Alkohol: Kein gewöhnliches Konsumgut" zusammen. Mit der jüngsten Überarbeitung dieses Buches werden die wissenschaftlichen Erkenntnisse über gesundheitspolitische Maßnahmen bei Alkoholkonsum aus der Sicht der Bevölkerungsgesundheit (Public Health) kritisch bewertet. Aufbau: Zusammenfassung des Buchinhalts nach fünf Hauptthemen. Ergebnisse: Eine Vielzahl epidemiologischer Studien zeigt, dass Alkoholkonsum in Ländern mit hohem, mittlerem und niedrigem Einkommen einen erheblichen Beitrag zur weltweiten Belastung durch Krankheit, Behinderung und Tod leistet. Aktuelle Trends von Alkoholprodukten und -vermarktung lassen erkennen, dass sich ein großer Teil der globalen Industrie zu einer kleinen Anzahl von transnationalen Konzernen fusioniert hat und diese Konzerne ihre Aktivitäten vor allem nach Asien, Afrika und Lateinamerika ausweiten. Der Hauptteil dieses Buches ist einem Überblick über strukturelle Maßnahmen und zumeist überindividuelle Strategien gewidmet, die alkoholbedingte Schäden verhindern oder minimieren sollen. Die wirksamsten Strategien zum Schutz der Bevölkerungsgesundheit sind – kurz gefasst – eine Besteuerung, die die Finanzierbarkeit des Konsums verringert, und Beschränkungen der physischen Verfügbarkeit von Alkohol. Ein vollständiges Verbot der Vermarktung von Alkohol ist ebenfalls eine wirksame Strategie zur Verringerung des Konsums. Darüber hinaus sind Maßnahmen zur Bekämpfung des Alkoholkonsums im Straßenverkehr, Kurzinterventionen bei Risikokonsument_innen und die Behandlung von Personen mit Alkoholabhängigkeit wirksam, um Schäden in Hochrisikosituationen und in Gruppen mit einem riskanten Trinkverhalten zu verhindern bzw. zu minimieren. Schlussfolgerungen: Alkoholpolitische Maßnahmen sind das Ergebnis konkurrierender Interessen, Werte und Ideologien unterschiedlicher Akteure. Die Zusammenarbeit mit der Alkoholindustrie zeitigt aufgrund des Interessenskonflikts zwischen Profit und Gesundheit meistens ineffektive politische Maßnahmen. Mit dem zunehmenden Wissen darüber, welche Strategien dem Gemeinwohl am besten dienen, sind die vielfältigen Umsetzungsmöglichkeiten einer evidenzbasierten Alkoholpolitik klarer als je zuvor.