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Tackling Harmful Alcohol Use

Economics and Public Health Policy

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Alcoholic beverages, and their harmful use, have been familiar fixtures in human societies since the beginning of recorded history. Worldwide, alcohol is a leading cause of ill health and premature mortality. It accounts for 1 in 17 deaths, and for a significant proportion of disabilities, especially in men. In OECD countries, alcohol consumption is about twice the world average. Its social costs are estimated in excess of 1% of GDP in high- and middle-income countries. When it is not the result of addiction, alcohol use is an individual choice, driven by social norms, with strong cultural connotations. This is reflected in unique patterns of social disparity in drinking, showing the well-to-do in some cases more prone to hazardous use of alcohol, and a polarisation of problem-drinking at the two ends of the social spectrum. Certain patterns of drinking have social impacts, which provide a strong economic rationale for governments to influence the use of alcohol through policies aimed at curbing harms, including those occurring to people other than drinkers. Some policy approaches are more effective and efficient than others, depending on their ability to trigger changes in social norms, and on how well they can target the groups that are most at risk. This book provides a detailed examination of trends and social disparities in alcohol consumption. It offers a wide-ranging assessment of the health, social and economic impacts of key policy options for tackling alcohol-related harms in three OECD countries (Canada, the Czech Republic and Germany), extracting relevant policy messages for a broader set of countries.

 

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Tackling alcohol-related harms: What policy approaches?

The target of policies aimed at addressing alcohol-related harms has been the subject of controversy in the policy debate. A traditional public health view holds that policy approaches addressing the entire spectrum of a risk factor, including those who are at low or no risk, are superior to approaches targeting only those at high risk. However, evidence of improved health outcomes in some moderate drinkers, means that potential health benefits might be forgone if policies were to affect consumption by those drinkers. This is a complex policy question involving political judgements that only individual governments can make. Governments have adopted a broad range of policy approaches to curb alcohol-related harms. These include information and education policies, as well as regulatory and fiscal options, traffic enforcement measures and interventions within the health care sector (particularly, in primary health care and mental health care). Especially in recent years, many attempts have been made to develop and test innovative policy approaches, such as minimum prices, education approaches, new measures to prevent traffic fatalities, but also to sharpen existing approaches and make them more effective in curbing heavy drinking. Business stakeholders have stepped up their corporate social responsibility efforts and a number of governments have established a dialogue with them. Multi-stakeholder initiatives have included attempts to reduce the quantity of alcohol on the market by providing incentives for consumers to demand lower-alcohol products.

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