Addressing NCDs: Penetration of the Producers of Hazardous Products into Global Health Environment Requires a Strong Response; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”

Timely warnings and examples of industry interference in relation to tobacco, alcohol, food and breast milk substitutes are given in the editorial by Tangcharoensathien et al. Such interference is rife at national levels and also at the global level. In an era of ‘private public partnerships’ the alcohol and food industries have succeeded in insinuating themselves into the global health environment and their influence is seen in key recommendations regarding non-communicable disease (NCD) risk factors in United Nations (UN) reports. The absence of legally binding health treaties in these areas facilitates this industry engagement and the Framework Convention on Tobacco Control provides a valuable model to apply to control of other hazardous products

International alcohol control study : analyses from the first wave

The article provides background to the international alcohol control (IAC) study including design for policy evaluation, methodology, countries involved, and study objectives. The IAC study has provided a research platform for diverse countries to collect alcohol consumption and policy-relevant data in comparable ways. This special journal issue presents the first cross country analyses from 10 countries of the IAC. Results from the Alcohol Environment Protocol describe differences in legislative and regulatory frameworks, socio-economic and policy-relevant behaviours, and key informants’ perceptions of alcohol policy implementation and enforcement. Taxation systems and prices paid for alcohol by survey respondents from six countries were analysed

Characteristics of amphetamine-type stimulant (ATS) use in New Zealand : informing policy responses

New Zealand has recently experienced dramatic increases in seizures of amphetamine-type stimulant (ATS) drugs and detections of clandestine amphetamine laboratories. Secondary analysis of ATS drug use in New Zealand from the 2001 National Drug Survey highlighted the greater harms associated with frequent ATS use and identified potential risks associated with increased use of ATS, such as the spread of intravenous drug use and the increased demand for other “hard” drug types. Crystal methamphetamine users emerged as the ATS-using group with the highest levels of daily use, poly-drug use, intravenous drug use and opioid use. The findings suggest New Zealand drug treatment and law enforcement resources will be more effective when applied to frequent ATS and crystal methamphetamine users. The work also underlined the rationale for an indicator drug survey that can track changes in drug-use patterns, including levels of intravenous administration, within a time frame that allows effective agency responses before drug problems become entrenched. The Office of the Commissioner of New Zealand Police has already made progress in this direction

Final technical report : The International Alcohol Control (IAC) Study - Working Meeting, Torino, Italy, 7th and 8th June 2014

This is part of a funding proposal report. Funding received was used to support costs associated with the preparation, facilitation and hosting of the IAC study meeting in Torino, Italy. In addition the financial support enabled three low and middle income (LMIC) researchers and one member of the New Zealand IAC study team to attend the working meeting. IAC survey data was shared from participating countries; cross-country analyses were discussed and planned; and methodological issues encountered by the different research teams were discussed

Alcohol taxes’ contribution to prices in high and middle-income countries : data from the International Alcohol Control Study

The paper draws on data from six participating countries of the International Alcohol Control Study to examine and evaluate their comparative prices and tax regimes. Both ad valorem and specific per unit of alcohol taxation systems are represented among the six countries. The prices differ widely between countries even though presented in terms of Purchasing Power Parity. The percentage of tax in the final price also varies widely but is much lower than the 75% goal set by the World Health Organization. There is a higher proportion of abstainers in middle-income countries and men drink much more alcohol than women

The Alcohol Environment Protocol: A new tool for alcohol policy

Introduction and Aim  To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country.  Method  This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross-country comparison and change over time.  Results  All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High-income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high- and middle-income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink-driving legislation was in place, it was less well enforced in middle-income countries.  Conclusion  In countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol-related harm

Alcohol environment protocol : a new tool for alcohol policy

Findings of the study show that in countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for increases in consumption as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol-related harm. This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies, and interviews with key informants to allow for cross-country comparison and change over time

Effective alcohol policies and lifetime abstinence An analysis of the International Alcohol Control policy index

Introduction Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alcohol policies and has shown strong associations with alcohol per capita consumption and drinking patterns. Uniquely, the index incorporates both policy ‘stringency’ and ‘impact’, reflecting policy implementation and enforcement, across effective policies. Here we assessed the association of the IAC policy index with lifetime abstinence in a diverse sample of jurisdictions. Methods We conducted a cross-sectional analysis of the relationship between the IAC policy index score, and its components, and lifetime abstinence among adults (15+ years) in 13 high and middle-income jurisdictions. We examined the correlations for each component of the index and stringency and impact separately. Results Overall, the total IAC policy index scores were positively correlated with lifetime abstinence (r = 0.76), as were both the stringency (r = 0.62) and impact (r = 0.82) scores. Marketing restrictions showed higher correlations with lifetime abstinence than other policy domains (r = 0.80), including restrictions on physical availability, pricing policies and drink-driving prevention. Discussion and Conclusion Our findings suggest that restricting alcohol marketing could be an important policy for the protection of alcohol abstention. The IAC policy index may be a useful tool to benchmark the performance of alcohol policy in supporting alcohol abstention in high and middle-income countries.Output Status: Forthcoming/Available Onlin

Effective alcohol policies and lifetime abstinence An analysis of the International Alcohol Control policy index

Introduction Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alcohol policies and has shown strong associations with alcohol per capita consumption and drinking patterns. Uniquely, the index incorporates both policy ‘stringency’ and ‘impact’, reflecting policy implementation and enforcement, across effective policies. Here we assessed the association of the IAC policy index with lifetime abstinence in a diverse sample of jurisdictions. Methods We conducted a cross-sectional analysis of the relationship between the IAC policy index score, and its components, and lifetime abstinence among adults (15+ years) in 13 high and middle-income jurisdictions. We examined the correlations for each component of the index and stringency and impact separately. Results Overall, the total IAC policy index scores were positively correlated with lifetime abstinence (r = 0.76), as were both the stringency (r = 0.62) and impact (r = 0.82) scores. Marketing restrictions showed higher correlations with lifetime abstinence than other policy domains (r = 0.80), including restrictions on physical availability, pricing policies and drink-driving prevention. Discussion and Conclusion Our findings suggest that restricting alcohol marketing could be an important policy for the protection of alcohol abstention. The IAC policy index may be a useful tool to benchmark the performance of alcohol policy in supporting alcohol abstention in high and middle-income countries.Output Status: Forthcoming/Available Onlin